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Sample records for chirurgie bariatrique prescriptions

  1. Chirurgie in die Grieks-Romeinse era

    Directory of Open Access Journals (Sweden)

    François P. Retief

    2006-09-01

    Full Text Available In die Grieks-Romeinse era het mediese behandeling kenmerkend uit drie elemente bestaan, naamlik regimen (dieet en gesonde leefwyse, geneesmiddels en chirurgie – laasgenoemde alleen toegepas indien regimen en geneesmiddels onsuksesvol was. Bewyse van primitiewe chirurgie dateer terug na die Bronstydperk, en in Homerus se eposse is heelwat vermelding van die chirurgiese hantering van oorlogswonde, met tussenkoms van die gode. Met die koms van empiriese geneeskunde in die 5de eeu v.C. het chirurgie in die Hippokratiese Corpus prominent gefigureer met beduidende bydraes in veral die ortopediese veld en hoofbeserings. Uitbouing van anatomiese en fisiologiese kennis, gebaseer op disseksie van menslike kadawers in Alexandrië vanaf die laat 4de eeu v.C., het chirurgie ’n hupstoot gegee. Teen die Romeinse era vanaf die 2de eeu v.C. het snykundetegnieke (en -instrumente beduidend verbeter, maar is steeds oorwegend deur Griekse geneeshere beoefen. Van geneeshere is steeds verwag om al drie bovermelde terapeutiese modaliteite te bemeester, maar chirurgie het meer aansien verwerf en daar is al meer in onderafdelings van chirurgie soos oogheelkunde, vrouesiektes en verloskunde, blaaskwale en mond- en keelsnykunde gespesialiseer. Militêre geneeskunde was in die Romeinse Ryk ’n belangrike aktiwiteit, en het veral traumachirurgie uitgebou. Betreding van die buik- en toraksholtes was nie meer noodwendig fataal nie, en veeartsenykunde het tot stand gekom. Die eerste beduidende chirurgiehandboek ná die Hippokratiese Corpus is in die 1ste eeu n.C. deur Celsus opgestel. Vanaf die 3de eeu het die chirurgieberoep min vordering gemaak, die beroepstaal het mettertyd van Grieks na Latyn verander en kundigheid is later veral deur Islam-geneeshere na die Middeleeue en later oorgedra.

  2. Kystes hydatiques de la rate: chirurgie radicale ou conservatrice?

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    Abdelmalek Ousadden

    2010-06-01

    Full Text Available INTRODUCTION: Concernant l’hydatidose, la localisation splénique vient en 3ème position après le foie et les poumons. En l’absence de traitement médical réellement efficace, l’hydatidose splénique amène souvent à la chirurgie. L’apparition du traitement percutané et la tendance actuellement conservatrice de la chirurgie surtout pour une pathologie bénigne, remettent en cause la splénectomie radicale. METHODES: Notre travail rétrospectif, a porté sur 23 cas d’hydatidose splénique isolés ou multi-viscérale. Le diagnostic reposait principalement sur le couple échographie abdominale et sérologie hydatique. Ces patients ont bénéficié dans leur majorité d’une splénectomie ou d’une résection du dôme saillant du kyste. RESULTATS: La morbidité postopératoire a été plus importante en cas de résection du dôme saillant (une hémorragie d’origine splénique, 3 abcès sur cavité résiduelle et 2 récidives. La mortalité a été nulle. Nous proposons une classification qui permet de stratifier les indications opératoires en fonction du type de kyste hydatique de la rate. CONCLUSION: Le choix entre chirurgie radicale ou conservatrice reste difficile vu les contraintes de chacune, les complications postopératoires respectives et la diversité des situations cliniques. Notre classification facilite ce choix.

  3. [Thoughts on the Revue de Chirurgie Plastique (1931-34) and the Revue de Chirurgie Structive (1935-38)].

    Science.gov (United States)

    Vrebos, J

    2007-08-01

    The history of modern plastic surgery starts when a young, restless ENT man, Dr M. Coelst, started a training in Plastic Surgery with Sebileau in Paris and Joseph in Berlin. This man of vision and far-sighted imagination realized that the separated efforts and publications of so many pioneers, scaterred all over the world, would be lost if not gathered in a scientific journal only devoted to plastic surgery for the benefit of all. This brought him to the idea of establishing, in 1931, at his own initiative, the first international Journal of Plastic Surgery ever published, the Revue de Chirurgie Plastique, fifteen years before the USA Journal Plastic and Reconstructive Surgery and sixteen years before the British Journal of Plastic Surgery. The name of the journal was changed in 1935 to the Revue de Chirurgie Structive. Coelst' Revue was promptly accepted as the leading Journal of Plastic Surgery and all the internationally known plastic Surgeons contributed to it by scientific papers of great value, even today.

  4. U.S. plastic surgeons who contributed to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive (1931-1938): "Giants" in our specialty.

    Science.gov (United States)

    Rogers, B O

    1999-01-01

    The Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938), edited by Maurice Coelst, M.D. from Brussels, were the first, full-fledged medical publications specifically devoted to plastic, reconstructive, and aesthetic surgery. Publishing original articles by J.W. Maliniac, J. Eastman Sheehan, and brief summaries of papers read at plastic surgery societies by C.R. Straatsma, L.A. Peer, G. Aufricht, and other well-known American plastic surgeons, these Revues drew attention to surgeons, most of whom were responsible for organizing the American Society of Plastic and Reconstructive Surgeons in 1931, the same year in which the Revue de Chirurgie Plastique first appeared.

  5. Scientific contributions of U.S. plastic surgeons to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938).

    Science.gov (United States)

    Vrebos, J

    1999-01-01

    The author emphasizes the close cooperation between U.S. plastic surgeons and the first international journal entirely devoted to plastic surgery, the Revue de Chirurgie Plastique (1931-1934) later to become the Revue de Chirurgie Structive (1935-1938) published under the editorship of Maurice Coelst, M.D. from Brussels. By the accurate recording of original articles, book reviews, proceedings of their annual meetings and summaries in three different languages (English, French, German), the author stresses the intense scientific dynamism and the achievements made by the U.S. pioneers of this new speciality, which really started during World War I.

  6. British plastic surgeons who contributed to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive (1931-1938): "the Big Four" in their Speciality.

    Science.gov (United States)

    Rogers, B O

    2001-01-01

    The Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938), edited by Maurice Coelst, M.D. from Brussels, were the first, full-fledged medical publications devoted specifically to plastic, reconstructive, and aesthetic surgery. Publishing original articles by H.D. Gillies, P.T. Kilner, A.H. McIndoe, and R. Mowlem--the "Big Four" as they were known to both English and American plastic surgeons--the Revues drew attention to these four surgeons who were mainly responsible for developing the prestige of English plastic surgery in the early 1930s.

  7. Surgery of malignant pancreatic tumors; Chirurgie maligner Pankreastumoren

    Energy Technology Data Exchange (ETDEWEB)

    Loos, M.; Friess, H.; Kleeff, J. [Klinikum rechts der Isar, Technische Universitaet Muenchen (Germany). Chirurgische Klinik und Poliklinik

    2009-02-15

    Ductal adenocarcinoma is the most common malignant tumor of the pancreas. Despite great efforts in basic and clinical pancreatic cancer research, the prognosis remains poor with an overall 5-year survival rate of less than 5%. Complete surgical resection represents the only curative treatment option and 5-year survival rates of 20-25% can be achieved following curative resection and adjuvant chemotherapy. Although pancreatic surgery is considered one of the most technically demanding and challenging procedures, there has been constant progress in surgical techniques and advances in perioperative care with a modern interdisciplinary approach including anesthesiology, oncology, radiology and nursing. This has reduced morbidity and especially mortality rates in high-volume centers. Among extended resection procedures multivisceral and venous resections are technically feasible and should be considered if a complete tumor resection can be achieved. Multimodal regimens have shown promising results, however, only adjuvant chemotherapy is supported by solid evidence from randomized controlled trials. (orig.) [German] Das duktale Adenokarzinom ist der haeufigste maligne Pankreastumor. Trotz intensiver Anstrengungen auf dem Gebiet der Pankreasforschung konnte die Gesamtprognose in den vergangenen Jahren nicht entscheidend verbessert werden. Die einzige potenziell kurative Therapie ist die chirurgische Resektion. In Kombination mit einer adjuvanten Chemotherapie liegen die 5-Jahres-Ueberlebensraten aktuell bei 20-25%. Dank kontinuierlicher Weiterentwicklung der chirurgischen Operationstechnik und Verbesserungen der perioperativen Versorgung der Patienten mit einer engen interdisziplinaeren Zusammenarbeit (Chirurgie, Anaesthesie, Onkologie, Radiologie und Pflege) konnten die perioperative Morbiditaets- und Mortalitaetsraten in den vergangenen Jahren deutlich gesenkt werden. Unter den erweiterten Resektionsverfahren sind Venen- oder multiviszerale Resektionen technisch sicher

  8. The scientific contributions of British Plastic Surgeons to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938).

    Science.gov (United States)

    Vrebos, J

    2001-01-01

    In 1931, Maurice Coelst, M.D. from Brussels started the publication of the first international journal of plastic surgery ever published: the Revue de Chirurgie Plastique (1931-1934), which eventually became the Revue de Chirurgie Structive (1935-1938). In 1936, he established the first European Society of Structive Surgery, which held its first congress in Brussels. Further congresses were held in London in 1937 and in Milan in 1938. It is the collaboration and the participation of British plastic surgeons in this Society, this journal, and these meetings that I want to stress, because I am firmly convinced that these documents fill a gap in the history of Plastic Surgery in Great Britain, since--as far as I know--no detailed information concerning this period was ever published in Plastic Surgery literature.

  9. Tarification de la chirurgie ambulatoire en France et à l’étranger : État des lieux et perspectives

    OpenAIRE

    Hirtzlin, Isabelle

    2013-01-01

    La chirurgie ambulatoire permet au patient de rejoindre son domicile le jour même de son intervention. Alors qu’elle s’est fortement développée dans de nombreux pays européens pour devenir très largement majoritaire, cette pratique ne représente en France qu’environ 40% du total des interventions chirurgicales.Pour favoriser le développement de cette activité, une tarification identique a été instaurée par les pouvoirs publics à partir de 2009 entre la chirurgie ambulatoire et la chirurgie co...

  10. Eine neuartige Roboterkinematik für die laparoskopische Single-Port Chirurgie

    OpenAIRE

    Sanagoo, Arash

    2015-01-01

    Minimal invasive Operationstechniken haben sich in den letzten Jahren sehr schnell weiterentwickelt. Unter anderem konnte sich die roboterassistierte Laparoskopie auf dem Markt etablieren. Solche Systeme können jedoch sehr eingeschränkt für die Single-Port Laparoskopie eingesetzt werden. Im Rahmen dieser Arbeit wurde basierend auf einer sphärischen Parallelkinematik ein kompakter Manipulator entwickelt. Dieser Manipulator wird in erster Linie für die laparoskopische Single-Port Chirurgie g...

  11. Prescriptive unitarity

    Science.gov (United States)

    Bourjaily, Jacob L.; Herrmann, Enrico; Trnka, Jaroslav

    2017-06-01

    We introduce a prescriptive approach to generalized unitarity, resulting in a strictly-diagonal basis of loop integrands with coefficients given by specifically-tailored residues in field theory. We illustrate the power of this strategy in the case of planar, maximally supersymmetric Yang-Mills theory (SYM), where we construct closed-form representations of all ( n-point N k MHV) scattering amplitudes through three loops. The prescriptive approach contrasts with the ordinary description of unitarity-based methods by avoiding any need for linear algebra to determine integrand coefficients. We describe this approach in general terms as it should have applications to many quantum field theories, including those without planarity, supersymmetry, or massless spectra defined in any number of dimensions.

  12. Prescription and

    Directory of Open Access Journals (Sweden)

    David Calderón-Guzmán

    2016-03-01

    Full Text Available Background: The knowledge about the pattern of prescription and consumption of solid oral drugs dispensed as unitary doses (UD in Mexico is sparing. Purpose: The aim of this study was to describe the pattern of prescription and consumption of solid oral drugs dispensed as unitary doses (UD in a third level private hospital of Mexico. A retrospective study of a 60-month period (from 2007 to 2011 was carried out to know the pattern of drugs dispensed as UD in a third level hospital. Results: Among the principal drugs consumed were analgesic, antihypertensive, antibiotic, anti-inflammatory, antiepileptic, and diuretics. The dispensation of drugs per year was as follows: 181 drugs with 85,167 UD in 2007; 199 with 90,519 UD in 2008; 193 with 101,479 UD in 2009; 195 with 100,798 UD in 2010; and 198 with 103,913 UD in 2011. Conclusion: The findings confirmed that prescription and consumption of unitary doses in the hospitalization service increased, and revealed the extensive use of analgesics as the principal prescribed drug in this kind of hospital.

  13. Opioid Basics: Prescription Opioids

    Science.gov (United States)

    ... Injury Violence Prevention WISQARS (Injury & Death Data) Prescription Opioids Recommend on Facebook Tweet Share Compartir Prescription opioids ... overdose before they start. Risk Factors for Prescription Opioid Abuse and Overdose Research shows that some risk ...

  14. Prescription Drug Abuse

    Science.gov (United States)

    ... over-the-counter medications. National Institute on Drug Abuse. http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter- ... 2015. Prescription drug abuse. National Institute on Drug Abuse. http://www.drugabuse.gov/publications/research-reports/prescription-drugs/ ...

  15. Contribution a l'étude des infections nosocomiales "service de chirurgie A "C.H.UTlemcen

    OpenAIRE

    LETRECHE, AMINE SOUFIANE

    2012-01-01

    Les infections nosocomiales (fl%) posent un véritable problème de santé publique du fait de leur fréquence, leur gravité, et Idur cout socio-économique, notre travail réalisé dans le cadre de «Contribution à l'étude des infections nosocomiales au niveau chirurgie A » qui s'est déroulée en centre Hospitalo- Universitaire Tlemcen en 2012. Qui avait pour objectifs de déterminer la fréquence globale des infections nosocomiales dans le service de chirurgie A et d'évçquer les princip...

  16. Pratique anesthésique à Lubumbashi: indications, types de chirurgie et types de patient

    Science.gov (United States)

    Kabey, Alain Kabey a; Lubanga, Muyumba; Tshamba, Mundongo; Kaut, Mukeng; Kakambal, Kaij; Muteya, Manika; Manzanza, Kilembe; Kalal, Kapend

    2015-01-01

    Introduction Cette étude a pour objectif de décrire la pratique anesthésique dans un pays à faible revenu et où le plateau technique anesthésique est moins équipé. Méthodes Une étude descriptive transversale a été menée durant l'année 2013. L'enquête a concerné les pratiques anesthésiques, les indications chirurgicales et les caractéristiques des malades. L'encodage et l'analyse des données ont été réalisées grâce aux logiciels Epi Info 3.5.3 et Excel 2010. Résultats Nous avons enregistré 2358 patients dont l’âge médian était de 29 + 15 ans, avec 81,5% âgés de 11 à 50 ans. Parmi eux, 67,3% des malades étaient du sexe féminin. Dans ensemble, 62,5% de ces patients étaient pris en charge pour les interventions programmées. L’évaluation du risque anesthésique a montré que 91,9% des patients étaient de la classe ASA I et II. La chirurgie la plus pratiquée était viscérale (46,7%) suivie de la chirurgie gynéco-obstétricale (29,2%). Les différents types d'anesthésie étaient les suivants: anesthésie générale (87,6%), locorégionale (11,8%) et combinée (0,6%). Conclusion La pratique anesthésique dans la population d’étude était dominée par l'anesthésie générale. Les malades étaient au trois quart de sexe féminin et de la classe ASA I et II. Les résultats de cette étude indiquent la nécessité d’évaluer l'issue de cette pratique. La pratique anesthésique à Lubumbashi est tributaire du plateau technique, des compétences du personnel et de l'acceptabilité du type d'anesthésie par les patients. PMID:26523180

  17. [Georges Mareschal (1658-1736) the founder of the Académie de Chirurgie].

    Science.gov (United States)

    Peumery, J J

    1996-01-01

    Georges Mareschal born in 1658 was the son of an Irish gentleman serving in the army of Louis XIII: John Marshall ennobled after the battle of Rocroi (1643) with a francisation of his name. He came to Paris in 1677 and worked with a master-surgeon: Le Breton. He went at the Charité hospital in 1684, was received master-surgeon in 1688 and became there chief-surgeon in 1692. He modified and improved lithotomy. After having operated several personalities and king Louis XIV he became his first surgeon in 1703, later "Maître d'Hôtel" in 1706 and was finally ennobled in 1707. He visited regularly sick people belonging to all classes of society in the Versailles area and played a part in the "poisons affair" in 1712. He remained the First Surgeon of Louis XV and received the cross of Saint-Michel order in 1723. He created with La Peyronie a School of Surgery in Paris officialized by patent letters in 1726. With the help of the same collaborator he founded in 1731 the "SociétéAcademique des chirurgiens de Paris" which will become in 1748 the "Académie Royale de Chirurgie" after his death and that of La Peyronie who had been nominated himself First Surgeon.

  18. Les masques de la masculinité dans le recours à la chirurgie esthétique

    Directory of Open Access Journals (Sweden)

    Michael Atkinson

    2009-10-01

    Full Text Available Depuis la fin des années 1990, un nombre croissant de Canadiens ont recours à la chirurgie esthétique comme véritable projet corporel. Un problème sociologique central émerge de ce recours massif. Pourquoi une pratique traditionnellement féminine devient-elle une pratique hautement signifiante pour ces Canadiens? La chirurgie plastique comme pratique culturelle équivaut à une mesure physique de l’évolution des pouvoirs entre les genres dans des pays comme le Canada. En outre, elle sert d’indicateur corporel de la manière dont les hommes vivent la crise actuelle de la masculinité. A la suite de Douglas (1970 ou Sontag (1991, le bouleversement normatif des corps, leurs modifications et leurs représentations publiques sont, en effet, des mesures corporelles des changements des relations de pouvoir entre hommes et femmes. Ces évolutions au Canada déstabilisent réellement les modèles de masculinité hégémonique, et sont directement observables à travers les modifications à même la peau de ces hommes. Ces recours chirurgicaux permettent de révéler les doutes, l’anxiété et l’anomie qui parsèment les cultures contemporaines. Ils redéfinissent les formes de ce travail corporel traditionnellement féminin. Il s’agit donc d’analyser comment les corps masculins modifiés par la chirurgie constituent une mesure aiguë du genre et un révélateur d’identités dans les sociétés comme le Canada.

  19. Prescription Drug Profiles PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Prescription Drug Profiles Public Use Files (PUFs) drawn from Medicare prescription drug claims for the year of the date on which the...

  20. Prescription Drug Abuse

    Science.gov (United States)

    ... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that ... purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, ...

  1. Inpatients’ medical prescription errors

    Directory of Open Access Journals (Sweden)

    Aline Melo Santos Silva

    2009-09-01

    Full Text Available Objective: To identify and quantify the most frequent prescription errors in inpatients’ medical prescriptions. Methods: A survey of prescription errors was performed in the inpatients’ medical prescriptions, from July 2008 to May 2009 for eight hours a day. Rresults: At total of 3,931 prescriptions was analyzed and 362 (9.2% prescription errors were found, which involved the healthcare team as a whole. Among the 16 types of errors detected in prescription, the most frequent occurrences were lack of information, such as dose (66 cases, 18.2% and administration route (26 cases, 7.2%; 45 cases (12.4% of wrong transcriptions to the information system; 30 cases (8.3% of duplicate drugs; doses higher than recommended (24 events, 6.6% and 29 cases (8.0% of prescriptions with indication but not specifying allergy. Cconclusion: Medication errors are a reality at hospitals. All healthcare professionals are responsible for the identification and prevention of these errors, each one in his/her own area. The pharmacist is an essential professional in the drug therapy process. All hospital organizations need a pharmacist team responsible for medical prescription analyses before preparation, dispensation and administration of drugs to inpatients. This study showed that the pharmacist improves the inpatient’s safety and success of prescribed therapy.

  2. Approches anatomique et par imagerie des nerfs du plexus brachial : application pour le bloc échoguidé lors de chirurgie de l'épaule

    OpenAIRE

    Zoccarato, Sophie

    2014-01-01

    La technique d’anesthésie loco-régionale est de plus en plus employée en per-opératoire pour optimiser l’analgésie. Chez le chien, différents blocs axillaires ont déjà montré leurs intérêts pour des chirurgies du membre thoracique. Cependant, lors de chirurgie de la région de l’épaule, seul un bloc paravertébral du plexus brachial est efficace pour anesthésier cette région. Une étude méticuleuse de l’anatomie a permis d’établir les rameaux ventraux des nerfs spinaux à anesthésier pour réussir...

  3. Getting a prescription filled

    Science.gov (United States)

    ... are located inside of a grocery or large "chain" store. It is best to fill all prescriptions ... be used for long-term medicines and medical supplies. The website should have clear directions for filling ...

  4. Dynamic Registration and High Speed Visual Servoing in Robot-Assisted Surgery (Dynamische registratie en visuele servoregeling bij hoge snelheid in robot ondersteunde chirurgie)

    OpenAIRE

    Blankenstein, Andrea

    2008-01-01

    Robot ondersteunde chirurgie ondersteunt de chirurg met intelligente werktuigen om de kwaliteit van medische ingrepen te verbeteren. In de hier gepresenteerde dissertatie worden robotsystemen uitgebreid met zogenaamde vaardigheden. Dit zijn aanvullende eigenschappen die het het robotsysteem mogelijk maken op veranderingen in de omgeving te reageren. Door de terugkoppeling van sensordata krijgt de robot de noodzakelijke informatie om de geplande trajecten aan te passen aan de veranderde condit...

  5. Untersuchung des Reinigungseffektes von Ultraschall auf Oberflächen von Chirurgie-Instrumenten und dessen prototypische Umsetzung in ein Dekontaminationsverfahren

    OpenAIRE

    Kahlen, Insa

    2012-01-01

    Viele Medizinprodukte aus der Chirurgie stellen besonders hohe Anforderungen an ihre Aufbereitung, da sie z.B. wie die so genannten „Langschaftinstrumente“ enge und sehr langgestreckte Lumen aufweisen, die zum Teil nicht einsehbar sind. Laut der Richtlinie „Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten“ vom RKI und der BfArM soll die Aufbereitung von solchen Medizinprodukten durch Anwendung validierter Verfahren durchgeführt werden und der Erfolg stets nachvollziehbar...

  6. Prescription drug misuse.

    Science.gov (United States)

    Monheit, Benny

    2010-08-01

    Recognising and dealing with patients who seek drugs for nonmedical purposes can be a difficult problem in general practice. 'Prescription shoppers' and patients with chronic nonmalignant pain problems are the main people who constitute this small but problematic group. The main drugs they seek are benzodiazepines and opioids. To provide data on current trends in prescription drug abuse and to discuss different strategies on how to deal with this issue in the clinic setting. Misuse of prescription drugs can take the form of injecting oral drugs, selling them on the street, or simply overusing the prescribed amount so that patients run short before the due date and then request extra prescriptions from the doctor. Currently oxycontin and alprazolam are the most abused drugs in Australia. Adequate prescription monitoring mechanisms at the systems level are lacking so we need to rely on our clinical skills and the patient's behaviour pattern over time to detect problematic prescription drug misuse. Management strategies may include saying 'no' to patients, having a treatment plan, and adopting a universal precaution approach toward all patients prescribed drugs of addiction. Among patients with chronic nonmalignant pain, requests for increasing opioid doses need careful assessment to elucidate any nonmedical factors that may be at play.

  7. Choc anaphylactique au cours de la chirurgie de kyste hydatique du foie : à propos d’un cas

    Directory of Open Access Journals (Sweden)

    Mohame Boughalem

    2010-08-01

    Full Text Available Nous rapportons l’observation d’un choc anaphylactique survenue au cours d’une chirurgie de kystes hydatiques hépatiques multiples. Il s’agit d’un enfant de 13 ans, de sexe féminin, sans antécédents pathologiques notables, en particulier allergique, programmé pour cure chirurgicale de kystes hydatiques hépatiques multiples. L’examen préopératoire est strictement normal. La patiente est classée ASA (American Society of Anaesthesiologists I. L’intervention est réalisée sous anesthésie générale. Au moment de la manipulation du deuxième kyste, une augmentation des pressions d’insufflation apparaît, avec des râles sibilants au niveau des deux champs pulmonaires et une désaturation, suivi d’un collapsus vasculaire avec hypotension artérielle 50/30. La prise en charge est débutée aussitôt par un remplissage vasculaire par du sérum salé 9%, suivi par des bolus d’adrénaline de 0,1mg à trois reprises, puis d’une perfusion continue à raison. L’adrénaline est arrêtée au bout de 48 heures et la patiente est adressée au service de chirurgie à j+4 de l’intervention. Le choc anaphylactique est une complication connue de la rupture intra péritonéale spontanée ou post-traumatique du kyste hydatique du foie. Sa survenue en peropératoire est devenue exceptionnelle, grâce aux mesures de prévention chirurgicale entretenues en peropératoire par l’éviction de manipulation du kyste, de le vider avant d’injecter le scolicide, et de ne pas l’administrer sous forte pression.

  8. Prescription Drug Overdose

    Centers for Disease Control (CDC) Podcasts

    2013-07-02

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the epidemic of prescription drug overdose, especially in women, and what can be done about it.  Created: 7/2/2013 by National Center for Injury Prevention and Control.   Date Released: 3/6/2014.

  9. Medicare Prescription Drug Benefit Manual

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Part D Prescription Drug Benefit Manual (PDBM) is user guide to Part D Prescription Drug Program. It includes information on general provisions, benefits,...

  10. Prescription in Dutch general practice.

    NARCIS (Netherlands)

    Dijk, L. van

    2006-01-01

    The second Dutch National Survey of General Practice (DNSGP-2) has combined registration data on morbidity and prescription, making it possible to unravel diagnosis-specific prescription behaviour of general practitioners(GPs). Prescription rates for different disorders vary considerably, especially

  11. Fermion field renormalization prescriptions

    OpenAIRE

    Zhou, Yong

    2005-01-01

    We discuss all possible fermion field renormalization prescriptions in conventional field renormalization meaning and mainly pay attention to the imaginary part of unstable fermion Field Renormalization Constants (FRC). We find that introducing the off-diagonal fermion FRC leads to the decay widths of physical processes $t\\to c Z$ and $b\\to s \\gamma$ gauge-parameter dependent. We also discuss the necessity of renormalizing the bare fields in conventional quantum field theory.

  12. From description to prescription

    DEFF Research Database (Denmark)

    McQuaid, Sara Dybris

    From Description to Prescription: Politics of Recognition, Consociational Theory and the Conflict in Northern Ireland. Within academic discourses on Northern Ireland the politics of recognition and particularly the theory of consociational democracy has made a profound impact. First introduced...... politico-cultural antagonisms in Northern Ireland. However, the terms ‘consociationalism’ or ‘consociational democracy’ are wholly absent from political discourses: they are never used in any of the governmental and constitutional documents between 1969 and 2006. As such, juxtaposing academic literature...... to integration, eventually converged in authoritative academic and political discourses....

  13. A prescription fraud detection model.

    Science.gov (United States)

    Aral, Karca Duru; Güvenir, Halil Altay; Sabuncuoğlu, Ihsan; Akar, Ahmet Ruchan

    2012-04-01

    Prescription fraud is a main problem that causes substantial monetary loss in health care systems. We aimed to develop a model for detecting cases of prescription fraud and test it on real world data from a large multi-center medical prescription database. Conventionally, prescription fraud detection is conducted on random samples by human experts. However, the samples might be misleading and manual detection is costly. We propose a novel distance based on data-mining approach for assessing the fraudulent risk of prescriptions regarding cross-features. Final tests have been conducted on adult cardiac surgery database. The results obtained from experiments reveal that the proposed model works considerably well with a true positive rate of 77.4% and a false positive rate of 6% for the fraudulent medical prescriptions. The proposed model has the potential advantages including on-line risk prediction for prescription fraud, off-line analysis of high-risk prescriptions by human experts, and self-learning ability by regular updates of the integrative data sets. We conclude that incorporating such a system in health authorities, social security agencies and insurance companies would improve efficiency of internal review to ensure compliance with the law, and radically decrease human-expert auditing costs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. From description to prescription

    DEFF Research Database (Denmark)

    McQuaid, Sara Dybris

    current prominent position within the academy. Structuring these interpretations alongside evolving constitutional policy, the paper will argue that although consociationalism has developed as an indeterminate research design, the inherent logic of managing diversity on the basis of equality as opposed......From Description to Prescription: Politics of Recognition, Consociational Theory and the Conflict in Northern Ireland. Within academic discourses on Northern Ireland the politics of recognition and particularly the theory of consociational democracy has made a profound impact. First introduced...... by the Dutch political scientist Arend Lijphart in a World Politics article from 1969, it has since increased in importance, both as an authoritative explanatory framework for the institutional design inherent in political agreements and as a desirable approach to manage, balance and potentially dissolve...

  15. Conception et réalisation d'une instrumentation terminale intégrée en chirurgie mini-invasive robotisée

    OpenAIRE

    Van Meer, Frédérick

    2005-01-01

    On assiste depuis quelques années à l'émergence d'une robotique médicale proposée pour accroître la précision des actes, améliorer les conditions de travail de l'équipe chirurgicale et le confort du patient. Nos recherches s'inscrivent dans le projet national EndoXiroB du RNTS dont l'objectif est la réalisation d'un ensemble robotisé de chirurgie mini-invasive. Elles sont dédiées à la conception et à la réalisation, en s'appuyant sur les technologies microsystèmes, d' une instrumentation chir...

  16. The Danish National Prescription Registry

    DEFF Research Database (Denmark)

    Kildemoes, Helle Wallach; Sørensen, Henrik Toft; Hallas, Jesper

    2011-01-01

    Introduction: Individual-level data on all prescription drugs sold in Danish community pharmacies has since 1994 been recorded in the Register of Medicinal Products Statistics of the Danish Medicines Agency. Content: The register subset, termed the Danish National Prescription Registry (DNPR......), contains information on dispensed prescriptions, including variables at the level of the drug user, the prescriber, and the pharmacy. Validity and coverage: Reimbursement-driven record keeping, with automated bar-code-based data entry provides data of high quality, including detailed information...

  17. Prescription Drugs and Cold Medicines

    Science.gov (United States)

    ... on past-month use for illicit drugs (including marijuana and prescription drugs), alcohol, and tobacco. ... neonatal abstinence syndrome, and provides evidence-based treatment options that have been shown to be safe ...

  18. The Danish National Prescription Registry

    DEFF Research Database (Denmark)

    Kildemoes, Helle Wallach; Toft Sørensen, Henrik; Hallas, Jesper

    2011-01-01

    Introduction: Individual-level data on all prescription drugs sold in Danish community pharmacies has since 1994 been recorded in the Register of Medicinal Products Statistics of the Danish Medicines Agency. Content: The register subset, termed the Danish National Prescription Registry (DNPR...... on the dispensed drug. Conclusion: The possibility of linkage with many other nationwide individual-level data sources renders the DNPR a very powerful pharmacoepidemiological tool...

  19. Antipsychotics dosage and antiparkinsonian prescriptions

    Directory of Open Access Journals (Sweden)

    Gasquet Isabelle

    2007-09-01

    Full Text Available Abstract Background To study the link between the dosage of several antipsychotics and the prescription of antiparkinsonians in an observational study. Methods In the context of a national naturalistic prospective observational study, a database containing all the prescriptions from 100 French psychiatrists during the year 2002 was analysed. The inclusion criteria were a diagnosis of schizophrenia or schizoaffective disorder and age over 18. The mean dosage of antipsychotics with and without antiparkinsonians was compared. Since there were multiple prescriptions for a given subject, generalised mixed linear models were also used to study the link between antiparkinsonian prescription and antipsychotic dosage. Results antiparkinsonians were prescribed to 32,9% of the patients. Two groups of antipsychotics were observed relating to differences in dosage when an antiparkinsonian was co prescribed or not : a first group, where the mean dosage was higher with antiparkinsonians (risperidone, amisulpride and haloperidol and a second group (clozapine, olanzapine, in which antiparkinsonian co prescription was not related to the dosage of antipsychotics. Conclusion As a conclusion, it can be said that it is important to consider the dosage and the type of antipsychotic in the treatment of patients suffering of schizophrenia, because neurological side effects are frequent and can impair quality of life. Moreover the prescription of antiparkinsonians can lead to different side effects such anticholinergic effects.

  20. Traitement hémostatique basé sur la Thromboélastometrie Rotatoire (ROTEM) chez les Patients opérés en urgence en Chirurgie cardiovasculaire

    OpenAIRE

    Sartorius, Danielle Marie

    2016-01-01

    La première cause de mortalité au cours d’une intervention de chirurgie cardiovasculaire en urgence est l’hémorragie. Le diagnostic précoce des troubles de la crase rencontrés dans ce contexte est primordial afin de cibler un traitement rapide et efficace. La thromboélastometrie est un examen qui permet d’analyser rapidement les propriétés viscoélastiques du caillot sanguin, au bloc opératoire. Dans un premier temps les spécificités des troubles de l’hémostase rencontrés en chirurgie cardiova...

  1. Anesthésie d’un greffé cardiaque en chirurgie non cardiaque: à propos d’un cas clinique et revue de la littérature

    Science.gov (United States)

    Nassirou, Oumarou Mahamane Mamane; Jaafari, Abdelhamid; Chlouchi, Abdellatif; Bensghir, Mustapha; Haimeur, Charki

    2016-01-01

    Le nombre et la durée de survie des patients transplantés cardiaque sont en augmentation. Une partie de ces patients se présentent régulièrement pour une chirurgie générale en dehors de la transplantation cardiaque. L’anesthésie chez ces patients peut être difficile en raison des particularités physiologiques du cœur dénervé et de la gestion du traitement immunosuppresseur avec le risque de rejet et d’infection. Nous discutons la prise en charge anesthésique à travers un cas d’un patient âgé de 60 ans transplanté cardiaque devant subir une chirurgie de cure d’éventration abdominale et une revue de la littérature. PMID:28154639

  2. Prescription Program Provides Significant Savings

    Science.gov (United States)

    Rowan, James M.

    2010-01-01

    Most school districts today are looking for ways to save money without decreasing services to its staff. Retired pharmacist Tim Sylvester, a lifelong resident of Alpena Public Schools in Alpena, Michigan, presented the district with a pharmaceuticals plan that would save the district money without raising employee co-pays for prescriptions. The…

  3. Medication safety: Filling your prescription

    Science.gov (United States)

    ... medicines. Also learn what each medicine looks like. Filling Your Prescriptions Your health plan may require you to use certain pharmacies. ... standards. The website should have clear directions for filling or ... seeing you. Make sure your health plan will cover the cost of using the ...

  4. Prescriptive Exercise for Older Adults.

    Science.gov (United States)

    Piscopo, John

    1985-01-01

    In addition to physical benefits, exercise also provides a natural way to sustain mental alertness in the aging individual by supplying oxygen to the brain. A table focuses on 10 specific health-fitness problems with suggested prescriptive exercises designed to ameliorate the condition. (MT)

  5. Therapeutic Audit Of Dermatological Prescriptions

    Directory of Open Access Journals (Sweden)

    Thawani V.R

    1995-01-01

    Full Text Available Dermatological prescribing trends in outdoor patients attending Dermatology Clinic of Govt. Medical College Hospital, Nagpur were studied. In all 190 prescriptions were audited to find number of drugs per prescription, use of generic/brand names, dosage forms, frequency, duration of treatment, dose and categorywise drug consumption. The age and sex distributions of patients and disease distribution were also studied. Polypharmacy was found to be widely prevalent. More drugs were prescribed by brand names than generic. Dosage form, frequency and duration were mentioned in most of the prescriptions; however, doses of the drugs were not, in majority. The major drugs in the prescriptions were antihistaminics followed by antimicrobials , steroids and vitamins. Not much difference was found in sexes attending the Clinic. There were more female patients of acne vulgaris, disseminated lupus erythematosus and Hansen’s disease. More males suffered from scables and tinea infections. There were 4 patients who were prescribed drugs without diagnosis. Except in some cases, the prescribing was relational.

  6. E-prescription across Europe

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick

    2013-01-01

    . The study concludes that member states have varying degrees of health care policy, privacy enforcement and laws concerning data protection, telecommunication services and digital signature with regards to e-Prescription. Interoperability of different systems is only a partial solution. Security...

  7. 21 CFR 1306.08 - Electronic prescriptions.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Electronic prescriptions. 1306.08 Section 1306.08 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS General Information... part 1311 of this chapter. (b) A pharmacy may fill an electronically transmitted prescription for a...

  8. Prescription Drug Abuse and Youth. Information Brief.

    Science.gov (United States)

    Department of Justice, Washington, DC. National Drug Intelligence Center.

    Prescription drugs, a category of psychotherapeutics that comprises prescription-type pain relievers, tranquilizers, stimulants, and sedatives, are among the substances most commonly abused by young people in the United States. Prescription drugs are readily available and can easily be obtained by teenagers who abuse these drugs to experience a…

  9. [Exercise prescription and nutrition therapy].

    Science.gov (United States)

    Shiota, Masatoshi; Sone, Ryoko; Matsuo, Eriko; Matsubara, Shigeru; Suzuki, Masato

    2014-08-01

    In the report of World Health Organization, the leading global risks for mortality in the world are high blood pressure (12.8%), tobacco use (8.7%), high blood glucose (5.8%), physical inactivity (5.5%), and overweight and obesity (4.8%). Increased blood pressure levels cause the increased morbidity and mortality of chronic diseases, such as stroke, myocardial infarction, chronic kidney disease. Improving the high blood pressure is considered as common challenges around the world. Exercise prescription and nutrition therapy might be important non-pharmacologic therapies in the control of hypertension. Applying these therapies to the general population can help to prevent an increase in blood pressure and decrease elevated blood pressure levels for those with hypertension. Exercise prescription and nutrition therapy are discussed using the international guidelines.

  10. Prescription Painkiller Overdoses PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-07-02

    This 60 second public service announcement is based on the July 2013 CDC Vital Signs report. Prescription painkiller overdoses are an under-recognized and growing problem among women. This program includes things that women and health care providers can do to reduce the risk of overdose.  Created: 7/2/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/2/2013.

  11. Laboratory Testing for Prescription Opioids

    OpenAIRE

    Milone, Michael C.

    2012-01-01

    Opioid analgesic misuse has risen significantly over the past two decades, and these drugs now represent the most commonly abused class of prescription medications. They are a major cause of poisoning deaths in the USA exceeding heroin and cocaine. Laboratory testing plays a role in the detection of opioid misuse and the evaluation of patients with opioid intoxication. Laboratories use both immunoassay and chromatographic methods (e.g., liquid chromatography with mass spectrometry detection),...

  12. Epidémiologie et facteurs de risque des complications respiratoires majeures après chirurgie de l'aorte abdominale au CHU Ibn Sina, Maroc

    Science.gov (United States)

    Awab, Almahdi; Elahmadi, Brahim; Lamkinsi, Tarik; El Moussaoui, Rachid; El Hijri, Ahmed; Azzouzi, Abderrahim; Alilou, Mustapha

    2013-01-01

    Introduction L'incidence des complications respiratoires postopératoires (CRPO) reste très diversement appréciées selon les critères diagnostiques retenues dans les différentes études, ce qui la fait varier de 5 à plus de 50%. Les CRPO majeurs après chirurgie de l'aorte abdominale sont responsables d'une grande morbi-mortalité pouvant aller jusqu’à 36%, d'une durée d'hospitalisation et d'un coût plus importants. Ainsi dans l'optique d'améliorer notre prise en charge périopératoire de la chirurgie de l'aorte, nous avons décidé de mener une étude pour dresser le profil épidémiologique et déterminer les facteurs de risque des complications respiratoires dans notre contexte Méthodes Il s'agit d'une étude de cohorte rétrospective du mois de Janvier 2007 au mois de décembre 2011 portant sur l'ensemble des patients opérés pour pathologie aortique au bloc opératoire central de l'hôpital Ibn Sina de Rabat, Maroc. Résultats Cent vingt cinq patients ont été inclus dans notre étude, 24 patients ont été opérés pour anévrysme de l'aorte abdominale et 101 patients pour lésion occlusive aortoiliaque. Dans notre série 22 malades soit 17,6% ont présenté une complication respiratoire majeure avec, une reventilation dans 4,8% des cas, une difficulté de sevrage de la ventilation artificielle dans 3,2% des cas, une pneumopathie dans 4% des cas, un syndrome de détresse respiratoire aigue (SDRA) dans 4% des cas et une nécessité de fibroaspiration bronchique dans 1,6% des cas. En analyse univariée: l’âge, la présence d'une BPCO avec dyspnée stade 3 ou 4, la présence d'une anomalie à l'EFR préopératoire, la présence d'un stade avancé (III ou IV) de LOAI et la reprise chirurgicale étaient statistiquement associés à la survenue d'une complication respiratoire postopératoire. En analyse multivariée, seule une anomalie à l'EFR en préopératoire constituait un facteur de risque indépendant de survenue d'une complication

  13. Laboratory testing for prescription opioids.

    Science.gov (United States)

    Milone, Michael C

    2012-12-01

    Opioid analgesic misuse has risen significantly over the past two decades, and these drugs now represent the most commonly abused class of prescription medications. They are a major cause of poisoning deaths in the USA exceeding heroin and cocaine. Laboratory testing plays a role in the detection of opioid misuse and the evaluation of patients with opioid intoxication. Laboratories use both immunoassay and chromatographic methods (e.g., liquid chromatography with mass spectrometry detection), often in combination, to yield high detection sensitivity and drug specificity. Testing methods for opioids originated in the workplace-testing arena and focused on detection of illicit heroin use. Analysis for a wide range of opioids is now required in the context of the prescription opioid epidemic. Testing methods have also been primarily based upon urine screening; however, methods for analyzing alternative samples such as saliva, sweat, and hair are available. Application of testing to monitor prescription opioid drug therapy is an increasingly important use of drug testing, and this area of testing introduces new interpretative challenges. In particular, drug metabolism may transform one clinically available opioid into another. The sensitivity of testing methods also varies considerably across the spectrum of opioid drugs. An understanding of opioid metabolism and method sensitivity towards different opioid drugs is therefore essential to effective use of these tests. Improved testing algorithms and more research into the effective use of drug testing in the clinical setting, particularly in pain medicine and substance abuse, are needed.

  14. Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists

    OpenAIRE

    Linda Rasubala; Lavanya Pernapati; Ximena Velasquez; James Burk; Yan-Fang Ren

    2015-01-01

    Prescription Drug Monitoring Programs (PDMP) are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Bas...

  15. Influence of pharmacists expertise on physicians prescription ...

    African Journals Online (AJOL)

    The influence of pharmacist factors on physician prescription decisions was identified ... Keywords: Physician prescription behaviour, Pharmacist factor, ... addition to the influence of marketing promotion .... from the drug sales, obtaining clinic rental ... also analyzed the current status of pharmacist's ..... the buyer-seller dyad.

  16. 21 CFR 801.109 - Prescription devices.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Prescription devices. 801.109 Section 801.109 Food... DEVICES LABELING Exemptions From Adequate Directions for Use § 801.109 Prescription devices. A device... direct the use of such device, and hence for which “adequate directions for use” cannot be...

  17. Pronostic visuel et évolution réfractive après chirurgie de la cataracte congénitale avec implantation primaire: étude d'une série de 108 cas

    Science.gov (United States)

    Hafidi, Zouheir; Ibrahimy, Wafaa; Ahid, Samir; Handor, Hanan; Ouafae Cherkaoui, Lalla; Bencherif, Zahid; Laghmari, Mina; Ouazzanni, Btissam; Boutimzine, Noureddine; Daoudi, Rajae

    2013-01-01

    La cataracte congénitale constitue la cause la plus fréquente de cécité évitable chez les enfants. Le but de cette étude est d’évaluer le pronostic réfractif et fonctionnel, des enfants opérés de cataracte congénitale avec implantation. Il s'agit d'une étude rétrospective de 108 enfants, dont 85 cataractes bilatérales, 23 unilatérales opérés entre 2007 et 2011. La réfraction a été mesurée à 1 mois, 3 mois, 6 mois, 1 an, 2 ans, 3 ans et/ou 4 ans en post-opératoire. La meilleure acuité visuelle corrigée, ainsi que l'incidence des complications post-opératoires ont été analysé. L’âge moyen de la chirurgie était de 25 mois avec une durée moyenne de suivi de 3,17 ans. Les complications retrouvées étaient l'inflammation, la prolifération secondaire, et le glaucome. L'acuité visuelle (AV) moyenne corrigée finale était de 5,75/10e pour les formes bilatérales, et de 4,16/10e pour les unilatérales (p = 0,001). Les facteurs de mauvais pronostic retrouvés étaient l’âge tardif de la chirurgie, la densité de la cataracte et la survenue de complications (p = 0,001). L'incidence des complications post-opératoires était significativement plus élevé chez les enfants opérés à un jeune âge (p = 0,001). Les facteurs de mauvais pronostic visuel chez les enfants opérés pour cataracte congénitale avec implantation, sont représentés par le caractère unilatéral de la cataracte, l’âge tardif de la chirurgie, la densité de la cataracte et la survenue de complications post opératoires. PMID:24672622

  18. Cosmetische ingrepen tijdens orthognathische chirurgie

    NARCIS (Netherlands)

    Jansma, Johan; Schepers, R H; Vissink, A

    2016-01-01

    The goal of a combined orthodontic-surgical treatment is to correct the dysgnathia and malocclusion and thereby achieve an improvement of function. As a supplement to osteotomy, enhancement of facial aesthetics is increasingly being used to gain more harmony in the face and/or to achieve facial reju

  19. Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists.

    Directory of Open Access Journals (Sweden)

    Linda Rasubala

    Full Text Available Prescription Drug Monitoring Programs (PDMP are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests. For patients who were prescribed pain medications, 452 (30.6%, 190 (14.1%, and 140 (9.6% received opioid analgesics in the three study periods respectively, signifying a statistically significant reduction in the number of opioid prescriptions after implementation of the mandatory PDMP (p<0.05. Total numbers of prescribed opioid pills in a 3-month period decreased from 5096 to 1120, signifying a 78% reduction in absolute quantity. Prescriptions for non-opioid analgesics acetaminophen increased during the same periods (p<0.05. We conclude that the mandatory PDMP significantly affected the prescription pattern for pain medications by dentists. Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain.

  20. Prescription Opioid Usage and Abuse Relationships: An Evaluation of State Prescription Drug Monitoring Program Efficacy

    Directory of Open Access Journals (Sweden)

    Richard M. Reisman

    2009-01-01

    Full Text Available Context: The dramatic rise in the use of prescription opioids to treat non-cancer pain has been paralleled by increasing prescription opioid abuse. However, detailed analyses of these trends and programs to address them are lacking.Objective: To study the association between state shipments of prescription opioids for medical use and prescription opioid abuse admissions and to assess the effects of state prescription drug monitoring programs (PDMPs on prescription opioid abuse admissions.Design and Setting: A retrospective ecological cohort study comparing state prescription opioid shipments (source: Automation of Reports and Consolidated Orders Systems database and inpatient admissions for prescription opioid abuse (source: Treatment Episode Data Set in 14 states with PDMPs (intervention group and 36 states without PDMPs (control group for the period 1997–2003.Results: From 1997 to 2003, oxycodone, morphine, and hydrocodone shipments increased by 479%, 100%, and 148% respectively. Increasing prescription oxycodone shipments were significantly associated with increasing prescription opioid admission rates (p 0.001. PDMP states had significantly lower oxycodone shipments than the control group. PDMP states had less increase in prescription opioid admissions per year (p = 0.063. A patient admitted to an inpatient drug abuse rehabilitation program in a PDMP state was less likely to be admitted for prescription opioid drug abuse (Odds ratio = 0.775, 95% Confidence Interval 0.764–0.785.Conclusions: PDMPs appear to decrease the quantity of oxycodone shipments and the prescription opioid admission rate for states with these programs. Overall, opioid shipments rose significantly in PDMP states during the study period indicating a negligible “chilling effect” on physician prescribing.

  1. Monitoring physicians' prescription patterns on electronic health record: the prescription pattern around clinical event (PACE) algorithm.

    Science.gov (United States)

    Yoon, Dukyong; Park, Inwhee; Park, Man Young; Hong, Seung Kwon; Park, Rae Woong

    2013-01-01

    Electronic health records (EHRs) have gained attention as a valuable data source for medical research, as its adoption rate continues to rise. However, no method for the monitoring of physicians' prescription patterns has been established. Since EHR maintain all prescription data as well as clinical events that occur during the care of patients, we hypothesized that a physician's prescription pattern can be monitored from EHR. In this study, we developed a novel algorithm named PACE, Prescription pattern Around Clinical Event. This algorithm analyzes distribution of the prescription of specific drugs around the time of a clinical event. In the proof of concept study, prescription changes with regard to hyperkalemia were well represented by the algorithm, and the observed patterns well correlated with the physician's knowledge on hyperkalemia (Cohen's kappa, 0.457-0.653). We expect that this algorithm can be used to monitor the guideline adherence of physicians.

  2. Medicare Prescription Drug Coverage - General Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MMA legislation provides seniors and people with disabilities with the first comprehensive prescription drug benefit ever offered under the Medicare program, the...

  3. Prescription Pain Medicines - An Addictive Path?

    Science.gov (United States)

    ... statistics showed that retail sales of five major painkillers rose 90 percent from 1997 to 2005. The report revealed that ever-increasing amounts of prescription painkillers called opioid analgesics are being used on a ...

  4. CDC Vital Signs: Prescription Painkiller Overdoses (Opioids)

    Science.gov (United States)

    ... reporting and access, integration with electronic health records, proactive unsolicited reporting, incentives for provider use, and interoperability ... – Office of Diversion Control Drugs, Brains, and Behavior: The Science of Addiction Prescription Drugs U.S. Food ...

  5. Prescription drug abuse in the elderly.

    Science.gov (United States)

    Martin, Caren McHenry

    2008-12-01

    The increased use of prescription drugs has brought pain relief too many and often improved the quality of life of elderly patients. But the increase in use and availability of prescription medications-especially controlled substances-brings with it an increased potential for abuse. Studies have shown that intentional abuse of prescription drugs is increasing among all age groups. As the number of persons 65 years of age and older skyrockets with the aging of the baby boomers, experts predict that prescription drug abuse among the elderly also will rise significantly. Efforts to increase awareness of drug abuse among elderly patients, caregivers, and health care practitioners, as well as research into how best to prevent and treat the elderly drug abuser, will be necessary to thwart what could become a significant public health problem.

  6. Assessment of prescription sales in Ukraine

    Directory of Open Access Journals (Sweden)

    N. V. Teterich

    2013-10-01

    Full Text Available Currently, the state of the national health system (health is characterized by a low level of funding for medical and pharmaceutical care and the lack of effective methods of free and preferential dispensing of medicines (drugs and compensation of their value. Thus the most urgent problem arises is unregulated drugs prescription, which is one of the main negative factors behind the rapid spread of self-medication and polypragmasy. Thus, improving drugs prescription dispensing is one of the current challenges of medicine and pharmacy management which should be solved to provide a safe, rational and effective drug therapy. The results of the questionnaire survey of doctors and pharmaceutical workers identified and explored key factors that contribute to a violation of drugs prescription. The authors analyzed the literature on the current state of drugs prescription in Ukraine, which resulted in selected priority issues that need resolution as soon as possible. Established that the main disadvantages of the national health care system is unreasonable approach to state regulation of the relevant system and the low level of funding. This situation prevents rational regulation of free and preferential delivery of drugs, the introduction of obligatory medical insurance and the reimbursement cost of drugs and other modern approaches that are effective in developed countries. Тhe main motive of view of legislative acts to implement strict drugs prescription in Ukraine is a link to international experience, guided by the standards of European and international practices that do not comply with the Law of Ukraine issued on 18.03.2004 № 1629-IV «On the National Program for Adaptation of Ukraine to the European Union, "and points to the disparity modern domestic rule-making European practice. The fundamental problem here is the comparison of the legal, social, financial and economic status of the counter in Ukraine with the countries in which the system

  7. Off-label prescriptions in diabetic foot

    OpenAIRE

    Luís Jesuíno de Oliveira Andrade; Larissa Santos França; Paulo Roberto Santana de Melo; Marcelo Araújo

    2014-01-01

    Prescription of a drug outside of the indications for which it was originally approved by regulators is internationally known as "off-label" prescription. We describe off-label treatments for the diabetic foot reported in international scientific literature. This is a qualitative and descriptive bibliographical review based on the results of a search of the Medline international database. The criteria for review were publication between January 1985 and November 2013, and the MeSH (Medical Su...

  8. [Good prescription practice for out-patients-quality requirements of prescriptions in Germany].

    Science.gov (United States)

    Faller, Christine K; Seidling, Hanna M; Haefeli, Walter E

    2014-06-01

    Because the written prescription is a central communication medium between the prescribing physician and the dispensing pharmacist measures to improve the prescription quality are top priorities. While most primary care physicians in Germany use electronic systems, in outpatient clinics and nursing homes and on special occasions such as emergency services and home visits, many prescriptions are still handwritten. Incorrectly and illegibly issued prescriptions impair the physician-pharmacist-patient relationship and thus represent a risk factor in the context of medication safety. Well issued prescriptions expedite the dispensing and thus the continuity of treatment of the patients and spare human resources by avoiding queries and unnecessary steps in the care process. At the same time, legible and unequivocal prescriptions facilitate measures for quality assurance by the dispensing pharmacists and are essential preconditions needed for insurance reimbursement. Probably the most important step to high quality prescriptions is the consistent use of suitable electronic prescription software. This is only possible if physicians are willing to cooperate and understand the significance and benefits of an electronic prescription system.

  9. Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists.

    Science.gov (United States)

    Rasubala, Linda; Pernapati, Lavanya; Velasquez, Ximena; Burk, James; Ren, Yan-Fang

    2015-01-01

    Prescription Drug Monitoring Programs (PDMP) are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests. For patients who were prescribed pain medications, 452 (30.6%), 190 (14.1%), and 140 (9.6%) received opioid analgesics in the three study periods respectively, signifying a statistically significant reduction in the number of opioid prescriptions after implementation of the mandatory PDMP (pPrescriptions for non-opioid analgesics acetaminophen increased during the same periods (pprescription pattern for pain medications by dentists. Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain.

  10. Antibiotic Prescription in Danish General Practice

    DEFF Research Database (Denmark)

    Sydenham, Rikke Vognbjerg; Plejdrup Hansen, Malene; Pedersen, Line Bjørnskov

    2016-01-01

    will explore how the GPs prescription behaviour is influenced by selected factors. Antibiotics are essential when treating potentially lethal infections. An increasing development of resistant bacteria is considered one of the primary threats to public health. The majority of antibiotics (90%) are prescribed...... from general practice. The prescription of broad-spectrum antibiotics can cause unnecessary side effects for the individual and increases the risk of development of bacteria resistant to antibiotic treatment. Both the prescription of broad-spectrum antibiotics and the level of resistant bacteria......1. Background & Aim The overall aim of the project is to describe antibiotic consumption in Danish general practice with emphasis on specific types of antibiotics. The project will shed light on the impact of microbiological diagnostic methods (MDM) on the choice of antibiotic and the project...

  11. Slim accretion discs with different viscosity prescriptions

    Energy Technology Data Exchange (ETDEWEB)

    Szuszkiewicz, E. (Max-Planck-Institut fuer Physik und Astrophysik, Garching (Germany, F.R.). Inst. fuer Astrophysik)

    1990-05-15

    The variability of X-ray sources powered by accretion may be connected to thermal instabilities in the innermost parts of slim discs. The time-scales of variability predicted by the theory with the standard {alpha}-viscosity prescription agree with those observed in a wide range of sources. The amplitudes (3-4 orders of magnitude in luminosity) are correctly predicted for X-ray transient sources, but in general are too big for quasars, Seyferts, galactic black hole candidates and LMXBs. We show here that a slight modification of the viscosity prescription can offer a much better agreement with observations. (author).

  12. The law on electronic medical prescriptions

    Directory of Open Access Journals (Sweden)

    Francis de Clippele

    2005-01-01

    Full Text Available Health care is one of the most important economic and business areas. The European Union has therefore worked out an e-health care strategy to achieving stronger growth and increased effectiviness of services. The application of information and communications technologies (ICT that affect the health care sector, is developing fast in Europe. In this respect various countries have launched pilot projects in order to modernize their medical prescription practices. A model of the electronic medical prescription must respect patient's rights and can only be deployed in a system of security in order to protect the confidentiality.

  13. On prescription-syndrome correspondence of classic prescriptions%认识经方方证

    Institute of Scientific and Technical Information of China (English)

    冯世纶

    2013-01-01

    This paper presents some considerations on prescription-syndrome correspondence of classic prescription.Prescription-syndrome is the basic structure of Treatise on Febrile and Miscellaneous Disease and originates from Shennong era.The accumulation of application experience of prescription-syndrome produces six meridian differentiation.What' s more, the theoretical basis of prescription correspondence to syndrome is eight principal syndromes, and prescription correspondence to syndrome includes the correspondence of prescription and syndrome, herb dosage and disorder severity, decoction-administration methods and disease condition.%介绍对经方方证的几点认识.认为方证是《伤寒杂病论》的基本构成,其形成起源于神农时代,方证应用经验的积累促使六经辨证的产生;方证相应的基础理论是八纲,方证是辨证的尖端,方证相应包括方与证对应、药量与病情对应、煎服法与病情对应.

  14. Mystery Written on Prescription Pads: Exploring Marketing Factors Influencing Prescription Behaviour using the AHP Approach

    Directory of Open Access Journals (Sweden)

    Hemant Bamoriya

    2012-12-01

    Full Text Available The Indian Pharma market is highly fragmented & nature of competition is intense. Further, in modern times influencing doctors’ prescription decision has become very complex as there is little systematic knowledge about factors affecting the doctors’ prescription behaviour and the weight of individual factor. This study aims to demystify this complex prescription behaviour of doctors, through examining the above mentioned factors. For this purpose, a focus group study will be followed by a quantitative study using the Analytic Hierarchy Process (AHP approach. The findings of the study will have important implications for the marketers in order to do proper allocation of their resources, to improve their promotional efficiency.

  15. Linguistic Prescription: Familiar Practices and New Perspectives.

    Science.gov (United States)

    Finegan, Edward

    2003-01-01

    Reports on a question by a law student of whether a correction of "sneaked" to "snuck" suggests misinformation and misguided rigidity in the context of better information about current legal usage and a perennial tendency to linguistic prescription. Explores attitudes to current borrowings from English into Japanese and French and distinguishes…

  16. 76 FR 51310 - Branded Prescription Drug Fee

    Science.gov (United States)

    2011-08-18

    ... Act (ACA). The regulations affect persons engaged in the business of manufacturing or importing... Clearance Officer, SE:W:CAR:MP:T:T:SP, Washington, DC 20224. Comments on the collection of information... business of manufacturing or importing branded prescription drugs by section 9008 of the ACA. The text of...

  17. An Expert System for Designing Fire Prescriptions

    Science.gov (United States)

    Elizabeth Reinhardt

    1987-01-01

    Managers use prescribed fire to accomplish a variety of resource objectives. The knowledge needed to design successful prescriptions is both quantitative and qualitative. Some of it is available through publications and computer programs, but much of the knowledge of expert practitioners has never been collected or published. An expert system being developed at the,...

  18. The Prescription Opioid Pain Medication Overdose Epidemic

    Centers for Disease Control (CDC) Podcasts

    2016-04-19

    Overdose related to prescription opioids has become an epidemic. This podcast discusses the risks of this type of drug sometimes used to treat pain, and how to protect yourself. .  Created: 4/19/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/19/2016.

  19. Respiratory infection and antibiotic prescription rates.

    NARCIS (Netherlands)

    Otters, H.; Wouden, J. van der; Schellevis, F.

    2004-01-01

    In the October issue of the BJGP, Fleming et al showed that a decrease in antibiotic prescription rates is directly related to a decrease in respiratory infections presented in general practice. We compliment the authors for their interesting study and the clear presentation of their results.

  20. Prescriptions Guiding Prospective Teachers in Teaching Mathematics

    Science.gov (United States)

    Zembat, Ismail Özgür; Aslan, Mustafa

    2016-01-01

    This study aims to investigate the nature of different mathematics teaching modes (prescriptions) that guide prospective teachers during their instruction. The participants were 24 junior prospective middle school mathematics teachers (19 females and 5 males) who were attending a mathematics methods course at a private university in central…

  1. COLOR PRESCRIPTION FORM FOR COSMETIC GLOVES

    Science.gov (United States)

    A technique is described for achieving more custom-like coloring of cosmetic gloves. The method involves the use of a color prescription form which...can be used to describe in greater detail the characteristics of those portions of the human hand of greater cosmetic significance.

  2. Preparing for a Hurricane: Prescription Medications

    Centers for Disease Control (CDC) Podcasts

    2006-08-10

    What you should do to protect yourself and your family from a hurricane. As you evacuate, remember to take your prescription medicines with you.  Created: 8/10/2006 by Emergency Communications System.   Date Released: 7/17/2008.

  3. Closing the Prescription Drug Coverage Gap

    Science.gov (United States)

    ... drugs they make are covered during the coverage gap for that calendar year. This includes prescription drugs on the plan’s formulary ( ... you pay for generic drugs during the coverage gap will decrease each year until it reaches 25% in 2020. The coverage ...

  4. New patient asking for a benzodiazepine prescription

    Institute of Scientific and Technical Information of China (English)

    Simon de Lusignan; Andy Kent

    2008-01-01

    @@ Your final patient on a Friday is a 26 year old man who is new to the list. He asks you for a repeat prescription for two months of diazepam, 5 mg up to four a day. He says he has been taking these for a whil for his "newves" and he has run out. You do not hold this patient's records.

  5. Half of Opioid Prescriptions Go to People with Mental Illness

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_167031.html Half of Opioid Prescriptions Go to People With Mental Illness Those ... disorders receive a troubling percentage of the nation's opioid prescriptions, a new study finds. Of the 115 ...

  6. U.S. Opioid Prescriptions Fall, But Numbers Still High

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_167050.html U.S. Opioid Prescriptions Fall, But Numbers Still High: CDC And ... THURSDAY, July 6, 2017 (HealthDay News) -- Prescriptions for opioid painkillers have dropped since 2010 in the United ...

  7. Medical prescription pitfalls of uncomplicated urinary tract infections ...

    African Journals Online (AJOL)

    user

    identify pitfalls in medical prescriptions of uncomplicated .... encourage laboratory tests to support antibiotic drug treatment. ... relevant systems such as prescriptions monitoring and adverse drug ... registration house officer year: how prepared.

  8. Prescription patterns and treatment outcomes of hypertension in ...

    African Journals Online (AJOL)

    Prescription patterns and treatment outcomes of hypertension in urban hospitals of Jos, Plateau State. ... Nigerian Journal of Pharmaceutical Research ... Results of this study revealed several rational and non-rational prescription practices in ...

  9. Abuse of Prescription (Rx) Drugs Affects Young Adults Most

    Science.gov (United States)

    ... Affects Young Adults Most Abuse of Prescription (Rx) Drugs Affects Young Adults Most Email Facebook Twitter Text Description of Infographic Young adults (age 18 to 25) are the biggest abusers of prescription (Rx) opioid pain relievers, ADHD stimulants, ...

  10. Prescription patterns of general practitioners in peshawar, pakistan

    National Research Council Canada - National Science Library

    Raza, Usman Ahmad; Khursheed, Tayyeba; Irfan, Muhammad; Abbas, Maryam; Irfan, Uma Maheswari

    2014-01-01

    To find out prescription patterns of general practitioners in Peshawar. Cross-sectional survey of drug prescriptions was done at six major hospitals and pharmacies of Peshawar between April and May 2011...

  11. Strategies Used by Adults to Reduce Their Prescription Drug Costs

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Strategies Used by Adults to Reduce Their Prescription Drug ... Interview Survey, alternative therapies, medication Adults used several strategies to reduce prescription drug costs. Figure 1. Percentages ...

  12. Prescription Drug Plan Formulary, Pharmacy Network, and P...

    Data.gov (United States)

    U.S. Department of Health & Human Services — These public use files contain formulary, pharmacy network, and pricing data for Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug Plans...

  13. 76 FR 17137 - Pregnancy and Prescription Medication Use Symposium

    Science.gov (United States)

    2011-03-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Pregnancy and Prescription Medication Use Symposium AGENCY... announcing the following meeting: Pregnancy and Prescription Medication Use Symposium. The topic to...

  14. Potentially inappropriate prescriptions in patients admitted to a psychiatric hospital

    DEFF Research Database (Denmark)

    Soerensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt

    2016-01-01

    the most frequent PIP. Predictive factors for PIP were polypharmacy (>5 prescriptions) and having one or more somatic diagnoses. Conclusion PIP is common in psychiatric patients and potentially fatal. Particularly polypharmacy (>5 prescriptions) and concomitant somatic illness were associated...

  15. Prescription, dispensation and marketing patterns of methylphenidate

    Science.gov (United States)

    Perini, Edson; Junqueira, Daniela Rezende Garcia; Lana, Lorena Gomes Cunha; Luz, Tatiana Chama Borges

    2014-01-01

    OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales – psychoactive and others – subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines. PMID:26039389

  16. Prescription, dispensation and marketing patterns of methylphenidate.

    Science.gov (United States)

    Perini, Edson; Junqueira, Daniela Rezende Garcia; Lana, Lorena Gomes Cunha; Luz, Tatiana Chama Borges

    2014-12-01

    OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales - psychoactive and others - subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines.

  17. Literacy and misunderstanding prescription drug labels.

    Science.gov (United States)

    Davis, Terry C; Wolf, Michael S; Bass, Pat F; Thompson, Jason A; Tilson, Hugh H; Neuberger, Marolee; Parker, Ruth M

    2006-12-19

    Health literacy has increasingly been viewed as a patient safety issue and may contribute to medication errors. To examine patients' abilities to understand and demonstrate instructions found on container labels of common prescription medications. Cross-sectional study using in-person, structured interviews. 3 primary care clinics serving mostly indigent populations in Shreveport, Louisiana; Jackson, Michigan; and Chicago, Illinois. 395 English-speaking adults waiting to see their providers. Correct understanding of instructions on 5 container labels; demonstration of 1 label's dosage instructions. Correct understanding of the 5 labels ranged from 67.1% to 91.1%. Patients reading at or below the sixth-grade level (low literacy) were less able to understand all 5 label instructions. Although 70.7% of patients with low literacy correctly stated the instructions, "Take two tablets by mouth twice daily," only 34.7% could demonstrate the number of pills to be taken daily. After potential confounding variables were controlled for, low (adjusted relative risk, 2.32 [95% CI, 1.26 to 4.28]) and marginal (adjusted relative risk, 1.94 [CI, 1.14 to 3.27]) literacy were significantly associated with misunderstanding. Taking a greater number of prescription medications was also statistically significantly associated with misunderstanding (adjusted relative risk, 2.98 [CI, 1.40 to 6.34] for > or =5 medications). The study sample was at high risk for poor health literacy and outcomes. Most participants were women, and all spoke English. The authors did not examine the association between misunderstanding and medication error or evaluate patients' actual prescription drug-taking behaviors. Lower literacy and a greater number of prescription medications were independently associated with misunderstanding the instructions on prescription medication labels.

  18. Prescription, dispensation and marketing patterns of methylphenidate

    Directory of Open Access Journals (Sweden)

    Edson Perini

    2014-12-01

    Full Text Available OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales – psychoactive and others – subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines.

  19. Irrational drug use in India: A prescription survey from Goa

    Directory of Open Access Journals (Sweden)

    Naik D

    2005-01-01

    Full Text Available BACKGROUND: There is concern regarding the irrational production, prescription and use of drugs in India. This study aimed to describe the quality of prescriptions by medical practitioners, including both the layout of the prescription and the type and number of drugs prescribed. MATERIALS AND METHODS: A survey of all prescriptions dispensed at a busy pharmacy in the state of Goa, India, was carried out over a consecutive seven-day period. Each prescription was rated on the basis of a priori and pilot-tested variable list. The prescriptions by private practitioners were compared with those from practitioners in the public healthcare system. RESULTS: Nine hundred and ninety prescriptions were collected. The majority (83.9% were from private practitioners. The quality of the layout of the prescriptions was unsatisfactory: information to identify the practitioner was incomplete in more than a third of the prescriptions and information to identify the patient was incomplete in more than half. Clarity of written instructions on how to take the medicines was unsatisfactory in the majority of prescriptions. Polypharmacy was the norm, with more than half (52.7% the prescriptions containing at least 3 medicines. Forty per cent of prescriptions included a vitamin or tonic preparation and a quarter of the prescriptions included an antibiotic and an analgesic. Over 90% of prescriptions contained only branded medicines. Private practitioners prescribed significantly greater number of medicines and were more likely to prescribe vitamins and antibiotics, and branded medicines. DISCUSSION: This study confirms that the quality of prescriptions, both in terms of layout and the content of the drugs prescribed, is inadequate. There is a need to standardize the format of prescriptions in India so that all essential information is included. There is a need to strengthen an independent mechanism for continuing professional development of practitioners to ensure that

  20. Exercise on Prescription: trial protocol and evaluation of outcomes

    OpenAIRE

    Puggaard Lis; Kjær Kirsten; Kragstrup Jakob; Sørensen Jes B

    2007-01-01

    Abstract Background In many countries exercise prescriptions are used in an attempt to initiate a physically active lifestyle in sedentary populations. Previous studies have primarily evaluated low intensive exercise prescription interventions and found moderately positive effects on physical activity and aerobic fitness. In a highly intensive Danish exercise prescription scheme called 'Exercise on Prescription' (EoP) the general practitioners can prescribe EoP to sedentary patients with life...

  1. 21 CFR 202.1 - Prescription-drug advertisements.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Prescription-drug advertisements. 202.1 Section...) DRUGS: GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug advertisements. (a)(1) The... ingredients in the advertisement shall be the same as the order of listing of ingredients on the label of...

  2. The Philosophical Foundations of Prescriptive Statements and Statistical Inference

    Science.gov (United States)

    Sun, Shuyan; Pan, Wei

    2011-01-01

    From the perspectives of the philosophy of science and statistical inference, we discuss the challenges of making prescriptive statements in quantitative research articles. We first consider the prescriptive nature of educational research and argue that prescriptive statements are a necessity in educational research. The logic of deduction,…

  3. Resonant Messages to Prevent Prescription Drug Misuse by Teens

    Science.gov (United States)

    Twombly, Eric C.; Holtz, Kristen D.; Agnew, Christine B.

    2011-01-01

    Prescription drug misuse is a major health problem, particularly among teens. A key step in curbing misuse is the development of effective prescription drug prevention messages. This paper explores the elements of prescription drug misuse prevention messages that resonate with teens using data from focus groups with seventh and eighth grade…

  4. The Philosophical Foundations of Prescriptive Statements and Statistical Inference

    Science.gov (United States)

    Sun, Shuyan; Pan, Wei

    2011-01-01

    From the perspectives of the philosophy of science and statistical inference, we discuss the challenges of making prescriptive statements in quantitative research articles. We first consider the prescriptive nature of educational research and argue that prescriptive statements are a necessity in educational research. The logic of deduction,…

  5. 21 CFR 1306.09 - Prescription requirements for online pharmacies.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Prescription requirements for online pharmacies... PRESCRIPTIONS General Information § 1306.09 Prescription requirements for online pharmacies. (a) No controlled... constitutes dispensing by means of the Internet unless such person is a pharmacist who is acting in the...

  6. Patterns of Prescription Medication Diversion among Drug Dealers

    Science.gov (United States)

    Rigg, Khary K.; Kurtz, Steven P.; Surratt, Hilary L.

    2012-01-01

    This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South…

  7. A European community pharmacy-based survey to investigate patterns of prescription fraud through identification of falsified prescriptions

    NARCIS (Netherlands)

    Lapeyre-Mestre, Maryse; Gony, Mireille; Carvajal, Alfonso; Macias, Diego; Conforti, Anita; D'incau, Paola; Heerdink, Rob; Van Der Stichele, Robert; Bergman, Ulf

    2014-01-01

    Aim: To identify prescription drugs involved in falsified prescriptions in community pharmacies in 6 European countries. Methods: A cross-sectional survey among 2,105 community pharmacies in Belgium, France, Italy, the Netherlands, Spain and Sweden was carried out to collect all suspect prescription

  8. A European community pharmacy-based survey to investigate patterns of prescription fraud through identification of falsified prescriptions

    NARCIS (Netherlands)

    Lapeyre-Mestre, Maryse; Gony, Mireille; Carvajal, Alfonso; Macias, Diego; Conforti, Anita; D'incau, Paola; Heerdink, Rob; Van Der Stichele, Robert; Bergman, Ulf

    2014-01-01

    Aim: To identify prescription drugs involved in falsified prescriptions in community pharmacies in 6 European countries. Methods: A cross-sectional survey among 2,105 community pharmacies in Belgium, France, Italy, the Netherlands, Spain and Sweden was carried out to collect all suspect prescription

  9. [Drug design ideas and methods of Chinese herb prescriptions].

    Science.gov (United States)

    Ren, Jun-guo; Liu, Jian-xun

    2015-09-01

    The new drug of Chinese herbal prescription, which is the best carrier for the syndrome differentiation and treatment of Chinese medicine and is the main form of the new drug research and development, plays a very important role in the new drug research and development. Although there are many sources of the prescriptions, whether it can become a new drug, the necessity, rationality and science of the prescriptions are the key to develop the new drug. In this article, aiming at the key issues in prescriptions design, the source, classification, composition design of new drug of Chinese herbal prescriptions are discussed, and provide a useful reference for research and development of new drugs.

  10. A polycarbonate ophthalmic-prescription lens series.

    Science.gov (United States)

    Davis, J K

    1978-08-01

    Improvements in polycarbonate material, production techniques, and scratch-resistant coatings, combined with a process-oriented design, have resulted in a precision lens series. Surface quality is comparable to that of untreated glass ophthalmic lenses. The repeatability of the process results in closely controlled axial power and off-axis performance. For most lens prescriptions, the ANSI Z80.1 optical-center specifications for prescription accuracy are maintained through a total field of view of 40 deg for an 8-mm range of center-of-rotation distances. Off-axis astigmatism is controlled for near-point seeing. The lenses are both lighter and thinner than those of crown glass. A scratch-resistant coating reduces the reflections normally associated with high-index (1.586) materials. Impact resistance exceeds that required by ANSI Z80.7 and is many times that required by ANSI Z80.1.

  11. Women who doctor shop for prescription drugs.

    Science.gov (United States)

    Worley, Julie; Thomas, Sandra P

    2014-04-01

    Doctor shopping is a term used to describe a form of diversion of prescription drugs when patients visit numerous prescribers to obtain controlled drugs for illicit use. Gender differences exist in regard to prescription drug abuse and methods of diversion. The purpose of this phenomenological study guided by the existential philosophy of Merleau-Ponty was to understand the lived experience of female doctor shoppers. Interviews were conducted with 14 women, which were recorded, transcribed, and analyzed. Included in the findings are figural aspects of the participants' experience of doctor shopping related to the existential grounds of world, time, body, and others. Four themes emerged from the data: (a) feeding the addiction, (b) networking with addicts, (c) playing the system, and (d) baiting the doctors. The findings suggest several measures that nurses can take to reduce the incidence of doctor shopping and to provide better care for female doctor shoppers.

  12. Information prescriptions: A tool for veterinary practices

    Directory of Open Access Journals (Sweden)

    L.R. Kogan

    2014-09-01

    Full Text Available The Internet has become a major source of health information and has the potential to offer many benefits for both human and animal health. In order for impact to be positive, however, it is critical that users be able to access reliable, trustworthy information. Although more pet owners are using the Internet to research animal health information than ever before, there remains limited research surrounding their online activities or the ability to influence owners’ online search behaviors. The current study was designed to assess the online behaviors and perceptions of pet owners after receiving either general or topic-specific information prescriptions as part of their veterinary appointment. Results indicate that nearly 60% of clients accessed the suggested websites and nearly all of these clients reported positive feelings about this addition to their veterinary services. These results suggest that offering information prescriptions to clients can facilitate better online searches by clients and positively impact both animal health and client satisfaction.

  13. Price Sensitivity of Demand for Prescription Drugs

    DEFF Research Database (Denmark)

    Simonsen, Marianne; Skipper, Lars; Skipper, Niels

    2016-01-01

    We investigate price sensitivity of demand for prescription drugs, using drug purchase records for the entire Danish population. We identify price responsiveness by exploiting variation in prices caused by kinked reimbursement schemes and implement a regression kink design. The results suggest so...... price responsiveness with corresponding price elasticities ranging from −0.2 to −0.7. Individuals with chronic disease and especially individuals above the age of 65 respond less to the price of drugs.......We investigate price sensitivity of demand for prescription drugs, using drug purchase records for the entire Danish population. We identify price responsiveness by exploiting variation in prices caused by kinked reimbursement schemes and implement a regression kink design. The results suggest some...

  14. Vital Signs-Preventing Prescription Drug Overdose

    Centers for Disease Control (CDC) Podcasts

    2014-07-01

    This podcast is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.  Created: 7/1/2014 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 7/1/2014.

  15. Preventing Prescription Drug Overdose PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2014-07-01

    This 60 second public service announcement is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.  Created: 7/1/2014 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 7/1/2014.

  16. Arts on prescription: a qualitative outcomes study.

    Science.gov (United States)

    Stickley, T; Eades, M

    2013-08-01

    In recent years, participatory community-based arts activities have become a recognized and regarded method for promoting mental health. In the UK, Arts on Prescription services have emerged as a prominent form of such social prescribing. This follow-up study reports on the findings from interviews conducted with participants in an Arts on Prescription programme two years after previous interviews to assess levels of 'distance travelled'. This follow-up study used a qualitative interview method amongst participants of an Arts on Prescription programme of work. Ten qualitative one-to-one interviews were conducted in community-based arts venues. Each participant was currently using or had used mental health services, and had been interviewed two years earlier. Interviews were digitally recorded, transcribed and analysed. For each of the 10 participants, a lengthy attendance of Arts on Prescription had acted as a catalyst for positive change. Participants reported increased self-confidence, improved social and communication skills, and increased motivation and aspiration. An analysis of each of the claims made by participants enabled them to be grouped according to emerging themes: education: practical and aspirational achievements; broadened horizons: accessing new worlds; assuming and sustaining new identities; and social and relational perceptions. Both hard and soft outcomes were identifiable, but most were soft outcomes. Follow-up data indicating progress varied between respondents. Whilst hard outcomes could be identified in individual cases, the unifying factors across the sample were found predominately in the realm of soft outcomes. These soft outcomes, such as raised confidence and self-esteem, facilitated the hard outcomes such as educational achievement and voluntary work. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Price Sensitivity of Demand for Prescription Drugs

    DEFF Research Database (Denmark)

    Skipper, Lars; Simonsen, Marianne; Skipper, Niels

    This paper investigates price sensitivity of demand for prescription drugs using drug purchase records for at 20% random sample of the Danish population. We identify price responsiveness by exploiting exogenous variation in prices caused by kinked reimbursement schemes and implement a regression ...... education and income are, however, more responsive to the price. Also, essential drugs that prevent deterioration in health and prolong life have lower associated average price sensitivity....

  18. [Evaluation of quality medication prescription of a teaching hospital].

    Science.gov (United States)

    Araújo, Patrícia Taveira de Brito; Uchôa, Severina Alice Costa

    2011-01-01

    The errors from doctor prescriptions can cause damage to the patient's health, consequently it is necessary to identify and to prevent them. This work aimed to evaluate if the legal and institutional aspects that are present in doctor prescription at the public and university pediatric hospital to make a diagnosis from the situation, and then to correct the problems. A survey was made was made using a cross-sectional method, where copies of 1,590 prescriptions were studied after the University Committee of Research approved the survey. The average was 4.47 drugs per prescription and following data were detectable: readable--32.39% of the prescriptions were unreadable, 49.81% presented only the commercial name, 5.25% of the drugs were not standardized. Quality of prescription in the chosen hospital needs to be better to avoid medication errors and the health care process gets safer. When prescription is unreadable, they can confuse health professionals and damage patients.

  19. Increasing access to emergency contraception through online prescription requests.

    Science.gov (United States)

    Averbach, Sarah; Wendt, Jacqueline Moro; Levine, Deborah K; Philip, Susan S; Klausner, Jeffrey D

    2010-01-01

    To describe a pilot program, Plan B Online Prescription Access, to provide easy access to prescriptions for emergency contraception via the Internet. We measured electronic prescriptions for Plan B (Duramed Pharmaceuticals, Cincinnati, Ohio) by month over time. Pharmacists faxed patient-generated prescriptions back to the Department of Public Health for confirmation. Despite no marketing, within the first 18 months of the program, 152 electronic prescriptions for Plan B were requested by 128 female San Francisco residents. Seventy-eight prescriptions were filled (51%) by pharmacists. If correctly marketed, online prescriptions for Plan B have the potential to be an effective means of increasing emergency contraception access in both urban and rural settings across the United States. Further user-acceptability studies are warranted.

  20. Reviewing prescription spending and accessory usage.

    Science.gov (United States)

    Oxenham, Julie

    This article aims to explore the role of the stoma nurse specialist in the community and how recent initiatives within the NHS have impacted on the roles in stoma care to react to the rising prescription costs in the specialty. The article will explore how the stoma care nurse conducted her prescription reviews within her own clinical commissioning group (CCG). The findings of the reviews will be highlighted by a small case history and a mini audit that reveals that some stoma patients may be using their stoma care accessories inappropriately, which may contribute to the rise in stoma prescription spending. To prevent the incorrect use of stoma appliances it may necessitate an annual review of ostomates (individuals who have a stoma), as the author's reviews revealed that inappropriate usage was particularly commonplace when a patient may have not been reviewed by a stoma care specialist for some considerable amount of time. Initial education of the ostomate and ongoing education of how stoma products work is essential to prevent the misuse of stoma appliances, particularly accessories, as the reviews revealed that often patients were not always aware of how their products worked in practice.

  1. Prescription Drug Misuse and Sexual Behavior Among Young Adults.

    Science.gov (United States)

    Wells, Brooke E; Kelly, Brian C; Rendina, H Jonathon; Parsons, Jeffrey T

    2015-01-01

    Though research indicates a complex link between substance use and sexual risk behavior, there is limited research on the association between sexual risk behavior and prescription drug misuse. In light of alarming increases in prescription drug misuse and the role of demographic characteristics in sexual risk behavior and outcomes, the current study examined demographic differences (gender, sexual identity, age, relationship status, parental class background, and race/ethnicity) in sexual risk behavior, sexual behavior under the influence of prescription drugs, and sexual risk behavior under the influence of prescription drugs in a sample of 402 young adults (ages 18 to 29) who misused prescription drugs. Nearly half of the sexually active young adult prescription drug misusers in this sample reported recent sex under the influence of prescription drugs; more than three-quarters reported recent sex without a condom; and more than one-third reported recent sex without a condom after using prescription drugs. Zero-inflated Poisson regression models indicated that White race, younger age, higher parental class, and being a heterosexual man were all associated with sexual risk behavior, sex under the influence of prescription drugs, and sexual risk under the influence of prescription drugs. Findings have implications for the targeting of prevention and intervention efforts.

  2. Épidémiologie des brûlures de la main chez les enfants vus dans le Centre National des Brûlés et de Chirurgie Plastique de Casablanca, Maroc

    Science.gov (United States)

    Rafik, A.; Lahlou, M.; Diouri, M.; Bahechar, N.; Chlihi, A.

    2015-01-01

    Summary Les brûlures de la main chez l’enfant constituent une source de séquelles invalidantes. A cet régard, la conservation et la restauration complète de la fonction de la main demeurent le but primordial de la prise en charge. Afin de répertorier les caractéristiques épidémiologiques, cliniques et évolutives des mains brûlées, nous avons réalisé une étude rétrospective étalée sur 4 ans, de janvier 2011 à janvier 2015. Cette étude a permis de colliger les cas de 313 enfants atteints de brûlure de la main vus dans le Centre National des Brulés et de Chirurgie Plastique du CHU Ibn Rochd de Casablanca. La majorité des brûlures touche les enfants de 3 à 6 ans (70% des cas), avec une légère prédominance masculine. La principale cause des brûlures survenant à cet âge est l’ébouillantement. Les brûlures par flamme représentent 33% des cas, celles par électricité 4,5%. Les brûlures chimiques et par contact sont anecdotiques (1 cas chacune). L’accident survient le plus souvent à domicile. Soixante douze pour cent des brûlures ont guéri spontanément. Afin de diminuer l’incidence de ces accidents, une approche préventive faite de sensibilisation et d’éducation devrait faire partie du cursus scolaire. PMID:27777543

  3. Knowledge of drug prescription in dentistry students

    Directory of Open Access Journals (Sweden)

    Guzmán-Álvarez R

    2012-06-01

    Full Text Available R Guzmán-Álvarezv,1 M Medeiros,2,3 LI Reyes Lagunes,4 AE Campos-Sepúlveda11Pharmacology Department, UNAM School of Medicine and Dentistry, Mexico City, 2Pharmacology Clinical Seminar, UNAM School of Medicine, Mexico City, 3Medical Sciences Department, Mexico Federico Gómez Children's Hospital, Mexico City, 4Measuring and Evaluation Unit, UNAM School of Psychology, Mexico City, MexicoBackground: Students in schools of dentistry attend to patients with illnesses, and often prescribe medication. Because students are still learning, they are influenced by a variety of factors: the different teaching approaches of the professors at the clinics and in the pharmacology course, fellow students, and even the information provided by the pharmaceutical industry.Objectives: The aim of this pilot study was to assess the prescription knowledge and common mistakes in fourth-year students at the School of Dentistry at the Universidad Nacional Autónoma de México.Methods: In March 2010, a survey was conducted among 66 fourth-year students at the School of Dentistry, applying a previously validated questionnaire consisting of six open-ended questions The following factors were assessed: the most frequent illness requiring dental prescription; the most prescribed nonsteroidal anti-inflammatory drugs and antibiotics; the most frequent errors; sources of information used for prescribing drugs; and whether the students knew and followed the World Health Organization Guide to Good Prescribing.Results: The most frequent response for each question was considered the most significant. The most common reason for prescribing medication was infection (n = 37, 56%, followed by pain (n = 24, 38%; the most used painkillers were ibuprofen and acetaminophen at equal levels (n = 25, 37.8%, followed by ketorolac (n = 7, 10.6%, naproxen (n = 6, 9.1%, diclofenac (n = 2, 3%, and aspirin (n = 1, 1.5%; the most widely prescribed antibiotics were amoxicillin (n = 52, 78

  4. Diagnosis-prescription studies – important steps towards a national drug prescription statistics in Norway

    Directory of Open Access Journals (Sweden)

    Jørund Straand

    2009-11-01

    Full Text Available  ABSTRACTIn the first part of this article, drug utilization and prescribing practice is discussed as seen from aNorwegian general practice perspective. Which are the data sources available? What kind of studieshave been performed? Prescription-diagnosis studies are reviewed, in particular the Møre & RomsdalPrescription Study (MRPS. Because the wholesales drug statistics do not include information aboutneither patients, prescribers or diagnoses, there is a current need for establishing a more comprehensivestatistics giving wider and deeper insights into the prescribing and utilization of drugs in the Norwegiansociety. The proposed Norwegian prescription statistics is discussed in relation to previous experiencesfrom prescription-diagnosis studies and current needs for research and statistics in the field. Someexamples are given illustrating why the 11-digit person number probably should be included in thedatabase. Lack of diagnostic information may to some extent be compensated for by introducing a moredifferentiated list of diagnoses for the drugs reimbursed. The use of data from this statistics for qualityassurance in e.g. general practice is discussed. Finally, some suggestions are given for how the Norwegianprescription statistics may be organised.

  5. [Medicinal products for human use in veterinary prescription].

    Science.gov (United States)

    Kolář, Jozef; Vargová, Lucia; Ambrus, Tünde

    2015-09-01

    The paper deals with the problem of prescription and use of the medicinal products for human use in veterinary medicine. Using partial model analysis describes volume and structure of the prescription of medicinal products for human use in the veterinary practice in the years 2007-2011. Prescriptions included to the study were dispensed in a community pharmacy located in a county town in the Slovak Republic. Data were obtained from the basic collection of 845 veterinary prescriptions that included 1178 prescribed items in a total of 2954 packages.

  6. Prescription Writing Errors of Midwifery Students in Common Gynecological problems

    Directory of Open Access Journals (Sweden)

    Serveh Parang

    2014-04-01

    Full Text Available Background and aim: Giving improper prescriptions is common among medical practitioners, mostly graduates, in most communities even developed countries. So far, to our knowledge, no study has been conducted on prescription writing of graduate midwifery students. Therefore, this study aimed to detect prescription writing errors of midwifery students in common gynecological problems. Methods: In this descriptive cross-sectional study, 56 bachelor midwifery students, who had passed the theoretical and clinical courses of gynecology, were evaluated by Objective Structured Clinical Examination (OSCE. A demographic questionnaire and a standard checklist for writing the prescriptions and medications were used for data collection. SPSS Version 16 was used to carry out descriptive statistics. Findings: Most of the students were single, with the mean age of 23.0±1.7 years. Most errors were related to not recording the patients’ age and sex, diagnosis, chief complaint, and the prescriber’s name (observed in less than 10% of the prescriptions. The complete dosage schedule and drug name were stated only in 1.8±4.8 and 14±18.6 of prescriptions, respectively. In more than 93% of the cases, route of use and treatment duration were not recorded. Conclusion: According to the results, the number of prescription errors of midwifery students was high. Therefore, it is recommended to run educational courses on prescription writing skills (e.g. writing prescriptions based on World Health Organization (WHO guidelines for the midwifery students.

  7. Prescription of asthma medications before and during pregnancy in France

    DEFF Research Database (Denmark)

    Beau, Anna-Belle; Didier, Alain; Hurault-Delarue, Caroline;

    2016-01-01

    OBJECTIVE: Asthma affects between 3 to 8% of pregnant women. Previous studies have suggested that women's prescriptions for asthma medication change during pregnancy. The aim was to describe the prescription of asthma medications before and during pregnancy in France. METHODS: Women from the EFEM......OBJECTIVE: Asthma affects between 3 to 8% of pregnant women. Previous studies have suggested that women's prescriptions for asthma medication change during pregnancy. The aim was to describe the prescription of asthma medications before and during pregnancy in France. METHODS: Women from...

  8. Prescription analysis of pediatric outpatient practice in Nagpur city

    Directory of Open Access Journals (Sweden)

    Pandey Anuja

    2010-01-01

    Full Text Available Background: Medication errors are probably one of the most common types of medical errors, as medication is the most common health-care intervention. Knowing where and when errors are most likely to occur is generally felt to be the first step in trying to prevent these errors. Objective: To study prescribing patterns and errors in pediatric OPD prescriptions presenting to four community pharmacies across Nagpur city and to compare the prescription error rates across prescriber profiles. Materials and Methods: The study sample included 1376 valid pediatric OPD prescriptions presenting to four randomly selected community pharmacies in Nagpur, collected over a period of 2 months. Confirmed errors in the prescriptions were reviewed and analyzed. The core indicators for drug utilization studies, mentioned by WHO, were used to define errors. Results: The 1376 prescriptions included in the study were for a total of 3435 drugs, prescribed by 41 doctors. Fixed dose formulations dominated the prescribing pattern, many of which were irrational. Prescribing by market name was almost universal and generic prescriptions were for merely 254 (7.4% drugs. The prescribing pattern also indicated polypharmacy with the average number of drugs per encounter of 2.5. Antibiotics were included in 1087 (79% prescriptions, while injectable drugs were prescribed in 22 (1.6% prescriptions. The prescription error score varied significantly across prescriber profiles. Conclusion: The findings of our study highlight the continuing crisis of the irrational drug prescribing in the country.

  9. Mirror Prescription Regression: A Differential Interferometric Technique

    Directory of Open Access Journals (Sweden)

    Brian M. Robinson

    2010-01-01

    Full Text Available We present a remote, differential method for measuring the prescription of aspheric mirrors using null interferometry in the center-of-curvature configuration. The method requires no equipment beyond that used in a basic interferometery setup (i.e., there are no shearing elements or absolute distance meters. We chose this configuration because of its widespread use. However, the method is generalizable to other configurations with an adjustment of the governing equation. The method involves taking a series of interferograms before and after small, known misalignments are applied to the mirror in the interferometry setup and calculating the prescription (e.g., radius of curvature and conic constant of the mirror, based on these differential measurements, using a nonlinear regression. We apply this method successfully to the testing of a Space Optics Research Lab off-axis parabola with a known focal length of 152.4 mm, a diameter of 76.2 mm, and an off-axis angle of 12°.

  10. Quantitative Information on Oncology Prescription Drug Websites.

    Science.gov (United States)

    Sullivan, Helen W; Aikin, Kathryn J; Squiers, Linda B

    2016-09-02

    Our objective was to determine whether and how quantitative information about drug benefits and risks is presented to consumers and healthcare professionals on cancer-related prescription drug websites. We analyzed the content of 65 active cancer-related prescription drug websites. We assessed the inclusion and presentation of quantitative information for two audiences (consumers and healthcare professionals) and two types of information (drug benefits and risks). Websites were equally likely to present quantitative information for benefits (96.9 %) and risks (95.4 %). However, the amount of the information differed significantly: Both consumer-directed and healthcare-professional-directed webpages were more likely to have quantitative information for every benefit (consumer 38.5 %; healthcare professional 86.1 %) compared with every risk (consumer 3.1 %; healthcare professional 6.2 %). The numeric and graphic presentations also differed by audience and information type. Consumers have access to quantitative information about oncology drugs and, in particular, about the benefits of these drugs. Research has shown that using quantitative information to communicate treatment benefits and risks can increase patients' and physicians' understanding and can aid in treatment decision-making, although some numeric and graphic formats are more useful than others.

  11. Diabetic nephropathy: Prescription trends in tertiary care

    Directory of Open Access Journals (Sweden)

    Devi D

    2008-01-01

    Full Text Available Diabetic nephropathy is a leading cause of end stage renal disease. Drug utilization studies could promote rational drug use. The objective of this study was to evaluate prescribing trends in hospitalized patients with diabetic nephropathy. A prospective, observational study was conducted in a tertiary care hospital. The demographic, disease and treatment data of patients with diabetic nephropathy were collected for a period of six months and analysed. Drugs were classified using World Health Organization recommended Anatomic Therapeutic Chemical classification. A total of 755 drugs (7.4 drugs per prescription were prescribed to 102 study patients, who were all hypertensive and in late stages of diabetic nephropathy. Drug classes with largest representation were those acting on gastrointestinal tract plus metabolism (37% and cardiovascular drugs (28%. Calcium channel blockers represented the largest antihypertensive drug class (41%. Almost three-fourths of patients received more than one antihypertensive agent. Approximately 37% of patients did not receive any antidiabetic medication. Of those who did, prescriptions for insulin (91% exceeded those of oral hypoglycaemic drugs (9%. Antimicrobials accounted for 10.2% of all drugs prescribed, of which 31.8% were quinolones. Drugs prescribed by generic name accounted for 11.98%. While all patients received antihypertensive therapy, more than a third were not on any antidiabetic treatment. Antihypertensive poly-therapy was observed in the majority with calcium channel blockers being most frequently prescribed antihypertensive drug class. Insulin was the preferred to hypoglycaemic drugs.

  12. The NAL-NL2 prescription procedure

    Directory of Open Access Journals (Sweden)

    G. Keidser

    2011-03-01

    Full Text Available NAL-NL2 is the second generation of prescription procedures from The National Acoustic Laboratories (NAL for fitting wide dynamic range compression (WDRC instruments. Like its predecessor NALNL1 (Dillon, 1999, NAL-NL2 aims at making speech intelligible and overall loudness comfortable. This aim is mainly driven by a belief that these factors are most important for hearing aid users, but is also driven by the fact that less information is available about how to adjust gain to optimise other parameters that affect prescription such as localisation, tonal quality, detection of environmental sounds, and naturalness. In both formulas, the objective is achieved by combining a speech intelligibility model and a loudness model in an adaptive computer- controlled optimisation process. Adjustments have further been made to the theoretical component of NAL-NL2 that are directed by empirical data collected during the past decade with NAL-NL1. In this paper, the data underlying NAL-NL2 and the derivation procedure are presented, and the main differences from NAL-NL1 are outlined.

  13. How prescriptive norms influence causal inferences.

    Science.gov (United States)

    Samland, Jana; Waldmann, Michael R

    2016-11-01

    Recent experimental findings suggest that prescriptive norms influence causal inferences. The cognitive mechanism underlying this finding is still under debate. We compare three competing theories: The culpable control model of blame argues that reasoners tend to exaggerate the causal influence of norm-violating agents, which should lead to relatively higher causal strength estimates for these agents. By contrast, the counterfactual reasoning account of causal selection assumes that norms do not alter the representation of the causal model, but rather later causal selection stages. According to this view, reasoners tend to preferentially consider counterfactual states of abnormal rather than normal factors, which leads to the choice of the abnormal factor in a causal selection task. A third view, the accountability hypothesis, claims that the effects of prescriptive norms are generated by the ambiguity of the causal test question. Asking whether an agent is a cause can be understood as a request to assess her causal contribution but also her moral accountability. According to this theory norm effects on causal selection are mediated by accountability judgments that are not only sensitive to the abnormality of behavior but also to mitigating factors, such as intentionality and knowledge of norms. Five experiments are presented that favor the accountability account over the two alternative theories.

  14. Oximetry alone versus portable polygraphy for sleep apnea screening before bariatric surger

    OpenAIRE

    Malbois, M.

    2010-01-01

    Rapport de SynthèseIntroductionLa recherche des apnées du sommeil est recommandée dans la prise en charge préopératoire des patients obèses chez qui une chirurgie bariatrique est envisagée. Toutefois le type d'examen nécessaire pour la détection des apnées dans cette population reste encore discuté. L'objectif de cette étude était de comparer la sensibilité de l'oxymétrie par rapport à la polygraphie lors du screening préopératoire de l'apnée obstructive du sommeil.MéthodeNous avons analysé r...

  15. Alcohol and prescription drug safety in older adults

    Directory of Open Access Journals (Sweden)

    Zanjani F

    2013-02-01

    Full Text Available Faika Zanjani,1,2 Aasha I Hoogland,1 Brian G Downer11Department of Gerontology, 2Building Interdisciplinary Research Careers in Women's Health University of Kentucky, Lexington, KY, USABackground: The objectives of this study were to investigate older adults' knowledge of prescription drug safety and interactions with alcohol, and to identify pharmacists' willingness to disseminate prescription drug safety information to older adults.Methods: The convenience sample consisted of 48 older adults aged 54–89 years who were recruited from a local pharmacy and who completed surveys addressing their alcohol consumption, understanding of alcohol and prescription drug interactions, and willingness to change habits regarding alcohol consumption and prescription drugs. To address pharmacist willingness, 90 pharmacists from local pharmacies volunteered and answered questions regarding their willingness to convey prescription drug safety information to older adults.Results: Older adults reported low knowledge of alcohol and prescription drug safety, with women tending to be slightly more knowledgeable. More importantly, those who drank in the previous few months were less willing to talk to family and friends about how alcohol can have harmful interactions with prescription drugs, or to be an advocate for safe alcohol and prescription drug use than those who had not had a drink recently. Pharmacists reported that they were willing to convey prescription drug safety information to older adults via a variety of formats, including displaying or distributing a flyer, and directly administering a brief intervention.Conclusion: In this study, older adults were found to have inadequate knowledge of prescription drug safety and interactions with alcohol, but pharmacists who regularly come in contact with older adults indicated that they were ready and willing to talk to older adults about prescription drug safety. Future research should focus on interventions

  16. Prescription writing trends of antihistamines at the university health centre.

    Science.gov (United States)

    Kumar, Anil; Beenta

    2009-05-01

    The aim of the present study was to establish antihistamines drug prescribing pattern in order to improve the rational prescribing of antihistamines by physicians at Panjab University Health Centre. The study was performed in between the months of November 2005 to April 2006. Five hundred out patients were monitored and data was collected on WHO-based prescription-auditing performa. Demographic analysis of this prospective study revealed that out of the 500 patients, 293 (58.6 %) were male and 207 (41.4 %) were female and maximum patients were in the age group of 21-40 (34.8 %). Chlorpheniramine maleate (235 prescriptions) was the highest prescribed among antihistamine prescriptions (36.89 %) followed by diphenhydramine hydrochloride (186 prescriptions, 29.19%), cetirizine (175 prescriptions, 27.47 %) and promethazine (41 prescriptions, 6.4%). In comparison to generic drugs (169 prescriptions, 26.54%), branded were more prescribed at PUHC. Majority of antihistamines were in form of tablets (414 prescriptions, 64.99%) followed by liquid formulations (195 prescriptions, 30.61%) and injections (28 prescriptions, 4.40%). The average cost of different antihistamine drugs prescribed was as follows: diphenhydramine hydrochloride Rs. 34.74 followed by promethzine Rs. 22.46, chlorpheniramine maleate Rs. 15.30, and cetirizine Rs. 13.50. Average numbers of drugs prescribed per prescription were 1.27. The average consulting and dispensing time was 4.82 and 3.56 min, respectively. Out of the 500 university patients, 258 (51.6%) had the knowledge regarding the medication prescribed and 242 (48.4%) were unaware of the medication prescribed.

  17. Prescription writing trends of antihistamines at the university health centre

    Directory of Open Access Journals (Sweden)

    Kumar Anil

    2009-01-01

    Full Text Available The aim of the present study was to establish antihistamines drug prescribing pattern in order to improve the rational prescribing of antihistamines by physicians at Panjab University Health Centre. The study was performed in between the months of November 2005 to April 2006. Five hundred out patients were monitored and data was collected on WHO-based prescription-auditing performa. Demographic analysis of this prospective study revealed that out of the 500 patients, 293 (58.6 % were male and 207 (41.4 % were female and maximum patients were in the age group of 21-40 (34.8 %. Chlorpheniramine maleate (235 prescriptions was the highest prescribed among antihistamine prescriptions (36.89 % followed by diphenhydramine hydrochloride (186 prescriptions, 29.19%, cetirizine (175 prescriptions, 27.47 % and promethazine (41 prescriptions, 6.4%. In comparison to generic drugs (169 prescriptions, 26.54%, branded were more prescribed at PUHC. Majority of antihistamines were in form of tablets (414 prescriptions, 64.99% followed by liquid formulations (195 prescriptions, 30.61% and injections (28 prescriptions, 4.40%. The average cost of different antihistamine drugs prescribed was as follows: diphenhydramine hydrochloride Rs. 34.74 followed by promethzine Rs. 22.46, chlorpheniramine maleate Rs. 15.30, and cetirizine Rs. 13.50. Average numbers of drugs prescribed per prescription were 1.27. The average consulting and dispensing time was 4.82 and 3.56 min, respectively. Out of the 500 university patients, 258 (51.6% had the knowledge regarding the medication prescribed and 242 (48.4% were unaware of the medication prescribed.

  18. 21 CFR 1306.06 - Persons entitled to fill prescriptions.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Persons entitled to fill prescriptions. 1306.06 Section 1306.06 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS... either registered individually or employed in a registered pharmacy, a registered central fill pharmacy...

  19. 21 CFR 1306.22 - Refilling of prescriptions.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Refilling of prescriptions. 1306.22 Section 1306.22 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS Controlled... pharmacy for a period of two years from the dispensing date. This printout of the day's controlled...

  20. Pharmaceutical interventions on prescription problems in a Danish pharmacy setting

    DEFF Research Database (Denmark)

    Pottegård, Anton; Hallas, Jesper; Søndergaard, Jens

    2011-01-01

    International studies regarding pharmacists' interventions towards prescription problems produce highly variable results. The only peer-reviewed study in a Danish setting estimated an intervention rate of 2.3 per 1,000 prescriptions. With the introduction of a new tool for registration, we hypoth...

  1. Relationship between e-prescriptions and community pharmacy workflow.

    Science.gov (United States)

    Odukoya, Olufunmilola K; Chui, Michelle A

    2012-01-01

    To understand how community pharmacists use electronic prescribing (e-prescribing) technology and to describe the workflow challenges pharmacy personnel encounter as a result of using e-prescribing technology. Cross-sectional qualitative study. Seven community pharmacies in Wisconsin from December 2010 to March 2011. 16 pharmacists and 14 pharmacy technicians (in three chain and four independent pharmacies). Think-aloud protocols and pharmacy group interviews. Pharmacy staff descriptions of their use of e-prescribing technology and challenges encountered in their daily workflow related to this technology. Two contributing factors were perceived to influence e-prescribing workflow: issues stemming from prescribing or transmitting software and issues from within the pharmacy. Pharmacies experienced both delayed and inaccurate e-prescriptions from physician offices. An overwhelming number of e-prescriptions with inaccurate or unclear information resulted in serious time delays for patients as pharmacists contacted physicians to clarify wrong information. In addition, lack of formal training and the disconnect between pharmacy procedures for verifying prescription accuracy and presentation of e-prescription information on the computer screen influenced the speed of processing an e-prescription. E-prescriptions processing can hinder pharmacy workflow. As the number of e-prescriptions transmitted to pharmacies increases because of legislative mandates, it is essential that the technology supporting e-prescriptions (both on the prescriber and pharmacy operating systems) be redesigned to facilitate pharmacy workflow processes and to prevent unintended increase in medication errors, user frustration, and stress.

  2. Prescriptive Profile Procedure for Children With Learning Disabilities.

    Science.gov (United States)

    Levine, Eleanor; Fineman, Carol

    The Prescriptive Profile Procedure (PPP) attempts to provide teachers of learning disabled elementary school children with a procedure of individualized diagnosis and educational prescription which encompasses strengths and weaknesses in prerequisite skills, basic school subjects, and behavioral factors. A competency statement and six to 12…

  3. Asthma prescription patterns for children: can GPs do better?

    NARCIS (Netherlands)

    Uijen, J.H.J.M.; Wouden, J.C. van der; Schellevis, F.G.; Willemsen, S.P.; Suijlekom-Smit, L.W.A. van; Bindels, P.J.E.

    2011-01-01

    Background: Assessing prescription patterns of asthma medication for children is helpful to optimize prescribing by general practitioners (GPs). The aim was to explore prescription patterns in children with physician-diagnosed asthma and its determinants in general practice. Methods: We used the Sec

  4. Prescription Drug Abuse Information in D.A.R.E.

    Science.gov (United States)

    Morris, Melissa C.; Cline, Rebecca J. Welch; Weiler, Robert M.; Broadway, S. Camille

    2006-01-01

    This investigation was designed to examine prescription drug-related content and learning objectives in Drug Abuse Resistance Education (D.A.R.E.) for upper elementary and middle schools. Specific prescription-drug topics and context associated with content and objectives were coded. The coding system for topics included 126 topics organized…

  5. [Failure mode and effects analysis on computerized drug prescriptions].

    Science.gov (United States)

    Paredes-Atenciano, J A; Roldán-Aviña, J P; González-García, Mercedes; Blanco-Sánchez, M C; Pinto-Melero, M A; Pérez-Ramírez, C; Calvo Rubio-Burgos, Miguel; Osuna-Navarro, F J; Jurado-Carmona, A M

    2015-01-01

    To identify and analyze errors in drug prescriptions of patients treated in a "high resolution" hospital by applying a Failure mode and effects analysis (FMEA).Material and methods A multidisciplinary group of medical specialties and nursing analyzed medical records where drug prescriptions were held in free text format. An FMEA was developed in which the risk priority index (RPI) was obtained from a cross-sectional observational study using an audit of the medical records, carried out in 2 phases: 1) Pre-intervention testing, and (2) evaluation of improvement actions after the first analysis. An audit sample size of 679 medical records from a total of 2,096 patients was calculated using stratified sampling and random selection of clinical events. Prescription errors decreased by 22.2% in the second phase. FMEA showed a greater RPI in "unspecified route of administration" and "dosage unspecified", with no significant decreases observed in the second phase, although it did detect, "incorrect dosing time", "contraindication due to drug allergy", "wrong patient" or "duplicate prescription", which resulted in the improvement of prescriptions. Drug prescription errors have been identified and analyzed by FMEA methodology, improving the clinical safety of these prescriptions. This tool allows updates of electronic prescribing to be monitored. To avoid such errors would require the mandatory completion of all sections of a prescription. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  6. Prosthetic prescription in the Netherlands: An observational study

    NARCIS (Netherlands)

    Van Der Linde, H.; Geertzen, J.H.B.; Hofstad, C.J.; Van Limbeek, J.; Postema, K.

    2003-01-01

    Prosthetic prescription for lower limb amputees and the methodology used are primarily based on empirical knowledge. Clinical expertise plays an important role that can lead to an adequate prescription; however, a clear evidence based motivation for the choices made cannot be given. This can lead to

  7. Pattern of prescription drug use in Nigerian army hospitals

    African Journals Online (AJOL)

    To our knowledge, only few studies have been done in Africa on this issue , with inadequate ... high number of drugs per prescription, high rate of antibiotic usage and unscientific prescription by doctors. ..... the managers of Nigerian public health institutions through the ... use promotes drug resistance, increases risk of side.

  8. Preventing Prescription Drug Abuse in Adolescence: A Collaborative Approach

    Science.gov (United States)

    Jones, Beth A.; Fullwood, Harry; Hawthorn, Melissa

    2012-01-01

    With the growing awareness of adolescent prescription drug abuse, communities and schools are beginning to explore prevention and intervention strategies which are appropriate for their youth. This article provides a framework for developing a collaborative approach to prescription drug abuse prevention--called the Prevention Awareness Team--that…

  9. Asthma prescription patterns for children: can GPs do better?

    NARCIS (Netherlands)

    Uijen, J.H.J.M.; Wouden, J.C. van der; Schellevis, F.G.; Willemsen, S.P.; Suijlekom-Smit, L.W.A. van; Bindels, P.J.E.

    2011-01-01

    Background: Assessing prescription patterns of asthma medication for children is helpful to optimize prescribing by general practitioners (GPs). The aim was to explore prescription patterns in children with physician-diagnosed asthma and its determinants in general practice. Methods: We used the

  10. 21 CFR 202.1 - Prescription-drug advertisements.

    Science.gov (United States)

    2010-04-01

    ...) DRUGS: GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug advertisements. (e) * * * (6... drug, nor may an advertisement contain a quantitative statement of safety or effectiveness (a) unless... effectiveness is supported by substantial evidence derived from adequate and well-controlled studies as defined...

  11. Overview of Four Prescription Monitoring/Review Programs in Canada

    Directory of Open Access Journals (Sweden)

    Andrea D Furlan

    2014-01-01

    Full Text Available BACKGROUND: Prescription monitoring or review programs collect information about prescription and dispensing of controlled substances for the purposes of monitoring, analysis and education. In Canada, it is the responsibility of the provincial institutions to organize, maintain and run such programs.

  12. Recognizing Signs of Prescription Drug Abuse and Addiction, Part I.

    Science.gov (United States)

    Felicilda-Reynaldo, Faye D

    2014-01-01

    Prescription drug abuse/misuse is increasing. Nonmedical use of prescription medications, especially opioid analgesics, now is considered an epidemic in the United States. Medical-surgical nurses are in a strategic position to help address substance abuse problems in patients.

  13. EXERCISE ON PRESCRIPTION AUDIT : A TOOL FOR PHARMACOLOGY PRACTICAL LESSON

    Directory of Open Access Journals (Sweden)

    Supreeti Biswas

    2012-07-01

    Full Text Available To improve the understanding and perception about rational prescribing among the Undergraduate (UG students, a record based study 'exercise on prescription audit' was undertaken as self-directed learning strategy. Study was conducted on Objectively Structured Evaluation of pharmacotherapy taking one year record of prescriptions in Bed Head Tickets (BHTs of discharged Ophthalmic in-patients. Standard format for prescription writing, WHO guide to Good prescribing and Essential Medicines were followed to assess the in-patient prescriptions. Students improved markedly (p< 0.001 in audit of real prescriptions. Results revealed that 37 types of drugs were prescribed over 948 BHTs. Completeness of the prescription showed 100% perfection in maximum indicators with exception in judicious investigations (99.89%, medication information (89.32% and relevant advices for patient (97.12%. Subsidiary or symptomatic drugs (56.76% were prescribed more than the core drugs (43.24% of total drugs prescribed. Generic prescription was 54.05%. Study in turn improved the understanding and perception about rational prescribing among the students. The students gained knowledge about the utilization of different types of dosage forms of drugs. Prescription audit as self-directed learning must be a tool for practical lesson of Pharmacology for UG-course as well as for PG-curriculum.

  14. Nonmedical Prescription Drug Use among Midwestern Rural Adolescents

    Science.gov (United States)

    Park, Nicholas K.; Melander, Lisa; Sanchez, Shanell

    2016-01-01

    Prescription drug misuse has been an increasing problem in the United States, yet few studies have examined the protective factors that reduce risk of prescription drug abuse among rural adolescents. Using social control theory as a theoretical framework, we test whether parent, school, and community attachment reduce the likelihood of lifetime…

  15. 77 FR 8174 - EPAAR Prescription for Work Assignments

    Science.gov (United States)

    2012-02-14

    ... revised language communicates to contract personnel and program staff that government cost-related... (EPA). ACTION: Final rule. SUMMARY: EPA will amend the EPA Acquisition Regulation (EPAAR) prescription for the work assignment clause. This final rule provides revised language to the prescription for the...

  16. 76 FR 26232 - EPAAR Prescription for Work Assignments

    Science.gov (United States)

    2011-05-06

    ... Acquisition Regulation (EPAAR) to update policy, procedures, and contract clauses. The proposed rule provides revised language to the prescription for the work assignment clause, incorporating prescriptive language that provides further instructions on use of the related clause. DATES: Comments must be received on or...

  17. Do Physicians Change Prescription Practice in Response to Financial Incentives?

    Science.gov (United States)

    Park, Sylvia; Han, Euna

    2016-07-01

    We assessed the impact on physician prescription behaviors of an outpatient prescription incentive program providing financial rewards to primary care physicians for saving prescription costs in South Korea. A 10% sample of clinics (N = 1,625) was randomly selected from all clinics in the National Health Insurance claims database for the years 2009-2012, and all claims with the primary diagnosis of peptic ulcer or gastro-esophageal reflux diseases were extracted from those clinics' data. A clinic-level random-effects model was used. After the program, clinics in general medicine showed a lower prescription rate (by 0.8 percentage points), lower number of medicines prescribed (by 0.02), lower prescription duration (by 0.15 days), and lower drug expenditure per claim (by 740 won). Small clinics on the <25th percentile of a regional sum of monthly drug expenditure had shorter prescription duration (by 0.76 days), while large clinics on the ≥75th percentile and clinics in group practice had a higher prescription rate (by 1.5 and 2.5 percentage points, respectively) and a higher number of medicines prescribed (by 0.03 for group practice only) after the program. The outpatient prescription incentive program worked as intended only in certain subgroup clinics for the target medicines.

  18. Controversy in Purchasing Prescription Drugs Online in China.

    Science.gov (United States)

    Yuan, Peng; Qi, Lin; Wang, Long

    2016-08-01

    China's government is considering legalization of online prescription drugs to increase the pharmaceutical market and enhance access to necessary medicines. However, challenges such as a shortage of licensed pharmacists and drug quality issues have raised concerns and delayed consensus on the proposal. China's government must address the most pressing issues so it can render a decision on online prescription sales.

  19. 77 FR 20637 - Request for Information on Prescription Medication Adherence

    Science.gov (United States)

    2012-04-05

    ... HUMAN SERVICES Request for Information on Prescription Medication Adherence AGENCY: Department of Health... potential solutions associated with the public health problem of prescription medication non-adherence in..., health care providers, and industry and private organizations in efforts to improve medication...

  20. Prosthetic prescription in the Netherlands : an observational study

    NARCIS (Netherlands)

    van der Linde, H; Geertzen, JHB; Hofstad, CJ; Postema, K

    2003-01-01

    Prosthetic prescription for lower limb amputees and the methodology used are primarily based on empirical knowledge. Clinical expertise plays an important role that can lead to an adequate prescription; however, a clear evidence based motivation for the choices made cannot be given. This can lead to

  1. Prescription Drug Monitoring Programs and Other Interventions to Combat Prescription Opioid Abuse

    Directory of Open Access Journals (Sweden)

    Bharath Chakravarthy

    2012-12-01

    Full Text Available The Center for Disease Control and Prevention (CDC has published significant data and trendsrelated to opioid prescription pain relievers (OPR. In 2008, 20,044 deaths were attributedto prescription drug overdose of which 14,800 (73.8% were due to OPR, an amount greaterthan the number of overdose deaths from heroin and cocaine combined. The majority of thesedeaths were unintentional. Between 1999-2008, overdose deaths from OPR increased almostfour-fold. Correspondingly, sales of OPR were four times greater in 2010 than in 1999. Mostsignificant to emergency physicians is the estimate that 39% of all opioids prescribed, administeredor continued come from the emergency department (ED. We present findings from theCDC’s Morbidity and Mortality Weekly Report (MMWR with commentary on current recommendationsand policies for curtailing the OPR epidemic.1

  2. The appropriateness of a proton pump inhibitor prescription.

    LENUS (Irish Health Repository)

    Moran, N

    2014-11-01

    Proton pump inhibitors (PPIs) are one of the most commonly prescribed groups of drug in Ireland, at great expense to the Irish healthcare executive. This study aims to evaluate the appropriateness of PPI prescriptions on admission and discharge in a tertiary referral hospital. All non-elective admissions in the Emergency Department in one week were included in the study. 102 patients in total were included, with 36 (35.4%) treated with a PPI on admission. Of these, only 3 (8.3%) had a clear indication noted as per current NICE guidelines. 18 new in-hospital PPI prescriptions were documented. 11 (61%) of which were present on discharge prescriptions. Continuing PPI prescription on discharge into the community may be inappropriate, costly and potentially harmful. Brief interventions aimed at reducing inappropriate PPI prescriptions have been shown to be effective at reducing the cost and potential harm of unnecessary treatment.

  3. Delayed antibiotic prescriptions for respiratory infections.

    Science.gov (United States)

    Spurling, Geoffrey Kp; Del Mar, Chris B; Dooley, Liz; Foxlee, Ruth; Farley, Rebecca

    2017-09-07

    Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost, and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007, and updated in 2010 and 2013. To evaluate the effects on clinical outcomes, antibiotic use, antibiotic resistance, and patient satisfaction of advising a delayed prescription of antibiotics in respiratory tract infections. For this 2017 update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, Issue 4, 2017), which includes the Cochrane Acute Respiratory Infection Group's Specialised Register; Ovid MEDLINE (2013 to 25 May 2017); Ovid Embase (2013 to 2017 Week 21); EBSCO CINAHL Plus (1984 to 25 May 2017); Web of Science (2013 to 25 May 2017); WHO International Clinical Trials Registry Platform (1 September 2017); and ClinicalTrials.gov (1 September 2017). Randomised controlled trials involving participants of all ages defined as having an RTI, where delayed antibiotics were compared to immediate antibiotics or no antibiotics. We defined a delayed antibiotic as advice to delay the filling of an antibiotic prescription by at least 48 hours. We considered all RTIs regardless of whether antibiotics were recommended or not. We used standard Cochrane methodological procedures. Three review authors independently extracted and collated data. We assessed the risk of bias of all included trials. We contacted trial authors to obtain missing information. For this 2017 update we added one new trial involving 405 participants with uncomplicated acute respiratory infection. Overall, this review included 11 studies with a total of 3555 participants. These 11 studies involved acute respiratory infections including acute otitis media (three studies

  4. How do community pharmacies recover from e-prescription errors?

    Science.gov (United States)

    Odukoya, Olufunmilola K; Stone, Jamie A; Chui, Michelle A

    2014-01-01

    The use of e-prescribing is increasing annually, with over 788 million e-prescriptions received in US pharmacies in 2012. Approximately 9% of e-prescriptions have medication errors. To describe the process used by community pharmacy staff to detect, explain, and correct e-prescription errors. The error recovery conceptual framework was employed for data collection and analysis. 13 pharmacists and 14 technicians from five community pharmacies in Wisconsin participated in the study. A combination of data collection methods were utilized, including direct observations, interviews, and focus groups. The transcription and content analysis of recordings were guided by the three-step error recovery model. Most of the e-prescription errors were detected during the entering of information into the pharmacy system. These errors were detected by both pharmacists and technicians using a variety of strategies which included: (1) performing double checks of e-prescription information; (2) printing the e-prescription to paper and confirming the information on the computer screen with information from the paper printout; and (3) using colored pens to highlight important information. Strategies used for explaining errors included: (1) careful review of patient's medication history; (2) pharmacist consultation with patients; (3) consultation with another pharmacy team member; and (4) use of online resources. In order to correct e-prescription errors, participants made educated guesses of the prescriber's intent or contacted the prescriber via telephone or fax. When e-prescription errors were encountered in the community pharmacies, the primary goal of participants was to get the order right for patients by verifying the prescriber's intent. Pharmacists and technicians play an important role in preventing e-prescription errors through the detection of errors and the verification of prescribers' intent. Future studies are needed to examine factors that facilitate or hinder recovery

  5. How do Community Pharmacies Recover from E-prescription Errors?

    Science.gov (United States)

    Odukoya, Olufunmilola K.; Stone, Jamie A.; Chui, Michelle A.

    2014-01-01

    Background The use of e-prescribing is increasing annually, with over 788 million e-prescriptions received in US pharmacies in 2012. Approximately 9% of e-prescriptions have medication errors. Objective To describe the process used by community pharmacy staff to detect, explain, and correct e-prescription errors. Methods The error recovery conceptual framework was employed for data collection and analysis. 13 pharmacists and 14 technicians from five community pharmacies in Wisconsin participated in the study. A combination of data collection methods were utilized, including direct observations, interviews, and focus groups. The transcription and content analysis of recordings were guided by the three-step error recovery model. Results Most of the e-prescription errors were detected during the entering of information into the pharmacy system. These errors were detected by both pharmacists and technicians using a variety of strategies which included: (1) performing double checks of e-prescription information; (2) printing the e-prescription to paper and confirming the information on the computer screen with information from the paper printout; and (3) using colored pens to highlight important information. Strategies used for explaining errors included: (1) careful review of patient’ medication history; (2) pharmacist consultation with patients; (3) consultation with another pharmacy team member; and (4) use of online resources. In order to correct e-prescription errors, participants made educated guesses of the prescriber’s intent or contacted the prescriber via telephone or fax. When e-prescription errors were encountered in the community pharmacies, the primary goal of participants was to get the order right for patients by verifying the prescriber’s intent. Conclusion Pharmacists and technicians play an important role in preventing e-prescription errors through the detection of errors and the verification of prescribers’ intent. Future studies are needed

  6. Identification and management of prescription drug abuse in pregnancy.

    Science.gov (United States)

    Worley, Julie

    2014-01-01

    Prescription drug abuse is a growing problem in the United States and many other countries. Estimates of prescription drug abuse rates during pregnancy range from 5% to 20%. The primary prescription drugs designated as controlled drugs with abuse potential in pregnancy are opiates prescribed for pain, benzodiazepines prescribed for anxiety, and stimulants prescribed for attention-deficit/hyperactivity disorder. Prescription drugs are obtained for abuse through diversion methods, such as purchasing them from others or by doctor shopping. The use of prescription drugs puts both the mother and the fetus at high risk during pregnancy. Identification of women who are abusing prescription drugs is important so that treatment can be ensured. It is crucial for healthcare professionals to use a multidisciplinary approach and be supportive and maintain a good rapport with pregnant women who abuse prescription drugs. Management includes inpatient hospitalization for detoxification and withdrawal symptoms, and in the case of opiate abuse, opiate maintenance is recommended for pregnant women for the duration of their pregnancy to reduce relapse rates and improve maternal and fetal outcomes. Other recommendations include referral for support groups and supportive housing.

  7. Prescription-induced jump distributions in multiplicative Poisson processes

    Science.gov (United States)

    Suweis, Samir; Porporato, Amilcare; Rinaldo, Andrea; Maritan, Amos

    2011-06-01

    Generalized Langevin equations (GLE) with multiplicative white Poisson noise pose the usual prescription dilemma leading to different evolution equations (master equations) for the probability distribution. Contrary to the case of multiplicative Gaussian white noise, the Stratonovich prescription does not correspond to the well-known midpoint (or any other intermediate) prescription. By introducing an inertial term in the GLE, we show that the Itô and Stratonovich prescriptions naturally arise depending on two time scales, one induced by the inertial term and the other determined by the jump event. We also show that, when the multiplicative noise is linear in the random variable, one prescription can be made equivalent to the other by a suitable transformation in the jump probability distribution. We apply these results to a recently proposed stochastic model describing the dynamics of primary soil salinization, in which the salt mass balance within the soil root zone requires the analysis of different prescriptions arising from the resulting stochastic differential equation forced by multiplicative white Poisson noise, the features of which are tailored to the characters of the daily precipitation. A method is finally suggested to infer the most appropriate prescription from the data.

  8. [Inappropriate prescription in older patients: the STOPP/START criteria].

    LENUS (Irish Health Repository)

    Delgado Silveira, Eva

    2009-09-01

    Older people are a heterogeneous group of patients, often with multiple comorbidities for which they are prescribed a large number of drugs, leading to an increased risk of adverse drug reactions (ADR) and drug interactions. This risk is compounded by physiological age-related changes in physiology, changes in drug pharmacokinetics and pharmacodynamics, as well as by disease-related, functional and social issues. Inappropriate prescription of drugs is common in the older individuals and contributes to the increased risk of ADR. Several tools have been developed to detect potentially inappropriate prescription, the most frequently used in Spain being Beers\\' criteria. However, the value of these criteria is limited, especially as they were developed in a different healthcare system. In this article, the Spanish version of a new tool to detect potentially inappropriate prescriptions-STOPP (Screening Tool of Older Person\\'s Prescriptions) and START (Screening Tool to Alert doctors to Right i.e. appropriate, indicated Treatment) criteria-is presented. The creation, development, reliability, and use of these criteria in routine practice is described and discussed. These criteria have shown better sensitivity than Beers\\' criteria in detecting prescription problems and have the added value of being able to detect not only inappropriate prescription of some drugs, but also the omission of well indicated drugs. The STOPP\\/START criteria could become a useful screening tool to improve prescription in older people.

  9. Influence of pharmaceutical marketing on prescription practices of physicians.

    Science.gov (United States)

    Narendran, Roshni; Narendranathan, M

    2013-01-01

    In India same drug molecules are sold under different brand names by different pharmaceuticals. To persuade the physicians to prescribe their brands pharmaceuticals engage in marketing techniques like giving samples, gifts, sponsoring travel etc. Many countries are striving to reduce the impact of incentives on prescription behaviour. This study explores the influence of pharmaceutical marketing on the prescription practices of doctors in India. There were 103 study subjects - 50 doctors and 53 sales personnel. Data collection was done by a self administered questionnaire. Data were collected on 36 variables which were supposed to influence prescription. The effectiveness of the promotional strategies on prescription behaviour was marked in a seven point Likert scale ranging from "not at all effective" (score=1) to "extremely effective" (score=7). Open ended questions were used to collect qualitative data. Good rapport with the doctor, launch meetings, reputation of the company, quality of the drug and brand names significantly influenced prescription behaviour, while direct mailers, advertisements in journals and giving letter pads and other brand reminders were less effective. Commonly used method of giving samples was not among the twenty most effective methods influencing prescription. Product quality and good company are still factors that influence prescription. Pharmaceutical marketing influences the choice of brands by a physician. The more expensive strategies involved in public relations are more effective. Sending mails and journal advertisements are less effective strategies. How expensive marketing strategies affect cost of the medicines has to be explored further.

  10. Geographical and temporal variations in clozapine prescription for schizophrenia

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Røge, Rasmus; Schjerning, Ole

    2012-01-01

    Despite its unsurpassed efficacy in treatment-resistant schizophrenia, clozapine remains underutilized. Trends in the prescription of clozapine in patients with ICD-10 F20.x schizophrenia were assessed using data from Danish national registers. Three substudies were carried out: (i) an assessment...... of differences in national prescription patterns between 1996 and 2007 using a cross-sectional design; (ii) a comparison of time from first schizophrenia diagnosis to first prescription of clozapine in a five-year cohort study, using the Cox regression model, of two patient groups who were first diagnosed...

  11. Future Challenges and Opportunities in Online Prescription Drug Promotion Research

    Science.gov (United States)

    Southwell, Brian G.; Rupert, Douglas J.

    2016-01-01

    Despite increased availability of online promotional tools for prescription drug marketers, evidence on online prescription drug promotion is far from settled or conclusive. We highlight ways in which online prescription drug promotion is similar to conventional broadcast and print advertising and ways in which it differs. We also highlight five key areas for future research: branded drug website influence on consumer knowledge and behavior, interactive features on branded drug websites, mobile viewing of branded websites and mobile advertisements, online promotion and non-US audiences, and social media and medication decisions. PMID:26927597

  12. The study of prescriptive and descriptive models of decision making

    Directory of Open Access Journals (Sweden)

    Ashok A Divekar

    2012-04-01

    Full Text Available The field of decision making can be loosely divided into two parts: the study of prescriptive models and the study of descriptive models. Prescriptive decision scientists are concerned with prescribing methods for making optimal decisions. Descriptive decision researchers are concerned with the bounded way in which the decisions are actually made. The statistics courses treat risk from a prescriptive, by suggesting rational methods. This paper brings out the work done by many researchers by examining the psychological factors that explain how managers deviate from rationality in responding to uncertainty.

  13. Viscosity prescription for gravitationally unstable accretion disks

    CERN Document Server

    Rafikov, Roman R

    2015-01-01

    Gravitationally unstable accretion disks emerge in a variety of astrophysical contexts - giant planet formation, FU Orioni outbursts, feeding of AGNs, and the origin of Pop III stars. When a gravitationally unstable disk is unable to cool rapidly it settles into a quasi-stationary, fluctuating gravitoturbulent state, in which its Toomre Q remains close to a constant value Q_0~1. Here we develop an analytical formalism describing the evolution of such a disk, which is based on the assumptions of Q=Q_0 and local thermal equilibrium. Our approach works in the presence of additional sources of angular momentum transport (e.g. MRI), as well as external irradiation. Thermal balance dictates a unique value of the gravitoturbulent stress \\alpha_{gt} driving disk evolution, which is a function of the local surface density and angular frequency. We compare this approach with other commonly used gravitoturbulent viscosity prescriptions, which specify the explicit dependence of stress \\alpha_{gt} on Toomre Q in an ad hoc...

  14. A new strategy for antidepressant prescription

    Directory of Open Access Journals (Sweden)

    Francis Lavergne

    2010-11-01

    Full Text Available From our research and literature search we propose an understanding of the mechanism of action of antidepressants (ADs that should lead to increase efficacy and tolerance.We understand that ADs promote synaptic plasticity and neurogenesis. This promotion is linked with dopamine (DA stimulation. Literature shows that all ADs (chemical, electroconvulsive therapy, repetitive transcranial magnetic stimulation, sleep deprivation increase at least one neuromodulator (serotonin, noradrenaline or DA; this article focuses on DA release or turn-over in the frontal cortex. DA increase promotes synaptic plasticity with an inverted U shape dose-response curve. Specific interaction between DA and glutamate relies on DA (D1 receptors and Glutamate (NMDA receptors and/or on neurotrophic factors activation. With the understanding that all ADs have a common, final, DArgic stimulation that promotes synaptic plasticity we can predict that:1AD efficiency is related to the compound strength for inducing DArgic stimulation.2AD efficiency presents a therapeutic window that coincides with the inverted U shape DA response curve.3AD delay of action is related to a synaptogenesis and neurogenesis delay of action.4The minimum efficient dose can be found by starting at a low dosage and increasing up to the patient response. 5An increased tolerance requires a concomitant prescription of a few ADs, with different or opposite adverse effects, at a very low dose.6ADs could improve all diseases with cognitive impairments and synaptic depression by increasing synaptic plasticity and neurogenesis.

  15. Expanded pharmacy technician roles: Accepting verbal prescriptions and communicating prescription transfers.

    Science.gov (United States)

    Frost, Timothy P; Adams, Alex J

    2016-11-29

    As the role of the clinical pharmacist continues to develop and advance, it is critical to ensure pharmacists can operate in a practice environment and workflow that supports the full deployment of their clinical skills. When pharmacy technician roles are optimized, patient safety can be enhanced and pharmacists may dedicate more time to advanced clinical services. Currently, 17 states allow technicians to accept verbal prescriptions called in by a prescriber or prescriber's agent, or transfer a prescription order from one pharmacy to another. States that allow these activities generally put few legal limitations on them, and instead defer to the professional judgment of the supervising pharmacist whether to delegate these tasks or not. These activities were more likely to be seen in states that require technicians to be registered and certified, and in states that have accountability mechanisms (e.g., discipline authority) in place for technicians. There is little evidence to suggest these tasks cannot be performed safely and accurately by appropriately trained technicians, and the track record of success with these tasks spans four decades in some states. Pharmacists can adopt strong practice policies and procedures to mitigate the risk of harm from verbal orders, such as instituting read-back/spell-back techniques, or requiring the indication for each phoned-in medication, among other strategies. Pharmacists may also exercise discretion in deciding to whom to delegate these tasks. As the legal environment becomes more permissive, we foresee investment in more robust education and training of technicians to cover these activities. Thus, with the adoption of robust practice policies and procedures, delegation of verbal orders and prescription transfers can be safe and effective, remove undue stress on pharmacists, and potentially free up pharmacist time for higher-order clinical care. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. How Typewriters Changed Correspondence: An Analysis of Prescription and Practice.

    Science.gov (United States)

    Walker, Sue

    1984-01-01

    Notes changes in the visual organization of correspondence brought about by the typewriter. Discusses the development of these changes, drawing examples both from the prescriptions for and the practice of commercial correspondence. (FL)

  17. The Language of Civil Engineering: Descriptive, Prescriptive, and Persuasive.

    Science.gov (United States)

    Machauf, Liora

    1990-01-01

    Focuses on the language of civil engineering as manifested in the professional journal "Civil Engineering ASCE." Articles are analyzed, both syntactically and lexically, in terms of three major rhetorical functions: description, prescription, and persuasion. (17 references) (GLR)

  18. Buying Prescription Medicine Online: A Consumer Safety Guide

    Science.gov (United States)

    ... Seniors Tips for Parents En Español Prescription Drug Advertising Information for Healthcare Professionals (Drugs) FDA Drug Info ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  19. Investigation of Medication Errors: A Prescription Survey from Sri ...

    African Journals Online (AJOL)

    Conclusion: Prescription errors are common in outpatient settings of Aluthgama and Kandy areas in. Sri Lanka. ..... irrational drug use in India were similar to the results that were .... and nature of dosing errors in paediatric medications:.

  20. 75 FR 16235 - Electronic Prescriptions for Controlled Substances

    Science.gov (United States)

    2010-03-31

    ...; these include opioids, stimulants, depressants, hallucinogens, anabolic steroids, and drugs that are... consequences of prescription drug abuse are seen in the data collected by the Substance Abuse and Mental...

  1. The “Black Box” of Prescription Drug Diversion

    Science.gov (United States)

    Inciardi, James A.; Surratt, Hilary L.; Cicero, Theodore J.; Kurtz, Steven P.; Martin, Steven S.; Parrino, Mark W.

    2009-01-01

    A variety of surveys and studies are examined in an effort to better understand the scope of prescription drug diversion and to determine if there are consistent patterns of diversion among various populations of prescription drug abusers. Data are drawn from the RADARS® System, the National Survey of Drug Use and Health (NSDUH), the Delaware School Survey, and a series of quantitative and qualitative studies conducted in Miami, Florida. The data suggest that the major sources of diversion include drug dealers, friends and relatives, smugglers, pain patients, and the elderly, but these vary by the population being targeted. In all of the studies examined, the use of the Internet as a source for prescription drugs is insignificant. Little is known about where drug dealers are obtaining their supplies, and as such, prescription drug diversion is a “black box” requiring concentrated systematic study. PMID:20155603

  2. Prescription and Cost Consideration at a Diabetic Clinic in Ibadan ...

    African Journals Online (AJOL)

    opsig

    Prescription and Cost Consideration at a Diabetic Clinic in Ibadan,. Nigeria: A Report ... drugs with proven efficacy based on best evidence, the prevailing social ... pharmacy using the current hospital drug-pricing list calculated the cost of the ...

  3. Which Classes of Prescription Drugs Are Commonly Misused?

    Science.gov (United States)

    ... may include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and involuntary leg movements. 29 Misuse of prescription opioids is also a risk factor for transitioning to heroin use. Read more about ...

  4. Opioid prescriptions before and after high-energy trauma

    DEFF Research Database (Denmark)

    Zwisler, Stine T; Hallas, Jesper; Larsen, Morten S

    2015-01-01

    OBJECTIVE: To describe the legal use of opioids in adult patients before and after high-energy trauma. DESIGN: The study was a retrospective database study. SETTING: Clinical care outside hospitals. PATIENTS: All patients who suffered high-energy trauma and were brought to Odense University...... Hospital (OUH), Denmark, in 2007 and 2008 were retrieved from the trauma database. These patients were linked with data on opioid use from the regional prescription database. In all, 938 patients were included. MAIN OUTCOME MEASURE: Redemption of opioid prescription during the 6 months prior...... to a multitrauma or redemption of two or more prescriptions for opioids 6 months or later after a multitrauma. RESULTS: Of the 938 patients brought to OUH with severe trauma within the study period, 61 patients died (7 percent) and six of these had redeemed prescriptions for opioids within 6 months prior...

  5. Toward Validation of the Diagnostic-Prescriptive Model

    Science.gov (United States)

    Ysseldyke, James E.; Sabatino, David A.

    1973-01-01

    Criticized are recent research efforts to validate the diagnostic prescriptive model of remediating learning disabilities, and proposed is a 6-step psychoeducational model designed to ascertain links between behavioral differences and instructional outcomes. (DB)

  6. Prescription patterns and utilisation of antihypertensive drugs in a ...

    African Journals Online (AJOL)

    Prescription patterns and utilisation of antihypertensive drugs in a specialist ... use in the management of essential hypertension in a specialist hospital and its ... of encounters, there were a total of 1544 drugs and 28 non-drug interventions.

  7. Pattern of Prescription of Antibiotics among Dental Practitioners in ...

    African Journals Online (AJOL)

    consistency in the antibiotic prescription pattern among dentists in Jeddah and overall low adherence to the ..... manuscript editing and review. Appendix I: Clinical case ... adhesion deficiency, antibiotic therapy is indicated. a*Adapted from ...

  8. Immersible ergocycle prescription as a function of relative exercise intensity

    Directory of Open Access Journals (Sweden)

    Mauricio Garzon

    2017-06-01

    Conclusion: The %HRR–%VO2R relationship appears to be the most accurate for exercise training prescription on IE. This study offers new tools to better prescribe, control, and individualize exercise intensity on IE.

  9. Forest Management Prescription : Compartment 9 : Mingo National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This is the Forest Management Prescription for Compartment 9 of Mingo NWR. It provides a description of the compartment, management objectives, proposed management...

  10. prescriptions involving analgesic drugs at a secondary health facility ...

    African Journals Online (AJOL)

    per patient were recorded and prescriptions involving analgesics were further ... documentation of any untoward effects in the over ... files were sent to the Pharmacy Department of the ..... Efficacy and safety of metamizol vs. acetylsalicylic acid.

  11. Basic Stand Alone Medicare Prescription Drug Events PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This is a Public Use File for Prescription Drug Events drawn from the 2008 Beneficiary Summary File of Medicare beneficiaries enrolled during the calendar year 2008,...

  12. Opioid prescriptions before and after high-energy trauma

    DEFF Research Database (Denmark)

    Zwisler, Stine T; Hallas, Jesper; Larsen, Morten S

    2015-01-01

    OBJECTIVE: To describe the legal use of opioids in adult patients before and after high-energy trauma. DESIGN: The study was a retrospective database study. SETTING: Clinical care outside hospitals. PATIENTS: All patients who suffered high-energy trauma and were brought to Odense University...... Hospital (OUH), Denmark, in 2007 and 2008 were retrieved from the trauma database. These patients were linked with data on opioid use from the regional prescription database. In all, 938 patients were included. MAIN OUTCOME MEASURE: Redemption of opioid prescription during the 6 months prior...... to a multitrauma or redemption of two or more prescriptions for opioids 6 months or later after a multitrauma. RESULTS: Of the 938 patients brought to OUH with severe trauma within the study period, 61 patients died (7 percent) and six of these had redeemed prescriptions for opioids within 6 months prior...

  13. An Exercise Prescription Intervention Program with Periodic Ergometric Grading

    Science.gov (United States)

    Owen, C. A.; Beard, E. F.

    1970-01-01

    A long term exercise prescription type of physical conditioning program has been available to executive personnel of the NASA Manned Spacecraft Center for the past two years. Periodic ergometric testing with a heart rate controlled, automatically programmed, bicycle ergometer is used to follow the individual's progress and appropriately alter his exercise prescription from time to time. Such a program appears feasible, and acceptance is excellent, dropout rates small and periodic testing participation good. Subjects training diligently can maintain satisfactory levels of conditioning.

  14. Transferring Lens Prescriptions Between Lens-Design Programs

    Science.gov (United States)

    Stacy, John E.; Wooley, Laura; Carlin, Brian

    1989-01-01

    Optical Lens Prescription Data Formatter computer program enables user to transfer complicated lens prescriptions quickly and easily from one major optical-design program to another and back again. One can take advantage of inherent strength of either program. Programs are ACCOS V from Scientific Calculations, Inc., of Fishers, NY, and CODE V from Optical Research Associates of Pasadena, CA. VAX version written in FORTRAN.

  15. Rationality of Antimicrobial Prescriptions in Community Pharmacy Users.

    Directory of Open Access Journals (Sweden)

    Sara I V C Lima

    Full Text Available Although there is a conflict between the treatment benefits for a single individual and society, restrictions on antibiotic use are needed to reduce the prevalence of resistance to these drugs, which is the main result of irrational use. Brazil, cataloged as a pharmemerging market, has implemented restrictive measures for the consumption of antibiotics. The objective of this study was to investigate the quality of antimicrobial prescriptions and user knowledge of their treatment with these drugs.A two-stage cross-sectional, combined and stratified survey of pharmacy users holding an antimicrobial prescription was conducted in the community between May and November 2014. A pharmacist analyzed each prescription for legibility and completeness, and applied a structured questionnaire to the users or their caregivers on their knowledge regarding treatment and user sociodemographic data. An estimated 29.3% of prescriptions had one or more illegible items, 91.3% had one or more missing items, and 29.0% had both illegible and missing items. Dosing schedule and patient identification were the most commonly unreadable items in prescriptions, 18.81% and 12.14%, respectively. The lack of complete patient identification occurred in 90.53% of the prescriptions. It is estimated that 40.3% of users have used antimicrobials without prescription and that 46.49% did not receive any guidance on the administration of the drug.Despite the measures taken by health authorities to restrict the misuse of antimicrobials, it was observed that prescribers still do not follow the criteria of current legislation, particularly relating to items needed for completion of the prescription. Moreover, users receive little information about their antimicrobial treatment.

  16. Self-prescription practices in recent Latino immigrants.

    Science.gov (United States)

    Coffman, Maren J; Shobe, Marcia A; O'Connell, Beth

    2008-01-01

    Self-prescription involves the purchase and use of restricted medications without medical advice. Although common in Central and South American countries, little is known about this practice among Latino immigrants in the United States. The purpose of this study, therefore, was to explore how Latino immigrants obtain and use prescription medications without accessing the formal health care system. This exploratory descriptive study used focus groups to gain an understanding of the use of prescription medications without medical care. Three focus group discussions were held with 19 adult Latino immigrants who were new residents in the United States, and did not have health insurance; most were undocumented. Analysis of the data revealed 4 major themes: (a) health care barriers, (b) cultural norms, (c) self-care, and (d) self-prescription. The data indicate that this population experiences significant barriers to accessing health care, forcing them to seek treatment alternatives including the purchase and use of drugs manufactured in Mexico. There are many public health and safety concerns related to self-prescription practices. Nurses need to be aware of the barriers to health care that lead to these potentially dangerous medication practices, and to recognize and understand self-prescription.

  17. Predicting prosthetic prescription after major lower-limb amputation

    Directory of Open Access Journals (Sweden)

    Linda Resnik, PT, PhD, OCS

    2015-09-01

    Full Text Available We describe prosthetic limb prescription in the first year following lower-limb amputation and examine the relationship between amputation level, geographic region, and prosthetic prescription. We analyzed 2005 to 2010 Department of Veterans Affairs (VA Inpatient and Medical Encounters SAS data sets, Vital Status death data, and National Prosthetic Patient Database data for 9,994 Veterans who underwent lower-limb amputation at a VA hospital. Descriptive statistics and bivariates were examined. Cox proportional hazard models identified factors associated with prosthetic prescription. Analyses showed that amputation level was associated with prosthetic prescription. The hazard ratios (HRs were 1.41 for ankle amputation and 0.46 for transfemoral amputation compared with transtibial amputation. HRs for geographic region were Northeast = 1.49, Upper Midwest = 1.26, and West = 1.39 compared with the South (p < 0.001. African American race, longer length of hospital stay, older age, congestive heart failure, paralysis, other neurological disease, renal failure, and admission from a nursing facility were negatively associated with prosthetic prescription. Being married was positively associated. After adjusting for patient characteristics, people with ankle amputation were most likely to be prescribed a prosthesis and people with transfemoral amputation were least likely. Geographic variation in prosthetic prescription exists in the VA and further research is needed to explain why.

  18. Illicit Use of Prescription Opiates among Graduate Students.

    Science.gov (United States)

    Varga, Matthew D; Parrish, Mark

    2015-01-01

    Through this study the authors assessed the prevalence rate, reasons for use, and poly-substance use of prescription opiates among graduate students. The authors employed a cross-sectional survey research design using an online, self-administered questionnaire to assess the prevalence rates of prescription opiate use among graduate students (N = 1,033), reasons for use, and their likelihood for poly-substance use. The survey was e-mailed to 5,000 graduate students. Graduate students (19.7%) reported illicit use of prescription opiates in their lifetime and 6.6% reported past-year illicit use. Those who indicated illicitly using prescription opiates did so for self-medication reasons; a few respondents indicated recreational use. Students using prescription opiates were 75% less likely to use marijuana; 79% less likely to use cocaine; and 75% less likely to use ecstasy. Graduate students are illicitly using prescription opiates, but primarily for self-medication, and, while doing so, are less likely to use other substances.

  19. Description, prescription and the choice of discount rates

    Energy Technology Data Exchange (ETDEWEB)

    Baum, Seth D. [Rock Ethics Institute, Pennsylvania State University, 201 Willard Building, University Park, PA 16802 (United States); Department of Geography, Pennsylvania State University, 302 Walker Building, University Park, PA 16802 (United States)

    2009-11-15

    The choice of discount rates is a key issue in the analysis of long-term societal issues, in particular environmental issues such as climate change. Approaches to choosing discount rates are generally placed into two categories: the descriptive approach and the prescriptive approach. The descriptive approach is often justified on grounds that it uses a description of how society discounts instead of having analysts impose their own discounting views on society. This paper analyzes the common forms of the descriptive and prescriptive approaches and finds that, in contrast with customary thinking, both forms are equally descriptive and prescriptive. The prescriptions concern who has standing (i.e. who is included) in society, how the views of these individuals are measured, and how the measurements are aggregated. Such prescriptions are necessary to choose from among the many possible descriptions of how society discounts. The descriptions are the measurements made given a choice of measurement technique. Thus, the labels 'descriptive approach' and 'prescriptive approach' are deeply misleading, as analysts cannot avoid imposing their own views on society. (author)

  20. Doctor Shopping Behavior and the Diversion of Prescription Opioids.

    Science.gov (United States)

    Simeone, Ronald

    2017-01-01

    "Doctor shopping" as a means of prescription opioid diversion is examined. The number and percentage of prescriptions and morphine-equivalent milligrams diverted in this manner are estimated by state and molecule for the period 2008-2012. Eleven billion prescriptions with unique patient, doctor, and pharmacy identifiers were used to construct diversion "events" that involved between 1 and 6 unique doctors and between 1 and 6 unique pharmacies. Diversion thresholds were established based on the probability of each contingency. A geographically widespread decline occurred between 2008 and 2012. The number of prescriptions diverted fell from approximately 4.30 million (1.75% of all prescriptions) in 2008 to approximately 3.37 million (1.27% of all prescriptions) in 2012, and the number of morphine-equivalent milligrams fell from approximately 6.55 metric tons (2.95% of total metric tons) in 2008 to approximately 4.87 metric tons (2.19% of total metric tons) in 2012. Diversion control efforts have likely been effective. But given increases in opioid-related deaths, opioid-related drug treatment admissions, and the more specific resurgence of heroin-related events, it is clear that additional public health measures are required.

  1. Bodily differences between Cold- and Heat-prescription groups in Sasang medicine

    Directory of Open Access Journals (Sweden)

    Young Joo Park

    2016-06-01

    Conclusion: In the SY-type men, the chest circumference was significantly greater in the Heat-prescription group compared to the Cold-prescription group. In the TE-type men, the rib-to-pelvic circumference ratio was significantly higher in the Heat-prescription group than in the Cold-prescription group.

  2. Impact de l'information préopératoire donnée par l'infirmière sur le rétablissement de patients adultes opérés d'une chirurgie élective

    OpenAIRE

    Pinto, Alexandra; Romeo, Letizia; Gagné, Line

    2015-01-01

    Titre : Impact de l’information préopératoire donnée par l’infirmière sur le rétablissement de patients adultes opérés d’une chirurgie élective. Contexte : L’admission du patient adulte en milieu hospitalier en vue d’y subir une intervention chirurgicale est anxiogène et stressante. L’entretien de préadmission réalisé par l’infirmière vise à offrir de l’information sur les soins pré- et postopératoires afin de diminuer l’anxiété, le stress et d’améliorer le rétablissement. Objectif : Identifi...

  3. Defining risk of prescription opioid overdose: pharmacy shopping and overlapping prescriptions among long-term opioid users in medicaid.

    Science.gov (United States)

    Yang, Zhuo; Wilsey, Barth; Bohm, Michele; Weyrich, Meghan; Roy, Kakoli; Ritley, Dominique; Jones, Christopher; Melnikow, Joy

    2015-05-01

    Use of multiple pharmacies concurrently (pharmacy shopping) and overlapping prescriptions may be indicators of potential misuse or abuse of prescription opioid medications. To evaluate strategies for identifying patients at high risk, we first compared different definitions of pharmacy shopping and then added the indicator of overlapping opioid prescriptions. We identified a cohort of 90,010 Medicaid enrollees who used ≥ 3 opioid prescriptions for ≥ 90 days during 2008 to 2010 from a multistate Medicaid claims database. We compared the diagnostic odds ratios for opioid overdose events of 9 pharmacy shopping definitions. Within a 90-day interval, a threshold of 4 pharmacies had the highest diagnostic odds ratio and was used to define pharmacy shopping. The overdose rate was higher in the subgroup with overlapping prescriptions (18.5 per 1,000 person-years [PYs]) than in the subgroup with pharmacy shopping as the sole indicator (10.7 per 1,000 PYs). Among the subgroup with both conditions, the overdose rate was 26.3 per 1,000 PYs, compared with 4.3 per 1,000 PYs for those with neither condition. Overlapping opioid prescriptions and pharmacy shopping measures had adjusted hazard ratios of 3.0 and 1.8, respectively, for opioid overdose. Using these measures will improve accurate identification of patients at highest risk of opioid overdose, the first step in implementing targeted prevention policies. Long-term prescription opioid use may lead to adverse events, including overdose. Both pharmacy shopping and overlapping opioid prescriptions are associated with adverse outcomes. This study demonstrates that using both indicators will better identify those at high risk of overdose. Published by Elsevier Inc.

  4. [Prescription appropriateness: Indication of citicoline in Primary Care].

    Science.gov (United States)

    Padilla Luz, A; Reyes Rodríguez, J F; Gómez Rodríguez de Acuña, A; González Gómez, C M; Álvarez Dorta, I; Pérez Cánovas, M E

    2015-01-01

    The economic situation has made it necessary to optimize resources by adjusting the pharmaceutical expenditure. Citicoline was (2011) the 10th drug by rank of billed amount. Its approved indications are stroke (acute and sub-acute) and head injury, but not cognitive decline associated with age, the presumed indication for most of its use. To assess the conditions of use of citicoline in the Health Area of Tenerife, in order to detect deviations from the indications of use as stipulated in the prescribing information sheet and the pattern of prescription, with emphasis on the analysis of its use in dementia where currently it has no indication or evidence to support it. Cross-sectional study of prescription-indication. A 680 patient sample, segmented by reference hospital (error±5%; CI: 0.95%; P=0.5) was taken from the 4036 patients with a prescription of citicoline billed during august-october 2011 (obtained from the prescription database program, Farmacanarias). We found that 123 patients (18.1%) had an appropriate indication. By including the prescription regimen, 28 patients (4.1%) had adequate indication and dose levels, and in only 2 patients (0.2%) an appropriate indication, dosage and duration were found. "The correct prescription-indication" of citicoline is inappropiate in almost all patients studied. Impact actions are needed in order to optimize prescription, improve patient safety by reducing potential interactions, and the occurrence of adverse effects, and improve efficiency by promoting savings. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Pediatric emergency department discharge prescriptions requiring pharmacy clarification.

    Science.gov (United States)

    Caruso, Michelle C; Gittelman, Michael A; Widecan, Michelle L; Luria, Joseph W

    2015-06-01

    The aims of the study were to analyze and classify reasons why retail pharmacies need to contact the pediatric emergency department (PED) for clarification on outpatient prescriptions generated using an electronic prescribing system and to categorize the severity of errors captured. A retrospective chart review was conducted at a PED that cares for approximately 92,000 patients annually. All pharmacy callbacks documented in the electronic medical record between August 1, 2008 and July 31, 2009 were included. A datasheet was used to capture patient demographics (age, sex, race, insurance), prescriptions written, and reason for callback. Each call was then assigned a severity level, and time to respond to all calls was estimated. Frequencies were used to analyze the data. A total of 731 errors for 695 callbacks were analyzed from 49,583 prescriptions written at discharge. The most common errors included administrative/insurance issues 342/731 (47%) and prescription writing errors 298/731 (41%). The errors were classified as insignificant (340/729 [47%]), problematic (288/729 [40%]), significant (77/729 [11%]), serious (12/729 [1.64%]), and severe (12/729 [1.64%]). Almost 96% of errant prescriptions were not able to be filled as originally written and required a change by the prescriber. These calls required approximately 127 hours to complete. Prescription errors requiring a pharmacy callback are typically insignificant. However, 13.8% of callbacks about an error were considered significant, serious, or severe. Automated dose checking and verifying insurance coverage of prescribed medications should be considered essential components of prescription writing in a PED.

  6. Use of a generic protocol in documentation of prescription errors in Estonia, Norway and Sweden

    Directory of Open Access Journals (Sweden)

    Haavik S

    2012-06-01

    Full Text Available Pharmacists have an important role in detecting, preventing, and solving prescription problems, which if left unresolved, may pose a risk of harming the patient.Objective: The objectives of this study were to evaluate the feasibility of a generic study instrument for documentation of prescription problems requiring contact with prescriber before dispensing. The study was organized: 1 by countries: Estonia, Norway and Sweden; 2 by type of prescriptions: handwritten prescriptions, printouts of prescriptions in the electronic medical record and electronically transmitted prescriptions to pharmacies; and 3 by recording method - self-completion by pharmacists and independent observers.Methods: Observational study with independent observers at community pharmacies in Estonia (n=4 and Sweden (n=7 and self-completed protocols in Norway (n=9.Results: Pharmacists’ in Estonia contacted the prescriber for 1.47% of the prescriptions, about 3 times as often as in Norway (0.45% and Sweden (0.38%. Handwritten prescriptions dominated among the problem prescriptions in Estonia (73.2%, printouts of prescriptions in the electronic medical record (89.1% in Norway and electronically transmitted prescriptions to pharmacies (55.9% in Sweden.More administrative errors were identified on handwritten prescriptions and printouts of prescriptions in the electronic medical record in Estonia and in Norway compared with electronically transmitted prescriptions to pharmacies in Sweden (p<0.05 for prescription types and p<0.01 for countries. However, clinically important errors and delivery problems appeared equally often on the different types of prescriptions. In all three countries, only few cases of drug interactions and adverse drug reactions were identified.Conclusion: Despite the different patterns of prescription problems in three countries, the instrument was feasible and can be regarded appropriate to document and classify prescription problems necessitating contact

  7. Predicting prosthetic prescription after major lower-limb amputation.

    Science.gov (United States)

    Resnik, Linda; Borgia, Matthew

    2015-01-01

    We describe prosthetic limb prescription in the first year following lower-limb amputation and examine the relationship between amputation level, geographic region, and prosthetic prescription. We analyzed 2005 to 2010 Department of Veterans Affairs (VA) Inpatient and Medical Encounters SAS data sets, Vital Status death data, and National Prosthetic Patient Database data for 9,994 Veterans who underwent lower-limb amputation at a VA hospital. Descriptive statistics and bivariates were examined. Cox proportional hazard models identified factors associated with prosthetic prescription. Analyses showed that amputation level was associated with prosthetic prescription. The hazard ratios (HRs) were 1.41 for ankle amputation and 0.46 for transfemoral amputation compared with transtibial amputation. HRs for geographic region were Northeast = 1.49, Upper Midwest = 1.26, and West = 1.39 compared with the South (p amputation were most likely to be prescribed a prosthesis and people with transfemoral amputation were least likely. Geographic variation in prosthetic prescription exists in the VA and further research is needed to explain why.

  8. Prescription Opioid Abuse: Challenges and Opportunities for Payers

    Science.gov (United States)

    Katz, Nathaniel P.; Birnbaum, Howard; Brennan, Michael J.; Freedman, John D.; Gilmore, Gary P.; Jay, Dennis; Kenna, George A.; Madras, Bertha K.; McElhaney, Lisa; Weiss, Roger D.; White, Alan G.

    2013-01-01

    Objective Prescription opioid abuse and addiction are serious problems with growing societal and medical costs, resulting in billions of dollars of excess costs to private and governmental health insurers annually. Though difficult to accurately assess, prescription opioid abuse also leads to increased insurance costs in the form of property and liability claims, and costs to state and local governments for judicial, emergency, and social services. This manuscript’s objective is to provide payers with strategies to control these costs, while supporting safe use of prescription opioid medications for patients with chronic pain. Method A Tufts Health Care Institute Program on Opioid Risk Management meeting was convened in June 2010 with private and public payer representatives, public health and law enforcement officials, pain specialists, and other stakeholders to present research, and develop recommendations on solutions that payers might implement to combat this problem. Results While protecting access to prescription opioids for patients with pain, private and public payers can implement strategies to mitigate financial risks associated with opioid abuse, using internal strategies, such as formulary controls, claims data surveillance, and claims matching; and external policies and procedures that support and educate physicians on reducing opioid risks among patients with chronic pain. Conclusion Reimbursement policies, incentives, and health technology systems that encourage physicians to use universal precautions, to consult prescription monitoring program (PMP) data, and to implement Screening, Brief Intervention, and Referral to6Treatment protocols, have a high potential to reduce insurer risks while addressing a serious public health problem. PMID:23725361

  9. RxGen General Optical Model Prescription Generator

    Science.gov (United States)

    Sigrist, Norbert

    2012-01-01

    RxGen is a prescription generator for JPL's in-house optical modeling software package called MACOS (Modeling and Analysis for Controlled Optical Systems), which is an expert optical analysis software package focusing on modeling optics on dynamic structures, deformable optics, and controlled optics. The objectives of RxGen are to simplify and automate MACOS prescription generations, reducing errors associated with creating such optical prescriptions, and improving user efficiency without requiring MACOS proficiency. RxGen uses MATLAB (a high-level language and interactive environment developed by MathWorks) as the development and deployment platform, but RxGen can easily be ported to another optical modeling/analysis platform. Running RxGen within the modeling environment has the huge benefit that variations in optical models can be made an integral part of the modeling state. For instance, optical prescription parameters determined as external functional dependencies, optical variations by controlling the in-/exclusion of optical components like sub-systems, and/or controlling the state of all components. Combining the mentioned capabilities and flexibilities with RxGen's optical abstraction layer completely eliminates the hindering aspects for requiring proficiency in writing/editing MACOS prescriptions, allowing users to focus on the modeling aspects of optical systems, i.e., increasing productivity and efficiency. RxGen provides significant enhancements to MACOS and delivers a framework for fast prototyping as well as for developing very complex controlled optical systems.

  10. Americans' access to prescription drugs stabilizes, 2007-2010.

    Science.gov (United States)

    Boukus, Ellyn R; Carrier, Emily R

    2011-12-01

    Despite the weak economy and more people lacking health insurance, the proportion of Americans reporting problems affording prescription drugs remained level between 2007 and 2010, with more than one in eight going without a prescribed drug in 2010, according to a new national study from the Center for Studying Health System Change (HSC). While remaining stable overall, access to prescription drugs improved for working-age, uninsured people, likely reflecting a decline in visits to health care providers, as well as changes in the composition of the uninsured population. Likewise, elderly people eligible for both Medicare and Medicaid saw a sharp drop in prescription drug access problems. The most vulnerable people--the uninsured, those with low incomes, people in fair or poor health, and those with multiple chronic conditions--continued to face the most unmet prescription needs. For example, 48 percent of uninsured people in fair or poor health went without a prescription drug because of cost concerns in 2010, almost double the rate of insured people with the same reported health status.

  11. Drug prescription appropriateness in the elderly: an Italian study

    Science.gov (United States)

    Allegri, Nicola; Rossi, Federica; Del Signore, Federica; Bertazzoni, Paolo; Bellazzi, Roberto; Sandrini, Giorgio; Vecchi, Tomaso; Liccione, Davide; Pascale, Alessia; Govoni, Stefano

    2017-01-01

    Purpose Correct drug prescription in the elderly is a difficult task that requires careful survey of the current pharmacological therapies. In this article, we reviewed the drug prescriptions provided to 860 persons aged 65 years or over, residing in a small city of Lombardy, Italy. Methods Subjects were recruited from a local nursing home, the Pavia and Vigevano Neuropsychological Center for Alzheimer’s Disease, general practitioners’ offices, and the local University of the Third Age. For each patient, the amount of potentially inappropriate prescriptions (PIPs), sedative and anticholinergic load (SL and AL, respectively), and drug–drug interactions were evaluated. Results Widespread polypharmacy, giving rise to 10.06% of PIPs in the whole collection of prescriptions, was observed. In particular, PIPs mainly concern drugs acting at the central nervous system level, mostly benzodiazepines and antipsychotics. Moreover, approximately one-fourth of the subjects had an elevated SL and approximately one-tenth a high AL. Drug–drug interactions were frequent (266 requiring medical attention), up to five for each single patient. Of concern was the underuse of antidementia drugs: only 20 patients received a cholinesterase inhibitor or memantine, although 183 patients were potentially suitable for this treatment. Conclusion These results demonstrate the need to develop novel strategies aimed at improving the quality of drug prescription. PMID:28228653

  12. Misuse of Prescription Opioid Medication among Women: A Scoping Review.

    Science.gov (United States)

    Hemsing, Natalie; Greaves, Lorraine; Poole, Nancy; Schmidt, Rose

    2016-01-01

    Background. National data from Canada and the United States identify women to be at greater risk than men for the misuse of prescription opioid medications. Various sex- and gender-based factors and patient and physician practices may affect women's use and misuse of prescription opioid drugs. Objectives. To explore the particular risks, issues, and treatment considerations for prescription opioid misuse among women who experience chronic noncancer pain and trauma. Methods. A scoping review for articles published between January 1990 and May 2014 was conducted on sex- and gender-based risks and treatment considerations among women who experience chronic noncancer pain and trauma. Results. A total of 57 articles were identified. The present narrative review summarizes the specific risks for the misuse of prescription opioid medication among women who have experienced violence and trauma, Aboriginal women, adolescents and young women, older women, pregnant women, women of a sexual minority, and transwomen. Discussion. The majority of the literature is descriptive, with few studies that evaluate approaches and interventions to respond to the issue of chronic pain, trauma, and misuse of prescription opioids among women, particularly vulnerable subgroups of women. Conclusions. Trauma-informed and women-centred approaches that address women's vulnerabilities and complex needs require further attention.

  13. Misuse of Prescription Opioid Medication among Women: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Natalie Hemsing

    2016-01-01

    Full Text Available Background. National data from Canada and the United States identify women to be at greater risk than men for the misuse of prescription opioid medications. Various sex- and gender-based factors and patient and physician practices may affect women’s use and misuse of prescription opioid drugs. Objectives. To explore the particular risks, issues, and treatment considerations for prescription opioid misuse among women who experience chronic noncancer pain and trauma. Methods. A scoping review for articles published between January 1990 and May 2014 was conducted on sex- and gender-based risks and treatment considerations among women who experience chronic noncancer pain and trauma. Results. A total of 57 articles were identified. The present narrative review summarizes the specific risks for the misuse of prescription opioid medication among women who have experienced violence and trauma, Aboriginal women, adolescents and young women, older women, pregnant women, women of a sexual minority, and transwomen. Discussion. The majority of the literature is descriptive, with few studies that evaluate approaches and interventions to respond to the issue of chronic pain, trauma, and misuse of prescription opioids among women, particularly vulnerable subgroups of women. Conclusions. Trauma-informed and women-centred approaches that address women’s vulnerabilities and complex needs require further attention.

  14. Socioeconomic Variations in Use of Prescription Medicines for COPD

    DEFF Research Database (Denmark)

    Jacobsen, Ramune; Ekholm, Ola; Rasmussen, Niels K.

    2016-01-01

    BACKGROUND: The purpose of this study was to examine socioeconomic variations in the use of prescription medicines among elderly subjects with COPD. METHODS: Data from the Danish national administrative registers were used. The study population included 1,365 individuals >60 y old residing...... in the Municipality of Copenhagen and diagnosed with COPD in a hospital setting in 2007. Logistic regression analysis was applied to examine the associations between the use of all prescription medicines for obstructive pulmonary diseases and the use of long-acting bronchodilators, in subject groups of different...... socioeconomic position. RESULTS: The study demonstrated that approximately 90% of subjects with COPD purchased at least one prescription medicine for obstructive pulmonary diseases, whereas approximately 50% purchased a long-acting bronchodilator. Medicine use did not vary according to educational status...

  15. Getting to the Root of High Prescription Drug Prices.

    Science.gov (United States)

    Waxman, Henry; Corr, Bill; Martin, Kristi; Duong, Sophia

    2017-07-01

    ISSUE: Historic increases in prescription drug prices and spending are contributing to unsustainable health care costs in the United States. There is widespread public support for elected officials to address the problem. GOAL: To document the drivers of high U.S. prescription drug prices and offer a broad range of feasible policy actions. METHODS: Interviews with experts and organizations engaged with prescription drug development and utilization, pricing, regulation, and clinical practice. Review of policy documents, proposals, and position statements from a variety of stakeholders. FINDINGS AND CONCLUSIONS: Congress and regulators can undertake a wide range of policy actions to begin to rebalance incentives for innovation and price competition, prioritize patient access and affordability, and maximize the availability of information to patients, providers, and payers.

  16. Ramp length/grade prescriptions for wheelchair dependent individuals.

    Science.gov (United States)

    Canale, I; Felici, F; Marchetti, M; Ricci, B

    1991-09-01

    The aim of this work was to provide well defined criteria for ramp construction for wheelchair dependent individuals (WDI). Force capability was measured in a large sample (140) of WDI, who presented different levels of motor impairment. Levels of impairment were established on the basis of the answers given in a questionnaire regarding the degree of self sufficiency at home as well as outside the home and active participation in sports events. Taking into account those WDI who exhibited at least a minimal level of self-sufficiency, the following prescriptions are indicated. For a 1 metre ramp length, allowable maximal incline 15%; up to 3 metre ramp length, maximal incline 10%. The reliability of such prescriptions was confirmed by having a test ramp traversed by 43 WDI. These values are suggested as confidence limits when faced with public building accommodations. Special prescriptions could be adopted for selected populations of WDI.

  17. Drug prescriptions in Danish out-of-hours primary care

    DEFF Research Database (Denmark)

    Christensen, Morten Bondo; Nørøxe, Karen Busk; Moth, Grete

    2016-01-01

    OBJECTIVE: General practitioners are the first point of contact in Danish out-of-hours (OOH) primary care. The large number of contacts implies that prescribing behaviour may have considerable impact on health-care expenditures and quality of care. The aim of this study was to examine...... the prevailing practices for medication prescription in Danish OOH with a particular focus on patient characteristics and contact type. DESIGN AND SETTING: A one-year population-based retrospective observational study was performed of all contacts to OOH primary care in the Central Denmark Region using registry...... data. MAIN OUTCOME MEASURES: Prescriptions were categorised according to Anatomical Therapeutic Chemical Classification (ATC) codes and stratified for patient age, gender and contact type (telephone consultation, clinic consultation or home visit). Prescription rates were calculated as number...

  18. Prescription drug monitoring programs in the United States of America

    Science.gov (United States)

    Félix, Sausan El Burai; Mack, Karin

    2015-01-01

    SYNOPSIS Since the late 1990s, the number of opioid analgesic overdose deaths has quadrupled in the United States of America (from 4 030 deaths in 1999 to 16 651 in 2010). The objectives of this article are to provide an overview of the problem of prescription drug overdose in the United States and to discuss actions that could help reduce the problem, with particular attention to the characteristics of prescription drug monitoring programs (PDMPs). These programs consist of state-level databases that monitor controlled substances. The information compiled in the databases is at the disposal of authorized persons (e.g., physicians, pharmacists, and other health-care providers) and may be used only for professional purposes. Suppliers can use such information to prevent interaction with other drugs or therapeutic duplication, or to identify drug-search behavior. Law enforcement agencies can use these programs to identify improper drug prescription or dispensing patterns, or drug diversion. PMID:25563153

  19. Utilisation of prescription and over-the-counter triptans

    DEFF Research Database (Denmark)

    Frisk, Pia; Kälvemark Sporrong, Sofia; Ljunggren, Gunnar

    2016-01-01

    triptans in Stockholm, Sweden. METHODS: Register data from 4759 patients dispensed triptans in 2014 were used to study documented diagnosis of migraine, concomitant acute and preventive treatment for migraine, and contraindications. Survey data from 49 patients purchasing OTC triptans in three pharmacies...... were used to capture physician-diagnosed migraine, concomitant acute and preventive treatment for migraine, a behaviour of combining or alternating between prescription and OTC triptans, and pharmacy counselling rates. RESULTS: Among the prescription triptan users, 52 % had a recorded diagnosis...... OTC and prescription triptans was rare. Concomitant acute treatment was reported in 53 % and preventive treatment was rare (4 %), despite high self-reported migraine frequencies. Some off-label use was detected, despite moderate to high counselling rates. CONCLUSION: Triptans are prescribed...

  20. Drug prescription appropriateness in the elderly: an Italian study

    Directory of Open Access Journals (Sweden)

    Allegri N

    2017-02-01

    Full Text Available Nicola Allegri,1 Federica Rossi,2 Federica Del Signore,2 Paolo Bertazzoni,3 Roberto Bellazzi,4 Giorgio Sandrini,5 Tomaso Vecchi,1 Davide Liccione,1 Alessia Pascale,6 Stefano Govoni6 1Department of Brain and Behavioral Sciences, University of Pavia, 2Pavia and Vigevano Neuropsychological Center for Alzheimer’s Disease, 3”Bertazzoni” Pharmacy General Partnership, Vigevano, 4Nephrology and Dialysis Ward, Civil Hospital of Vigevano, 5C. Mondino National Institute of Neurology Foundation, IRCCS, 6Department of Drug Sciences, Section of pharmacology, University of Pavia, Pavia, Italy Purpose: Correct drug prescription in the elderly is a difficult task that requires careful survey of the current pharmacological therapies. In this article, we reviewed the drug prescriptions provided to 860 persons aged 65 years or over, residing in a small city of Lombardy, Italy.Methods: Subjects were recruited from a local nursing home, the Pavia and Vigevano Neuropsychological Center for Alzheimer’s Disease, general practitioners’ offices, and the local University of the Third Age. For each patient, the amount of potentially inappropriate prescriptions (PIPs, sedative and anticholinergic load (SL and AL, respectively, and drug–drug interactions were evaluated.Results: Widespread polypharmacy, giving rise to 10.06% of PIPs in the whole collection of prescriptions, was observed. In particular, PIPs mainly concern drugs acting at the central nervous system level, mostly benzodiazepines and antipsychotics. Moreover, approximately one-fourth of the subjects had an elevated SL and approximately one-tenth a high AL. Drug–drug interactions were frequent (266 requiring medical attention, up to five for each single patient. Of concern was the underuse of antidementia drugs: only 20 patients received a cholinesterase inhibitor or memantine, although 183 patients were potentially suitable for this treatment.Conclusion: These results demonstrate the need to develop

  1. Prescription opioid analgesics increase the risk of depression.

    Science.gov (United States)

    Scherrer, Jeffrey F; Svrakic, Dragan M; Freedland, Kenneth E; Chrusciel, Timothy; Balasubramanian, Sumitra; Bucholz, Kathleen K; Lawler, Elizabeth V; Lustman, Patrick J

    2014-03-01

    Prescription opioid analgesic use has quintupled recently. Evidence linking opioid use with depression emanates from animal models and studies of persons with co-occurring substance use and major depression. Little is known about depressogenic effects of opioid use in other populations. The purpose of this study was to determine whether prescription opioids are associated with increased risk of diagnosed depression. Retrospective cohort study, new user design. Medical record data from 49,770 US Department of Veterans Affairs (VA) health care system patients with no recent (24-month) history of opioid use or a diagnosis of depression in 1999 and 2000. Propensity scores were used to control for bias by indication, and the data were weighted to balance the distribution of covariates by duration of incident opioid exposure. Cox proportional hazard models with adjustment for painful conditions were used to estimate the association between duration of prescription opioid use and the subsequent risk of development of depression between 2001 and 2007. Of 49,770 patients who were prescribed an opioid analgesic, 91 % had a prescription for 180 days. Compared to patients whose prescription was for opioid prescription increased (HR = 1.25; 95 % CI: 1.05-1.46 for 90-180 days, and HR = 1.51; 95 % CI:1.31-1.74 for > 180 days). In this sample of veterans with no recent (24-month) history of depression or opioid analgesic use, the risk of development of depression increased as the duration of opioid analgesic exposure increased. The potential for depressogenic effect should be considered in risk-benefit discussions, and patients initiating opioid treatment should be monitored for development of depression.

  2. Potential misuse and inappropriate prescription practices involving opioid analgesics.

    Science.gov (United States)

    Liu, Ying; Logan, Joseph E; Paulozzi, Leonard J; Zhang, Kun; Jones, Christopher M

    2013-08-01

    Opioid misuse and abuse are growing concerns among the medical and public health communities. To examine the prevalence of indicators for potential opioid misuse in a large, commercially insured adult population. We adapted existing indicators developed by expert panels to include having overlapping opioid prescriptions, overlapping opioid and benzodiazepine prescriptions, long-acting/ extended release (LA/ER) opioids for acute pain,and high daily doses of opioids (>100 morphine milligram equivalents). These indicators were assessed among continuously enrolled individuals aged 18-64 years from the 2009 Truven Health MarketScan databases. Analyses were stratified by sex. We identified 3,391,599 eligible enrollees who received at least 1 opioid prescription. On average, enrollees obtained 3.3 opioid prescriptions, and the average annual days of supply was 47 days. Twice as many enrollees received opioid prescriptions for acute pain as for chronic pain. About a quarter of the enrollees had at least 1 indicator of either potential misuse by patients or inappropriate prescription practices by providers. About 15% of enrollees had high daily doses;7.8% had opioid overlap; and 7.9% had opioid and benzodiazepine overlap. Among those prescribed LA/ER opioids, 24.3% were treated for acute pain. Overlap indicators were more common among women. Our findings underscore the critical need to develop programs aimed at promoting appropriate use of opioids. Retrospective opioid utilization reviews similar to our analyses can potentially help managed care organizations and healthcare providers improve patient care and reduce the risk of adverse outcomes related to these medications.

  3. Prescription Opioid Analgesics Commonly Unused After Surgery: A Systematic Review.

    Science.gov (United States)

    Bicket, Mark C; Long, Jane J; Pronovost, Peter J; Alexander, G Caleb; Wu, Christopher L

    2017-08-02

    Prescription opioid analgesics play an important role in the treatment of postoperative pain; however, unused opioids may be diverted for nonmedical use and contribute to opioid-related injuries and deaths. To quantify how commonly postoperative prescription opioids are unused, why they remain unused, and what practices are followed regarding their storage and disposal. MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched from database inception to October 18, 2016, for studies describing opioid oversupply for adults after a surgical procedure. The primary outcome-opioid oversupply-was defined as the number of patients with either filled but unused opioid prescriptions or unfilled opioid prescriptions. Two reviewers independently screened studies for inclusion, extracted data, and assessed the study quality. Six eligible studies reported on a total of 810 unique patients (range, 30-250 patients) who underwent 7 different types of surgical procedures. Across the 6 studies, 67% to 92% of patients reported unused opioids. Of all the opioid tablets obtained by surgical patients, 42% to 71% went unused. Most patients stopped or used no opioids owing to adequate pain control, and 16% to 29% of patients reported opioid-induced adverse effects. In 2 studies examining storage safety, 73% to 77% of patients reported that their prescription opioids were not stored in locked containers. All studies reported low rates of anticipated or actual disposal, but no study reported US Food and Drug Administration-recommended disposal methods in more than 9% of patients. Postoperative prescription opioids often go unused, unlocked, and undisposed, suggesting an important reservoir of opioids contributing to nonmedical use of these products, which could cause injuries or even deaths.

  4. Regional variation in infant hypoallergenic formula prescriptions in Australia.

    Science.gov (United States)

    Mullins, Raymond J; Clark, Sunday; Camargo, Carlos A

    2010-03-01

    There is little information on the regional distribution of food allergy in Australia. We examined the influence of latitude (a marker of sunlight/vitamin D status) on food allergy, as measured by 2007 infant hypoallergenic formula (IHF) prescription rates in children ages 0-2 yrs. Data were compiled from the 52 statistical divisions in mainland Australia plus the island of Tasmania (n=53 observations). Data from the Australian Department of Health and Aging and the Australian Bureau of Statistics were analysed by statistical division. There was significant regional variability in hypoallergenic formula prescription rates (per 100,000 population/yr), with the highest rates in southern Australia (14,406) and the lowest in the north (721), compared with a national average of 4099. Geographical factors (decreasing latitude and increasing longitude) were associated with a higher rate of IHF prescriptions, such that rates were higher in southern vs. northern regions, and in eastern compared with western regions. Controlling for longitude, physician density and markers of socioeconomic status, southern latitudes were associated with higher hypoallergenic formulae prescription rates [beta, -147.98; 95% confidence interval (CI)=-281.83 to -14.14; p=0.03]. Controlling for latitude, physician density and markers of socioeconomic status, eastern longitudes were also associated with higher hypoallergenic formulae prescription rates (beta, 89.69; 95% CI=2.90-176.49; p=0.04). Among young children, hypoallergenic formula prescription rates are more common in the southern and eastern regions of Australia. These data provide support for a possible role of sun exposure/vitamin D status (amongst other potential factors) in the pathogenesis of food allergy.

  5. Electronic prescription as contributing factor for hospitalized patients' safety.

    Directory of Open Access Journals (Sweden)

    Gimenes FRE

    2006-03-01

    Full Text Available The following study was performed to identify factors related to medication errors in the computerized physician order entry and their advantages and disadvantages according to doctors, nursing team and administrative officers. It is a survey descriptive study carried out at three units of a Brazilian academic hospital in the southeast area. The study was divided in two phases. In the first phase, we analyzed a total of 1,349 prescriptions from general medical unit, surgical and orthopaedic wards during 30 days consecutively. A semi-structured instrument, elaborated by a group of researchers for the study proposals, was used. In the second phase, a semi-structured questionnaire was applied to the health professionals containing closed and open items approaching their opinion about the composition of electronic prescription, the advantages and disadvantages of them, and their suggestions for its improvement. Out of 1,349 prescriptions observed, 17.5% presented deletions, 25.0% medicines written manually and 17.0% of them were incomplete. Some of the advantages pointed by health professionals were its legibility (37.5%, little time spent when elaborating and emitting them (20.5% and the way they are a practical and organized (8%. The disadvantages pointed were repetition of previous prescriptions (34%, typing mistakes (17%, dependence on computers (11% and alterations made manually (7%. We conclude, this way, that the computerized prescription order entry represents a great progress among the strategies used to minimize medication errors caused by prescriptions badly formulated. However, it doesn't eradicate the possibility of medication error occurrences, needing some system modifications.

  6. An exercise prescription primer for people with depression.

    Science.gov (United States)

    Stanton, Robert; Happell, Brenda M

    2013-08-01

    A substantial body of evidence supports the value of exercise in the treatment of people with depression. The guidelines for exercise prescription, however, are limited, and based on those developed for healthy populations. This article explores the evidence for exercise in the treatment of depression and the role mental health nurses may play in the delivery of this information. A model of exercise prescription is put forward based on the available evidence and taking into account the challenges faced by mental health nurses and people with depression.

  7. Chiropractors' attitudes toward drug prescription rights: a narrative review.

    Science.gov (United States)

    Emary, Peter Charles; Stuber, Kent Jason

    2014-01-01

    The right to prescribe drugs remains a contentious issue within the chiropractic profession. Nevertheless, drug prescription by manual therapy providers is currently an important topic. Notably, physiotherapists in the United Kingdom were recently granted limited independent prescribing rights. Reports suggest that physiotherapists in Australia now want those same rights, and as such a review of chiropractors' general attitudes toward drug prescription is needed. To examine the literature concerning chiropractors' attitudes toward drug prescription rights and to compare the opinions of chiropractors currently licensed to prescribe medication with those in the profession who are not. This was a narrative review, consisting of a formal literature search and summary of included articles. Electronic databases searched included the Cumulative Index to Nursing and Allied Health Literature, PubMed, and the Index to Chiropractic Literature. Inclusion criteria consisted of prospective studies published in English in peer-reviewed journals. Studies were required to contain data on chiropractors' opinions toward medication prescription rights. Of 33 articles identified, a total of seven surveys were included in the review. Of these, there was a general split in opinion among chiropractors regarding the right to prescribe drugs in chiropractic practice. Those supportive of prescribing rights favoured a limited number of over-the-counter and/or prescription-based medications such as analgesics, anti-inflammatories, and muscle relaxants. When questioned on full prescribing rights, however, chiropractors were generally opposed. In jurisdictions where chiropractors are currently licensed to prescribe from a limited formulary, such as in Switzerland, the majority perceived this right as an advantage for the profession. Moreover, continuing education in pharmacology was viewed as a necessary component of this privilege. Based on the literature to date there is a general split in

  8. Prescription of fixed dose combination drugs for diarrhoea.

    Science.gov (United States)

    Chakrabarti, Amit

    2007-01-01

    Fixed-dose combinations (FDCs) of an antiprotozoal and an antibacterial, for treatment of diarrhoea, have been available in the Indian pharmaceutical market for about a decade. There is little evidence to substantiate this combination therapy. We evaluated 2,163 physician prescriptions for diarrhoea and found that 59 per cent of prescriptions were for FDCs. This is unethical because prescribing such combinations exposes a patient to higher risks of adverse drug reactions and also increases the chances of drug resistance. Physicians' prescribing practices in India are influenced by socioeconomic factors and the pharmaceutical industry's marketing techniques that include giving incentives to physicians to prescribe certain drugs.

  9. Justice implications of a proposed Medicare prescription drug policy.

    Science.gov (United States)

    Larkin, Heather

    2004-07-01

    Social justice is a core value to the mission of social work. Older people are among the most vulnerable populations for whom social workers are called on to advocate. Although Medicare prescription drug coverage has been a top legislative issue over the past few years, such a benefit expansion has yet to be implemented. This article examines the historical context of Medicare and reviews the proposals for prescription drug coverage, identifying the concerns raised. Literature critiquing the justice dimensions of health care for the elderly population is reviewed. Justice claims are identified and refined, and social justice theories are used in the analysis of the proposed policies.

  10. A Research Report on the Prescription Rights of Chinese Nurses

    Institute of Scientific and Technical Information of China (English)

    Shi-Fan Han; Rui-Fang Zhu; Hui-Hui Han

    2015-01-01

    Objective:To explore the feasibility of the nurse’s prescription right in China,to develop the requirements for the qualification of the applicant for the prescription right of nurse,and to determine the content of certain prescriptions in the specific circumstances.Methods:Literature review on the relevant articles/material with the contents of the nurse’ s right of prescription home and abroad.Semi-structured depth interview method was used to interview 18 experts on whether the nurses can participate in the graded nursing decision and whether nurses with certain ability can make the decision.Using the self-made questionnaire "Nurses involved in graded nursing decision-recognition questionnaire",553 nurses completed questionnaires on willingness to nurse decision-making grading.Using the analytic hierarchy process,the 23 experts’ judgment on the main body of the graded nursing was rated.Using semi-structured depth interview method,17 experts were interviewed on the graded nursing quality assessment and training outline.The form of expert personal judgment and the "grading nursing qualification experts predict questionnaire" were used as a preliminary designing tool,32 experts were asked to predict the graded nursing quality.The relatively important factors that might promote implementation of right of Chinese nurse prescribing weights setting were obtained by analytic hierarchy process.Using Delphi method,2 rounds of consultation to 291 experts/times were performed,and determined its content on the fields of graded nursing decision,nurses’ job description,decision making nurse in graded nursing work process and related management system,decision-making main body of clinical nursing,nurse authority of prescription application qualification,clinical nurses,diabetes specialist nurses,tumor specialist nurses,nurses in emergency department,community nurses in certain circumstances writing prescription,and nursing undergraduate added with nurse authority of

  11. A Research Report on the Prescription Rights of Chinese Nurses☆

    Institute of Scientific and Technical Information of China (English)

    Shi-Fan Han; Rui-Fang Zhu; Hui-Hui Han

    2015-01-01

    Objective: To explore the feasibility of the nurse’ s prescription right in China, to develop the requirements for the qualification of the ap-plicant for the prescription right of nurse, and to determine the content of certain prescriptions in the specific circumstances. Methods: Literature review on the relevant articles/material with the contents of the nurse’ s right of prescription home and a-broad. Semi-structured depth interview method was used to interview 18 experts on whether the nurses can participate in the graded nursing decision and whether nurses with certain ability can make the decision. Using the self-made questionnaire“Nur-ses involved in graded nursing decision-recognition questionnaire”, 553 nurses completed questionnaires on willingness to nurse decision-making grading. Using the analytic hierarchy process, the 23 experts’ judgment on the main body of the graded nurs-ing was rated. Using semi-structured depth interview method, 17 experts were interviewed on the graded nursing quality assess-ment and training outline. The form of expert personal judgment and the“grading nursing qualification experts predict question-naire”were used as a preliminary designing tool, 32 experts were asked to predict the graded nursing quality. The relatively im-portant factors that might promote implementation of right of Chinese nurse prescribing weights setting were obtained by analytic hierarchy process. Using Delphi method, 2 rounds of consultation to 291 experts/times were performed, and determined its con-tent on the fields of graded nursing decision, nurses’ job description, decision making nurse in graded nursing work process and related management system, decision-making main body of clinical nursing, nurse authority of prescription application qualifi-cation, clinical nurses, diabetes specialist nurses, tumor specialist nurses, nurses in emergency department, community nurses in certain circumstances writing prescription, and nursing

  12. 21 CFR 1306.05 - Manner of issuance of prescriptions.

    Science.gov (United States)

    2010-04-01

    ... not prepared in the form prescribed by DEA regulations. (b) An individual practitioner exempted from..., who fills a prescription not prepared in the form prescribed by DEA regulations. (g) An individual... not conform in all essential respects to the law and regulations. A corresponding liability rests upon...

  13. User-oriented Understanding of Descriptive, Proscriptive and Prescriptive Lexicography

    DEFF Research Database (Denmark)

    Bergenholtz, Henning

    2003-01-01

    There is much uncertainty and confusion as to the real differences between prescrip-tive and descriptive dictionaries. In general, the majority of existing accounts can be summarised as follows: Descriptive relates to the empirical basis; accordance between the empirical data and the dictionary i...

  14. Antidepressant Prescription and Suicide Rates: Effect of Age and Gender

    Science.gov (United States)

    Kalmar, Sandor; Szanto, Katalin; Rihmer, Zoltan; Mazumdar, Sati; Harrison, Katrin; Mann, J. John

    2008-01-01

    To determine whether the effect of antidepressant exposure on suicide rate is modified by age and gender in Hungary, annual antidepressant prescription rates and suicide rates of about 10 million inhabitants between 1999-2005 were analyzed by age and gender groups. The suicide rate was inversely related to the increased use of antidepressants in…

  15. Scleral Lens Prescription and Management Practices: The SCOPE Study.

    Science.gov (United States)

    Harthan, Jennifer; Nau, Cherie B; Barr, Joseph; Nau, Amy; Shorter, Ellen; Chimato, Nicolette T; Hodge, David O; Schornack, Muriel M

    2017-04-06

    To assess current scleral lens prescription and management practices by conducting an international online survey of eye care providers. The SCOPE (Scleral Lenses in Current Ophthalmic Practice: an Evaluation) study group designed and administered an online survey regarding current scleral lens prescription and management practices. The survey was open from January 15 to March 31, 2015, and generated 723 responses from individuals who had fit at least 5 patients with scleral lenses. Respondents (n=663) prescribed scleral lenses that ranged from 15 to 17 mm in diameter (65%), smaller than 15 mm (18%), and larger than 18 mm (17%). More than 50 lens designs were identified. Average daily wearing time of 11.8 hr was consistent across 651 respondents, and 475/651 (73%) recommended midday removal on some, most, or all days. Most respondents recommended nonpreserved saline to fill the bowl of the lens before application (single-use vials, 392/653 [60%]; bottled products, 372/653 [57%]). A hydrogen peroxide-based disinfection system was the most commonly recommended care product (397/651 [61%]). A reasonable degree of consensus exists regarding some aspects of scleral lens prescription and management (average lens diameter, daily wearing time, and use of nonpreserved products for lens application). Further study is needed to develop evidence-based guidelines for scleral lens prescription and management.

  16. Prescriptions for Educational Reform: Dilemmas of the Real World.

    Science.gov (United States)

    Spaulding, Seth

    1988-01-01

    Explores prescriptions offered for reforming education and the dilemmas they raise. Programs for democratizing education are reviewed with respect to expanding facilities, reforming admission policies, joining teaching and learning, offering experimental courses, and making structural changes. Results of programs for education about democracy and…

  17. Assessment of prescription pattern in asthma therapy at Shamli hospitals.

    Science.gov (United States)

    Srivastava, Rishabh; Sharma, Sanjay; Keshri, Lav; Wal, Pranay

    2012-05-01

    This drug utilization or prescription-monitoring study was conducted to evaluate the drug-prescribing trend of anti-asthmatic drugs in various hospitals (health care centre) of Shamli, (Prabuddha Nagar, Uttar Pradesh, India). The study was conducted in three famous hospitals of Shamli on three hundred thirty (330) patients, using a developed prescription auditing Performa. Data was recorded from the co-operating patients, attending the outpatient department using a chance random sample method for six months by interviewing and information was filled in the performa. The collected data was studied statistically for determining the most prominently prescribed medication for the treatment. The collected information suggested that β-agonist were the most frequently prescribed anti-asthmatic drugs followed by corticosteroids, Methylxanthine, anti-histaminics and leukotriene antagonist. Also the performed prescription analysis revealed that there is significant difference in the prescriptions for multiple drug therapy (90%) as compared to single drug therapy (10%). Also even after the commercial development of pulmonary targeted systems, oral dosage form like tablets (54.93%) were preferred over inhalation (31.69%). Thus, it can be concluded that the present prescribing pattern of antiasthmatics in Shamli does not completely meet standard guidelines for the asthma treatment. Hence there is a need of awareness amongst the physicians of Shamli so that they can follow the guidelines while treating asthma. Also the patients must be encouraged to use newly developed inhalational drug delivery systems for improving the treatment.

  18. Epidemiological study of epilepsy by monitoring prescriptions of antiepileptic drugs.

    Science.gov (United States)

    Banfi, R; Borselli, G; Marinai, C; Borgheresi, A; Cavalieri, A

    1995-07-28

    The aim of this study is to evaluate a simple and effective method of acquiring epidemiological information about epilepsy. Data on antiepileptic drug prescriptions was collected, the utilization pattern being based on defined daily doses (DDDs). Antiepileptic drugs are epidemiological tracers of epilepsy due to their chronic and highly specific usage. Consequently, a prevalence rate for the whole population may be obtained by using DDDs. Data on antiepileptic drug prescriptions for a period of 6 months in 1992 and 6 months in 1993 indicate a utilization of approximately 7 DDDs of antiepileptic drugs per 1,000 inhabitants. The prevalence of epilepsy was estimated by correcting the exposure calculated in DDDs by a factor of 0.68. In our sample, the prevalence of the disease was 5.2 per 1,000 inhabitants in 1992 and 4.9 per 1,000 in 1993. Physician prescriptions were concentrated on four compounds, namely phenobarbital, carbamazepine, valproic acid and phenytoin, which together represented 90% of total antiepileptic drug prescriptions.

  19. Prescription of neuroleptics for children and adolescents in Italy.

    Science.gov (United States)

    Traversa, G; Spila-Alegiani, S; Arpino, C; Ferrara, M

    1998-01-01

    The objective of this study was to describe the use of neuroleptics among children and adolescents in the province of Rome. Subjects 5 to 19 years of age who received neuroleptic prescriptions within the National Health Service between 1986 and 1991 were identified. Prevalence and incidence of use were estimated. The yearly prevalence of use during the study period ranged from 1.3 to 1.7 per 1000 inhabitants. The incidence during 1989 was 1.1 per 1000, with a marked increase with age. Haloperidol was the drug most frequently prescribed; 59.2% of the subjects received only one prescription during the year. Among subjects with more than one prescription, 42.3% received neuroleptics in combination. The observed pattern of use suggests that in current practice neuroleptics are also used for the treatment of nonpsychotic conditions. The analysis of data derived from a prescription monitoring system may provide an important contribution to the description of neuroleptic use among children and adolescents.

  20. 21 CFR 201.100 - Prescription drugs for human use.

    Science.gov (United States)

    2010-04-01

    ..., storage, or wholesale distribution of prescription drugs; or (ii) In the possession of a retail, hospital... without naming their components. (ii) Color additives may be designated as coloring without naming specific color components unless the naming of such components is required by a color additive...

  1. Medical and Nonmedical Users of Prescription Drugs among College Students

    Science.gov (United States)

    Rozenbroek, Katelyn; Rothstein, William G.

    2011-01-01

    Objectives: To examine medical and nonmedical users of prescription opioids, central nervous system depressants, and stimulants taken individually and in combination. Participants: Undergraduates at an urban mid-Atlantic university with 12,000 students. Methods: A questionnaire administered in classes provided 413 responses, with a usable response…

  2. Non-prescription medications: considerations for the dental practitioner.

    Science.gov (United States)

    Kingon, Angus

    2012-04-01

    The widespread availability of non-prescription medications has a significant potential impact on dental practice. Dentists are trained to provide scientifically-based advice on the appropriate use of medications, but it is not uncommon for patients to take matters into their own hands, especially if it is felt that the treatment provided is not solving a specific problem, or is insufficient. Well-meaning but often ill-informed family and friends frequently have an opinion as to what should be done. Not only may the suggested treatment not be effective, it may also be harmful. Over-the-counter medications can easily be obtained, and there is nothing to stop individuals exceeding recommended doses, and if this occurs, there could be adverse medical sequelae. Patient compliance in taking prescription medications is known to be problematic, and when combined with the ready availability of complementary medications, probiotics and illicit drugs, the risk of self-harm can be seen to be a distinct possibility. To compound the position, sometimes there seems to be, in a practical sense, little regulation on the advertising and marketing of non-prescription medications, which can leave consumers not only confused but potentially vulnerable. While complementary medicines may not have a significant role in dental practice in 2012, that may not always be the case as research continues, and reference is made to some aspects of ongoing work. Non-prescription medications are discussed, and some effects on oral health are considered.

  3. Prescribing style and variation in antibiotic prescriptions for sore throat

    DEFF Research Database (Denmark)

    Cordoba Currea, Gloria Cristina; Siersma, Volkert Dirk; Lopez-Valcarcel, Beatriz Gonzalez

    2015-01-01

    Background: Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we...

  4. Prescription options for the below knee amputee. A review.

    Science.gov (United States)

    Abrahamson, M A; Skinner, H B; Effeney, D J; Wilson, L A

    1985-02-01

    In 1973 a workshop sponsored by the National Academy of Sciences recommended that "efforts to develop prescription criteria for use of the numerous variants of the BK prosthesis should be intensified." This paper provides a review of the important considerations in the prescription of a below-knee prosthesis. It is intended that this information would assist the physician to make better informed decisions regarding the specific type of prosthesis for a particular patient. No attempt has been made to describe all prosthetic options since a majority of amputees are fit with only a few prescriptions. Thus, socket design, suspension, shank type, and foot specification may be optimized for individual patients through mutual agreement of the prosthetist and the knowledgeable physician. This paper will present some of the more difficult prescription solutions to the various fitting problems that are representative of our nation's amputee population. This is done with the knowledge that there may be other and equally successful solutions to these problems. Several illustrative examples are provided.

  5. ERs May Need to Rethink Opioid Prescription Practices

    Science.gov (United States)

    ... pills, the study showed. "Looking only at the cases analyzed in this study, if all prescriptions written for more than 20 ... be prescribed for ankle sprain at all." The study was scheduled to be ... meeting, in Orlando. Findings presented at meeting are generally viewed as ...

  6. Developing multilingual prescription instructions for patients with limited english proficiency.

    Science.gov (United States)

    Bailey, Stacy Cooper; Hasnain-Wynia, Romana; Chen, Alice Hm; Sarkar, Urmimala; Schoua-Glusberg, Alisu; Lindquist, Lee A; Schillinger, Dean; Wolf, Michael S

    2012-02-01

    This article describes the development of a set of patient-centered prescription medication instructions and their translation into Chinese, Korean, Russian, Spanish, and Vietnamese. Challenges and lessons learned from this process are reported to inform future efforts to develop easy-to-understand, multilingual materials for use in health care settings.

  7. Prescriptions: Hyperrealism and the Chemical Regulation of Mood

    Science.gov (United States)

    Bleakley, Alan; Jolly, Margaretta

    2012-01-01

    Using contemporary literary sources, we explore the powerful ideological framework that normalises prescription dependency as part of everyday life, focusing upon the treatment of mood disorders. Through a literary critical methodology, we read novels by American hyperrealists such as Bret Easton Ellis, David Foster Wallace and Rick Moody as…

  8. Outpatient antibiotic prescriptions from 1992 to 2001 in The Netherlands

    NARCIS (Netherlands)

    Kuyvenhoven, MM; van Balen, FAM; Verheij, TJM

    2003-01-01

    Objectives: Although Dutch outpatient antibiotic prescription rates are low compared with other European countries, continuing to scrutinize trends in outpatient antibiotic use is important in order to identify possible increases in antibiotic use or inappropriate increases in the use of particular

  9. 21 CFR 886.5844 - Prescription spectacle lens.

    Science.gov (United States)

    2010-04-01

    ... for the patient. The device may be modified to protect the eyes from bright sunlight (i.e...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5844 Prescription spectacle lens. (a... photosensitized. (b) Classification. Class I (general controls). The device is exempt from the...

  10. Outpatient antibiotic prescriptions from 1992 to 2001 in The Netherlands

    NARCIS (Netherlands)

    Kuyvenhoven, MM; van Balen, FAM; Verheij, TJM

    2003-01-01

    Objectives: Although Dutch outpatient antibiotic prescription rates are low compared with other European countries, continuing to scrutinize trends in outpatient antibiotic use is important in order to identify possible increases in antibiotic use or inappropriate increases in the use of particular

  11. Peer Influence: Use of Alcohol, Tobacco, and Prescription Medications

    Science.gov (United States)

    Varela, Alberto; Pritchard, Mary E.

    2011-01-01

    Objective: Risk-taking behavior (eg, alcohol abuse, tobacco usage, misuse of prescription medications) among college students is a widespread problem. This study focused not only on the frequency of risky health behaviors in college students, but also the companions with whom they engaged in such behaviors. Methods: Three hundred and twelve…

  12. 31 CFR 900.1 - Prescription of standards.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Prescription of standards. 900.1 Section 900.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL... policies regarding the classification of debt for accounting purposes (for example, write off...

  13. Buying prescription drugs on the internet: promises and pitfalls.

    Science.gov (United States)

    Weiss, Alan M

    2006-03-01

    Patients can save time and money by purchasing drugs from Internet pharmacies, but they can also end up with counterfeit or substandard medications. Online pharmacies bypass the safeguards of a doctor-patient relationship, creating a dangerous opportunity for prescription drug abuse and unchecked medication interactions and side effects.

  14. A population analysis of prescriptions for asthma medications during pregnancy

    NARCIS (Netherlands)

    Zetstra-van der Woude, Priscilla A.; Vroegop, J. Sebastiaan; Bos, H. Jens; de Jong-van den Berg, Lolkje T. W.

    2013-01-01

    Background: It is important to control asthma during pregnancy. However, some studies indicate that women stop or change their asthma medications when they become pregnant. Objective: We used a population database to analyze changes in prescriptions for asthma medications to patients before, during,

  15. Advertising of antihypertensive medicines and prescription sales in Australia.

    Science.gov (United States)

    Vitry, A; Lai, Y H

    2009-11-01

    Drug promotion is one of the main factors that influence prescribing practices, but there are limited data available to quantify the relationship between drug advertising and prescription sales. To investigate the relationship between advertising for antihypertensive medicines and prescription sales in Australia between 1993 and 2002. Retrospective observational study. Advertising trends were monitored by counting the number of advertisements published in three Australian medical journals. Monthly prescription dispensing data were obtained from Drug Utilisation Sub-Committee and expressed as numbers of defined daily doses/1000 inhabitants/day. Linear regression and cross-correlations of time series were used in the analysis. The drug classes the most heavily advertised, angiotensin-converting enzyme inhibitors and calcium channel blockers, were also the most prescribed during the study period, while the drugs the least advertised, thiazide diuretics and beta-blockers, were the least used. In 5 of the 7 main antihypertensive classes, the product the most advertised was also the most prescribed. Other factors, such as the publication of large clinical trials, may have also influenced prescribing patterns. Prescription sales of antihypertensives in Australia are correlated with promotional advertising. The newest and most expensive medicines may be chosen over older effective drugs by prescribers. New policies on drug promotion control need to be developed.

  16. Exploring University Students' Online Information Seeking about Prescription Medications

    Science.gov (United States)

    Alkhalaf, Ahmad Abdullah

    2013-01-01

    This study explored university students' information seeking behaviors related to prescription medication (PM) information. Specifically, it examined the different sources students use for PM information, their use and perceptions of online sources, the types of PM information they seek, their concerns about, and methods they apply to verify the…

  17. English Grammar Comparison:Descriptive Grammar vs. Prescriptive Grammar

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jing-wen; LI Yi-an

    2015-01-01

    English grammar is thought as one of the most important parts in both language learning and teaching. While few peo⁃ple know there is more than one kind of English grammar. This essay provides the features and comparison between two com⁃monly used English grammar, namely descriptive grammar and prescriptive grammar, and assist English teachers to explore further in grammar teaching.

  18. Adequacy of anti-tuberculosis drug prescriptions in Viet Nam

    DEFF Research Database (Denmark)

    Hoa, N B; Lauritsen, J M; Rieder, H L

    2012-01-01

    SETTING: National Tuberculosis Program, Viet Nam, 2008. OBJECTIVES: To determine drug prescription adherence to national guidelines, to examine factors associated with an erroneous dosage of rifampin (RMP) and to evaluate the impact of an insufficient RMP dosage on treatment outcome. METHODS: A r...

  19. 21 CFR 801.110 - Retail exemption for prescription devices.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Retail exemption for prescription devices. 801.110 Section 801.110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES LABELING Exemptions From Adequate Directions for Use § 801.110 Retail...

  20. Prosthetic prescription in the Netherlands : an interview with clinical experts

    NARCIS (Netherlands)

    Van Der Linde, H; Geertzen, JHB; Hofstad, CJ; Postema, K

    2004-01-01

    In the process of guideline development for prosthetic prescription in the Netherlands the authors made a study of the daily clinical practice of lower limb prosthetics. Besides the evidence-based knowledge from literature the more implicit knowledge from clinical experts is of importance for guidel

  1. Prescription, Description, Reflection: the shape of the software process improvement field

    DEFF Research Database (Denmark)

    Hansen, Bo; Rose, Jeremy; Tjørnehøj, Gitte

    2004-01-01

    in software organisations), or   prescriptive descriptive reflective (theoretically analytical). The field is found to be rather dominated by one approach (the Capability Maturity Model (CMM)) and heavily biased towards prescriptive contributions. Neither of these trends is necessarily beneficial...

  2. prescription pattern of anti-hypertensive drugs in a tertiary health

    African Journals Online (AJOL)

    Emmanuel Ameh

    Objective: This study examined the pattern of physicians' prescription of ... combination therapy, and demonstrate an apparent higher efficacy of calcium channel blocker ... Key words: Antihypertensive, prescription, blood pressure control.

  3. 77 FR 16973 - Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in...

    Science.gov (United States)

    2012-03-23

    ... Prescription Drug Advertisements; Presentation of the Major Statement in Television and Radio Advertisements in... determining whether the major statement in direct-to- consumer (DTC) television and radio advertisements... and Benefit Information in Direct-to-Consumer Prescription Drug Television...

  4. Availability of prescription drugs for bipolar disorder at online pharmacies.

    Science.gov (United States)

    Monteith, Scott; Glenn, Tasha; Bauer, Rita; Conell, Jörn; Bauer, Michael

    2016-03-15

    There is increasing use of online pharmacies to purchase prescription drugs. While some online pharmacies are legitimate and safe, there are many unsafe and illegal so-called "rogue" online pharmacies. This study investigated the availability of psychotropic drugs online to consumers in the US, using 5 commonly prescribed drugs for bipolar disorder. Using the search term "buy [drug name]" in the Google, Yahoo and Bing search engines, the characteristics of the online pharmacies found on the first two pages of search results were investigated. The availability of the requested dosage and formulations of two brand (Seroquel XR, Abilify) and three generic drugs (lamotrigine, lithium carbonate and bupropion SR) were determined. Of 30 online pharmacies found, 17 (57%) were rated as rogue by LegitScript. Of the 30 pharmacies, 15 (50%) require a prescription, 21 (70%) claim to be from Canada, with 20 of these having a Canadian International Pharmacy association (CIPA) seal on the website. Only 13 of the 20 sites with a CIPA seal were active CIPA members. There were about the same number of trust verification seals on the rogue and legitimate pharmacy sites. Some rogue pharmacies are professional in appearance, and may be difficult for consumers to recognize as rogue. All five brand and generic drugs were offered for sale online, with or without a prescription. However, many substitutions were presented such as different strengths and formulations including products not approved by the FDA. No evaluation of product quality, packaging or purchasing. Psychotropic medications are available online with or without a prescription. The majority of online pharmacy websites were rogue. Physicians should ask about the use of online pharmacies. For those who choose to use online pharmacies, two measures to detect rogue pharmacies are recommended: (1) only purchase drugs from pharmacies that require a prescription, and (2) check all pharmacy verification seals directly on the website

  5. Frequency of outpatient antibiotic prescription on discharge to hospice care.

    Science.gov (United States)

    Furuno, Jon P; Noble, Brie N; Horne, Kristi N; McGregor, Jessina C; Elman, Miriam R; Bearden, David T; Walsh, Eric W; Fromme, Erik K

    2014-09-01

    The use of antibiotics is common in hospice care despite limited evidence that it improves symptoms or quality of life. Patients receiving antibiotics upon discharge from a hospital may be more likely to continue use following transition to hospice care despite a shift in the goals of care. We quantified the frequency and characteristics for receiving a prescription for antibiotics on discharge from acute care to hospice care. This was a cross-sectional study among adult inpatients (≥18 years old) discharged to hospice care from Oregon Health & Science University (OHSU) from 1 January 2010 to 31 December 2012. Data were collected from an electronic data repository and from the Department of Care Management. Among 62,792 discharges, 845 (1.3%) patients were discharged directly to hospice care (60.0% home and 40.0% inpatient). Most patients discharged to hospice were >65 years old (50.9%) and male (54.6%) and had stayed in the hospital for ≤7 days (56.6%). The prevalence of antibiotic prescription upon discharge to hospice was 21.1%. Among patients discharged with an antibiotic prescription, 70.8% had a documented infection during their index admission. Among documented infections, 40.3% were bloodstream infections, septicemia, or endocarditis, and 38.9% were pneumonia. Independent risk factors for receiving an antibiotic prescription were documented infection during the index admission (adjusted odds ratio [AOR]=7.00; 95% confidence interval [95% CI]=4.68 to 10.46), discharge to home hospice care (AOR=2.86; 95% CI=1.92 to 4.28), and having a cancer diagnosis (AOR=2.19; 95% CI=1.48 to 3.23). These data suggest that a high proportion of patients discharged from acute care to hospice care receive an antibiotic prescription upon discharge.

  6. A Theoretical Approach to Electronic Prescription System: Lesson Learned from Literature Review

    OpenAIRE

    Samadbeik, Mahnaz; Ahmadi, Maryam; Hosseini Asanjan, Seyed Masoud

    2013-01-01

    Context The tendency to use advanced technology in healthcare and the governmental policies have put forward electronic prescription. Electronic prescription is considered as the main solution to overcome the major drawbacks of the paper-based medication prescription, such as transcription errors. This study aims to provide practical information concerning electronic prescription system to a variety of stakeholders. Evidence Acquisition In this review study, PubMed, ISI Web of Science, Scopus...

  7. A Survey of the Studies on Compatible Law of Ingredients in Chinese Herbal Prescriptions

    Institute of Scientific and Technical Information of China (English)

    Wei Guoli; Zheng Xuebao

    2008-01-01

    @@ To prescribe a Chinese herbal prescription for the patient is the main thing done by the doctor in TCM clinic,and also an important link in TCM difierential treatment.The key point in the study of TCM prescriptions is the compatibility of Jaerbal ingredients in a prescription.To reveal the compatible law of TCM prescriptions is an important component part for TCM modernization.The following is a brief account on this kind of studies.

  8. Prescription Opioid Abuse, Prescription Opioid Addiction, and Heroin Abuse among Adolescents in a Recovery High School: A Pilot Study

    Science.gov (United States)

    Vosburg, Suzanne K.; Eaton, Thomas A.; Sokolowska, Marta; Osgood, Eric D.; Ashworth, Judy B.; Trudeau, Jeremiah J.; Muffett-Lipinski, Michelle; Katz, Nathaniel P.

    2016-01-01

    The progression from prescription opioid (RXO) abuse to RXO addiction is not well understood in adolescents, nor is the progression from RXO addiction to heroin abuse. The purpose of this pilot study was to characterize the development of RXO drug abuse, RXO drug addiction, and heroin abuse in a small cohort of adolescents recovering from opioid…

  9. Adding a Prescription Drug Benefit to Medicare: An Analysis of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

    Science.gov (United States)

    2004-09-01

    unpredictable and potentially high costs ( Marmor , 2000). The missing benefit was outpatient prescription drug coverage. On July 30th, President Johnson...Proposed Medicare Benefit At-a-Glance Chart. Retrieved September 12, 2004, from: http://www.kff.org/medicare/ medicarebenefitataglance.cfm Marmor , T.R

  10. Prescription pattern of drugs in pregnancy induced hypertension in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Naveen Kumar T

    2013-12-01

    Conclusion: The incidence of single drugs therapy and two drugs was high. Irrational prescriptions were few. The present pattern of prescriptions can be improved by advocating rational drug prescription and awareness regarding safe use of drugs to the obstetricians. [Int J Basic Clin Pharmacol 2013; 2(6.000: 783-787

  11. 76 FR 41434 - Removal of Certain Requirements Related to the Prescription Drug Marketing Act; Opportunity for...

    Science.gov (United States)

    2011-07-14

    ... prescription drug marketing and distribution. The primary purpose of the PDMA was to increase safeguards to... the Prescription Drug Marketing Act; Opportunity for Public Comment AGENCY: Food and Drug... remove a section of the Prescription Drug Marketing Act (PDMA) regulations requiring that prior to...

  12. Linking Annual Prescription Volume of Antidepressants to Corresponding Web Search Query Data: A Possible Proxy for Medical Prescription Behavior?

    Science.gov (United States)

    Gahr, Maximilian; Uzelac, Zeljko; Zeiss, René; Connemann, Bernhard J; Lang, Dirk; Schönfeldt-Lecuona, Carlos

    2015-12-01

    Persons using the Internet to retrieve medical information generate large amounts of health-related data, which are increasingly used in modern health sciences. We analyzed the relation between annual prescription volumes (APVs) of several antidepressants with marketing approval in Germany and corresponding web search query data generated in Google to test whether web search query volume may be a proxy for medical prescription practice. We obtained APVs of several antidepressants related to corresponding prescriptions at the expense of the statutory health insurance in Germany from 2004 to 2013. Web search query data generated in Germany and related to defined search terms (active substance or brand name) were obtained with Google Trends. We calculated correlations (Person's r) between the APVs of each substance and the respective annual "search share" values; coefficients of determination (R) were computed to determine the amount of variability shared by the 2 variables. Significant and strong correlations between substance-specific APVs and corresponding annual query volumes were found for each substance during the observational interval: agomelatine (r = 0.968, R = 0.932, P = 0.01), bupropion (r = 0.962, R = 0.925, P = 0.01), citalopram (r = 0.970, R = 0.941, P = 0.01), escitalopram (r = 0.824, R = 0.682, P = 0.01), fluoxetine (r = 0.885, R = 0.783, P = 0.01), paroxetine (r = 0.801, R = 0.641, P = 0.01), and sertraline (r = 0.880, R = 0.689, P = 0.01). Although the used data did not allow to perform an analysis with a higher temporal resolution (quarters, months), our results suggest that web search query volume may be a proxy for corresponding prescription behavior. However, further studies analyzing other pharmacologic agents and prescription data that facilitate an increased temporal resolution are needed to confirm this hypothesis.

  13. Antipsychotic prescription and mortality in hospitalized older persons.

    Science.gov (United States)

    Chiesa, Deborah; Marengoni, Alessandra; Nobili, Alessandro; Tettamanti, Mauro; Pasina, Luca; Franchi, Carlotta; Djade, Codjo D; Corrao, Salvatore; Salerno, Francesco; Marcucci, Maura; Romanelli, Giuseppe; Mannucci, Pier Mannuccio

    2017-06-06

    Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Società Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Among 2703 patients included in the study, 135 (5%) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38% and 36% of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71% had an SBT score ≥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score <5 (indicative of normal cognition). In-hospital mortality was slightly higher in patients prescribed antipsychotic drugs (14.3% vs 9.4%; P = 0.109), but in multivariate analysis only male sex, older age, and higher SBT scores were significantly related to mortality during hospitalization. At 3-month follow-up, only male sex, older age, and higher SBT scores were associated with mortality. We found that the prescription of antipsychotic

  14. Prescription drug overdose: between patients and their doctors

    Directory of Open Access Journals (Sweden)

    Ling W

    2013-01-01

    Full Text Available Walter Ling,1 Li-Tzy Wu21Department of Psychiatry and Biobehavioral Science, Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA; 2Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USAPrescription drug overdoses, mainly involving prescription opioids, have reached epidemic proportions in the United States over the past 20 years.1,2 Since 2003, prescription opioids have been involved in more drug-related overdose deaths than heroin and cocaine combined. Among patients who were prescribed opioids, an estimated 20% were prescribed high doses of opioids by either single or multiple physicians, and these patients appeared to account for the majority of prescription opioid-related overdoses.1,3,4 The increase in prescription overdose deaths has coincided with a major increase in prescription opioid sales.2 The prescribing practices of some physicians are often believed to have contributed in part to the increase in these overdose deaths. In a recently published perspective, Anna Lembke speculated on why doctors prescribe opioids to known prescription opioid abusers.5 Her article raises a timely and troubling issue for all of us interested in this area of medicine. Lembke identifies the root of the problem to lie in the changing societal attitude towards pain and suffering, the ever-growing availability of opioid medications, the regulatory requirements promulgated, and the perceived shift in the role of the medical professional in this context. Central to her argument is that physicians must now practice according to a set of externally imposed expectations of patients, payers, and regulators, putting the prescriber in the position of being "damned if you do and damned if you don’t". If Lembke is right, the physician now prescribes not according to what he or she wants to do, but according to what he or she must do. The result, at one extreme, is the patient acting as their

  15. A pharmacoepidemiological study of prescription pattern in outpatient clinics in Southwestern Saudi Arabia.

    Science.gov (United States)

    Irshaid, Yacoub M; Al-Homrany, Mohammed A; Hamdi, Anwar A; Adjepon-Yamoah, Keneth K; Mahfouz, Ahmed A

    2004-12-01

    To study the pattern of prescriptions in outpatient clinics in a teaching hospital in Southwestern Saudi Arabia. A total of 3796 prescriptions from outpatient clinics of Aseer Central Hospital, Abha, Kingdom of Saudi Arabia were screened randomly and systemically over one-year period (April 2000 to April 2001). The prescriptions were analyzed for the essential elements of the prescription order, and for the number and classes of drugs prescribed, source of prescription and appropriateness of prescription to the diagnosis. The source of prescriptions was not provided in 61.5% of prescriptions. The diagnosis was missing in 15.1% and not readable in 18.9% of prescriptions. Upper respiratory tract infection (URTI) was the most frequent diagnosis and was included in 21.6% of prescriptions. The average number of drugs per prescription was 2.1 +/- 1.05 (Mean +/- SD), with 90.8% of prescriptions containing 3 or fewer drugs. The most frequently prescribed drugs were nonsteroidal anti-inflammatory drugs (NSAIDs), including paracetamol which were included in 51.2% of prescriptions, followed by antibacterial agents (33.2%). Only 46.4% of prescriptions were appropriate to the diagnosis, while 11.1% were partially appropriate and 5.3% were inappropriate. For the rest (37.2%), it was difficult to evaluate appropriateness due to deficient information. General practitioners and specialists were more likely to prescribe appropriately than emergency room physicians (64.6% and 60.4% versus 35.7%). None of the prescriptions for antiplatelet and anticoagulant drugs and antihypertensive agents were inappropriate. These results emphasize the need for continuing medical education on rational prescribing, and for periodic monitoring of physicians habits on drug utilization.

  16. [Witchcraft medicine and folklore in Wushierbingfang ('Prescriptions for fifty-two diseases')].

    Science.gov (United States)

    Jia, Hai-yan

    2010-03-01

    One important characteristic of early stage of TCM is the intermixture of witches medicine and folklore. A few witch prescriptions in Wushierbingfang ('Prescriptions for fifty-two diseases') indicated the residual traces of the mixture of witch and medicine in the medical literatures. The witch prescriptions recorded in Wushierbingfang ('Prescriptions for fifty-two diseases') could be divided into supplication, Yu-step, exorcism, Nuo ritual and peach wood charms etc. Witchcraft developed into folklore and the application of witchcraft sometimes manifested as the form of folklore, which were also reflected in the records of ('Prescriptions for fifty-two diseases').

  17. Pharmacists correcting schedule II prescriptions: DEA flip-flops continue.

    Science.gov (United States)

    Abood, Richard R

    2010-12-01

    The Drug Enforcement Administration (DEA) has in recent years engaged in flip-flopping over important policy decisions. The most recent example involved whether a pharmacist can correct a written schedule II prescription upon verification with the prescriber. For several years the DEA's policy permitted this practice. Then the DEA issued a conflicting policy statement in 2007 in the preamble to the multiple schedule II prescription regulation, causing a series of subsequent contradictory statements ending with the policy that pharmacists should follow state law or policy until the Agency issues a regulation. It is doubtful that the DEA's opinion in the preamble would in itself constitute legal authority, or that the Agency would try to enforce the opinion. Nonetheless, these flip-flop opinions have confused pharmacists, caused some pharmacies to have claims rejected by third party payors, and most likely have inconvenienced patients.

  18. Is the DEA's new "prescription series" regulation balanced?

    Science.gov (United States)

    Gilson, Aaron M; Joranson, David E

    2008-01-01

    To address the dual public health imperatives of enhanced pain management and decreased abuse and diversion of prescription medications, the U.S. Drug Enforcement Administration (DEA) recently adopted regulations to allow practitioners to issue multiple prescriptions for a Schedule II controlled substance on the same day, to be dispensed sequentially. Public feedback suggested there was concern that practitioners could interpret the initially proposed language as limiting the quantity of prescribed medication and establishing an ambiguous practice standard. The DEA later explicitly confirmed that they did not intend to impose undue limits on practice. Rather, if implemented appropriately, the new regulation can be considered an important mechanism to control medication diversion while maintaining access for legitimate medical purposes and patient care.

  19. Equivalence of Two Contour Prescriptions in Superstring Perturbation Theory

    CERN Document Server

    Sen, Ashoke

    2016-01-01

    Conventional superstring perturbation theory based on the world-sheet approach gives divergent results for the S-matrix whenever the total center of mass energy of the incoming particles exceeds the threshold of production of any final state consistent with conservation laws. Two systematic approaches have been suggested for dealing with this difficulty. The first one involves deforming the integration cycles over the moduli space of punctured Riemann surfaces into complexified moduli space. The second one treats the amplitude as a sum of superstring field theory Feynman diagrams and deforms the integration contours over loop energies of the Feynman diagram into the complex plane. In this paper we establish the equivalence of the two prescriptions to all orders in perturbation theory. Since the second approach is known to lead to unitary amplitudes, this establishes the consistency of the first prescription with unitarity.

  20. Meaning of prescriptions I and II in Higgs inflation

    CERN Document Server

    Hamada, Yuta; Nakanishi, Yukari; Oda, Kin-ya

    2016-01-01

    We consider the prescription dependence of the Higgs effective potential under the presence of general non-minimal couplings. We evaluate the fermion loop correction to the effective action in a simplified Higgs-Yukawa model whose path integral measure takes simple form either in the Jordan or Einstein frame. The resultant effective action becomes identical in both cases when we properly take into account the quartically divergent term coming from the change of measure. Working in the counter-term formalism, we clarify that the difference between the prescriptions I and II comes from the counter term to cancel the logarithmic divergence. This difference can be absorbed into the choice of tree-level potential from the infinitely many possibilities, including all the higher-dimensional terms. We also present another mechanism to obtain a flat potential by freezing the running of the effective quartic coupling for large field values, using the non-minimal coupling in the gauge kinetic function.

  1. Chronic pain, opioid prescriptions, and mortality in Denmark

    DEFF Research Database (Denmark)

    Ekholm, Ola; Kurita, Geana Paula; Højsted, Jette

    2014-01-01

    This study aimed to investigate the risk of death, development of cancer, and hospital inpatient admissions resulting from injuries and toxicity/poisoning among opioid users with chronic noncancer pain. A population-based cohort of 13,127 adults, who have participated in the Danish Health Interview...... Surveys in 2000 or 2005 and have been followed up prospectively by registers until the end of 2011, were classified according to the absence or presence of chronic pain (ie, pain lasting ⩾ 6 months) and long-term or short-term opioid use (individuals using at least 1 prescription per month for 6 months...... in the previous year and at least 1 prescription in the previous year, respectively). The risk of all-cause mortality was 1.72 (95% confidence interval [CI]=1.23-2.41) times higher among long-term opioid users than among individuals without chronic pain. The risk of death was lower, but still significantly higher...

  2. Thick prescriptions: toward an interpretation of pharmaceutical sales practices.

    Science.gov (United States)

    Oldani, Michael J

    2004-09-01

    Anthropologists of medicine and science are increasingly studying all aspects of pharmaceutical industry practices--from research and development to the marketing of prescription drugs. This article ethnographically explores one particular stage in the life cycle of pharmaceuticals: sales and marketing. Drawing on a range of sources-investigative journalism, medical ethics, and autoethnography--the author examines the day-to-day activities of pharmaceutical salespersons, or drug reps, during the 1990s. He describes in detail the pharmaceutical gift cycle, a three-way exchange network between doctors, salespersons, and patients and how this process of exchange is currently in a state of involution. This gift economy exists to generate prescriptions (scripts) and can mask and/or perpetuate risks and side effects for patients. With implications of pharmaceutical industry practices impacting everything from the personal-psychological to the global political economy, medical anthropologists can play a lead role in the emerging scholarly discourse concerned with critical pharmaceutical studies.

  3. Proton pump inhibitor prescription abuse and sepsis in cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Antonio Picardi; Umberto Vespasiani-Gentilucci

    2016-01-01

    Proton pump inhibitors(PPIs) represent one of the most extensively prescribed classes of drugs in general and in patients with liver cirrhosis. Many prescriptions are made without a clear adherence to standard indications. As a class of ordinarily well tolerated drug, PPIs are not free of side-effects and concerns have been raised about a possible role for PPIs in predisposing patients to an increased risk of bacterial infections and sepsis. As evidences of different power are accumulating on this topic, prospective studies are needed to reach a more universal agreement, but definitely more attention is needed by prescribers in being more adherent to the few recognized indications for the use of PPIs, particularly in patients with liver cirrhosis. Otherwise, doctors could run the risk of being accused of "abused" prescription.

  4. Changes in prescription habits with the introduction of generic fluoxetine.

    Science.gov (United States)

    McLay, Robert; Klinski, Angelica

    2008-01-01

    When the patent on fluoxetine expired in 2001, prices for it fell sharply and marketing decreased. We investigated how market share for fluoxetine changed with the introduction of the generic. Prescribing information was tracked at a military hospital where providers knew the cost of medication, but were not compelled to use the cheaper form. Market share for fluoxetine among selective serotonin reuptake inhibitors was observed for the 64 months surrounding the introduction, and changes were examined by linear regression analysis. Results showed that in the 32 months before the introduction of the generic, fluoxetine maintained a relatively steady share of prescriptions. After the introduction of the generic, fluoxetine steadily lost market share over time. No significant relationship could be seen between drug company visits and gains for their individual products. Examination of all Department of Defense prescriptions for the 16 months surrounding the introduction of generic fluoxetine showed a similar drop in its market share.

  5. Determining prescription durations based on the parametric waiting time distribution

    DEFF Research Database (Denmark)

    Støvring, Henrik; Pottegård, Anton; Hallas, Jesper

    2016-01-01

    ). When the IAD consisted of a mixture of two Log-Normal distributions, but was analyzed with a single Log-Normal distribution, relative bias did not exceed 9%. Using a Log-Normal FRD, we estimated prescription durations of 117, 91, 137, and 118 days for NSAIDs, warfarin, bendroflumethiazide...... two-component mixture model for the waiting time distribution (WTD). The distribution component for prevalent users estimates the forward recurrence density (FRD), which is related to the distribution of time between subsequent prescription redemptions, the inter-arrival density (IAD), for users......, and the method was applied to empirical data for four model drugs: non-steroidal anti-inflammatory drugs (NSAIDs), warfarin, bendroflumethiazide, and levothyroxine. RESULTS: Simulation studies found negligible bias when the data-generating model for the IAD coincided with the FRD used in the WTD estimation (Log-Normal...

  6. Prematurity and prescription asthma medication from childhood to young adulthood

    DEFF Research Database (Denmark)

    Damgaard, Anne Louise; Hansen, Bo Moelholm; Mathiasen, Rene

    2015-01-01

    INTRODUCTION: Preterm birth is associated with increased risk of asthma-like symptoms and purchase of prescription asthma medication in childhood. We investigated whether this association persists into adulthood and whether it is affected by accounting for neonatal respiratory morbidity (acute...... respiratory disease and bronchopulmonary dysplasia). METHODS: A national cohort of all infants born in Denmark in the period 1980-2009 was included in this register study. Data on purchase of asthma medication (combination of inhaled β-2 agonists and other drugs for obstructive airway disease) in 2010......-2011 were obtained from the Danish National Prescription Registry. Associations between gestational age (GA), neonatal respiratory morbidity and a cross-sectional evaluation of asthma medication purchase were explored by multivariate logistic regressions. RESULTS: A full dataset was obtained on 1...

  7. Nationwide and population-based prescription patterns in bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2016-01-01

    OBJECTIVES: The aim of the present study was to describe prescription patterns and changes in these patterns over the last decade for patients diagnosed with bipolar disorder in mental healthcare, using population-based and nationwide data, and to relate the findings to recommendations from...... international guidelines. METHODS: A population-based, nationwide study was carried out. It included register-based longitudinal data on all patients with a first-ever contact with mental healthcare with a diagnosis of mania/bipolar disorder from the entire Danish population, and all prescription data...... for this population during the decade from 2000 to 2011, inclusive. RESULTS: A total of 3,205 patients were included in the study. Lithium was prescribed less, and antiepileptic and atypical antipsychotic agents were prescribed substantially more during the study period. Lithium went from being the first drug...

  8. Prescription drug monitoring program utilization in Kentucky community pharmacies

    OpenAIRE

    Wixson SE; Blumenschein K; Goodin AJ; Talbert J; Freeman PR

    2015-01-01

    Objective: Identify characteristics of Kentucky community pharmacists and community pharmacists? practice environment associated with utilization of the Kentucky All Schedule Prescription Electronic Reporting Program (KASPER). Methods: Surveys were mailed to all 1,018 Kentucky pharmacists with a KASPER account and an additional 1,000 licensed pharmacists without an account. Bivariate analyses examined the association between KASPER utilization and practice type (independent or chain) and prac...

  9. Assessment of prescription writing skills among undergraduate medical students

    Directory of Open Access Journals (Sweden)

    M. J. Sudha

    2016-08-01

    Conclusions: There are widespread lacunae in prescription writing by medical undergraduates. There is perceived need for reinforcement sessions at third and final phase of undergraduate education to address this gap. Most participants opine that clinicians do not discuss this issue during case discussion. There is knowledge and practice gap in using generic names while prescribing. [Int J Basic Clin Pharmacol 2016; 5(4.000: 1586-1593

  10. Vital Signs – Prescription Painkiller Overdoses

    Centers for Disease Control (CDC) Podcasts

    2013-07-02

    This podcast is based on the July 2013 CDC Vital Signs report. Prescription painkiller overdoses are an under-recognized and growing problem among women. This program includes things that women and health care providers can do to reduce the risk of overdose.  Created: 7/2/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/2/2013.

  11. Medication wrong-route administrations in relation to medical prescriptions

    OpenAIRE

    GIMENES, Fernanda Raphael Escobar; Marques, Tatiane Cristina; Teixeira,Thalyta Cardoso Alux; MOTA, Maria Lurdemiler Sabóia; Silva,Ana Elisa Bauer de Camargo; Cassiani, Silvia Helena De Bortoli

    2011-01-01

    This study analyzes the influence of medical prescriptions' writing on the occurrence of medication errors in the medical wards of five Brazilian hospitals. This descriptive study used data obtained from a multicenter study conducted in 2005. The population was composed of 1,425 medication errors and the sample included 92 routes through which medication was wrongly administered. The pharmacological classes most frequently involved in errors were cardiovascular agents (31.5%), medication that...

  12. Drug prescription behavior in a Teaching Hospital of Western Maharashtra

    OpenAIRE

    Gurpreet Singh; Anuj Bhatnagar; Sandip Mukherji; Dhruv Goel

    2016-01-01

    Context: To identify drug prescription behavior and thus, guide further actions to recommend evidence-based module for learning in postgraduate curriculum. Aims: To determine drug prescribing behavior of postgraduate residents. Settings and Design: Retrospective historical data-based cross-sectional study in a tertiary care, multispecialty teaching hospital. Materials and Methods: Calculation of sample size and sampling procedure was based on standard recommendations of the World Health Organ...

  13. Direct-to-consumer advertising of prescription drugs.

    Science.gov (United States)

    Williams, J R; Hensel, P J

    1995-01-01

    Starting consumers off on the "path to purchase" by encouraging them to seek more information is a major goal of direct-to-consumer (DTC) advertising for prescription medications. But the authors found that a consumer's attitude toward DTC advertising can determine which of several paths he or she is likely to take. The attitudes of older adults are especially significant for pharmaceutical marketers because these consumers are heavy users of the drugs being advertised.

  14. Understanding Preclerkship Medical Students’ Poor Performance in Prescription Writing

    Directory of Open Access Journals (Sweden)

    Henry James

    2016-05-01

    Full Text Available Objectives: This study aimed to explore reasons for poor performance in prescription writing stations of the objective structured practical examination (OSPE and absenteeism in prescription writing sessions among preclerkship medical students at the Arabian Gulf University (AGU in Manama, Bahrain. Methods: This descriptive study was carried out between September 2014 and June 2015 among 157 preclerkship medical students at AGU. Data were collected using focus group discussions and a questionnaire with closed- and open-ended items. Results: All 157 students participated in the study (response rate: 100.0%. The most frequently cited reasons for poor performance in OSPE stations were an inability to select the correct drugs (79.6%, treatment duration (69.4%, drug quantity (69.4% and drug formulation (68.2%. Additionally, students reported inadequate time for completing the stations (68.8%. During focus group discussions, students reported other reasons for poor performance, including examination stress and the difficulty of the stations. Absenteeism was attributed to the length of each session (55.4%, lack of interest (50.3%, reliance on peers for information (48.4% and optional attendance policies (47.1%. Repetitive material, large group sessions, unmet student expectations and the proximity of the sessions to summative examinations were also indicated to contribute to absenteeism according to open-ended responses or focus group discussions. Conclusion: This study suggests that AGU medical students perform poorly in prescription writing OSPE stations because of inadequate clinical pharmacology knowledge. Participation in prescription writing sessions needs to be enhanced by addressing the concerns identified in this study. Strategies to improve attendance and performance should take into account the learner-teacher relationship.

  15. Prescription audit of outpatient attendees of secondary level government hospitals in Maharashtra.

    Science.gov (United States)

    Potharaju, Hanumantha Rao; Kabra, S G

    2011-04-01

    The main objective of the prescription audit of the secondary level government hospitals under the Maharashtra Health Systems Development Project (MHSDP) was to develop a list of essential drugs. Other objectives were to articulate measures for improving the prescription practices and to generate information on the core prescribing indicators proposed by the World Health Organization (WHO). The study was conducted among a representative sample of 31 secondary level hospitals under MHSDP. A copy of the prescription was obtained with the help of a pre-inserted carbon, in a special format. Data for only 'first encounter prescriptions' was collected for all patients attending the Outpatient Department (OPD). About 77 percent of the prescriptions contained only one diagnosis. The average number of drugs per prescription was 3.1. About 60 percent of the drugs were prescribed by generic names and about 23 percent of the prescribed drugs were in combination. About 25 percent of the prescriptions contained at least one injection, while 35 percent contained at least one antibiotic. In 16 percent of the prescriptions a vitamin or tonic was prescribed. About 46 percent of the single ingredient formulations were as per the WHO 2003, Essential Medicines List (EML). Based on the findings of the Prescription Audit an EML was prepared for each category of the secondary level hospitals, for use in the OPD. Prescription audits are useful in generating data on morbidity, which forms the basis for preparing the list of essential medicines. Mechanisms necessary for improving prescription practices are suggested.

  16. Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas

    Directory of Open Access Journals (Sweden)

    Shana Harris

    2015-12-01

    Full Text Available Objective: Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors. Methods: Data were drawn from a cross-sectional Internet study (N = 846 of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions. Results: While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion. Conclusion: Findings suggest that predictive characteristics vary according to diverter group.

  17. Influences of motivational contexts on prescription drug misuse and related drug problems.

    Science.gov (United States)

    Kelly, Brian C; Rendina, H Jonathon; Vuolo, Mike; Wells, Brooke E; Parsons, Jeffrey T

    2015-01-01

    Prescription drug misuse has emerged as a significant problem among young adults. While the effects of motivational contexts have been demonstrated for illicit drugs, the role of motivational contexts in prescription drug misuse remains understudied. Using data from 400 young adults recruited via time-space sampling, we examined the role of motivational contexts in the frequency of misuse of three prescription drug types as well as drug-related problems and symptoms of dependency. Both negative and positive motivations to use drugs are associated with increases in prescription drug misuse frequency. Only negative motivations are associated directly with drug problems and drug dependence, as well as indirectly via prescription pain killer misuse. Addressing positive and negative motivational contexts of prescription drug misuse may not only provide a means to reduce misuse and implement harm reduction measures, but may also inform the content of treatment plans for young adults with prescription drug misuse problems.

  18. Delayed prescriptions: attitudes and experiences of general practitioners in the Midwest.

    Science.gov (United States)

    Hayes, M; Faherty, A; Hannon, D

    2013-06-01

    141 questionnaires were posted to GPs randomly selected in the Mid-West. 103 responses were received. 32 GPs (31%) strongly agreed and 65 GPs (63%) agreed that antibiotics are over used in general practice. 35 GPs (34%) felt under pressure to prescribe an antibiotic at least once a day. 41 GPs (40%) agreed that delayed prescriptions are a safe prescribing strategy. 53 GPs (51%) agreed that delayed prescriptions have the potential to reduce antibiotic use. 33 GPs (32%) disagreed that giving delayed prescriptions increases the duration of the consultation. 49 GPs (47%) agreed that delayed prescriptions decrease the likelihood of return visit in the same illness. 55 GPs (53%) agreed that delayed prescriptions help to involve patients in managing their own illness. 46 GPs (45%) disagreed that patients find delayed prescriptions confusing. The majority of GPs (41/39.8%) use delayed prescriptions once a week or at least once a day (34/33%).

  19. Psychosocial factors associated with the prescription of generic drugs.

    Science.gov (United States)

    Rodríguez-Calvillo, Javier A; Lana, Alberto; Cueto, Antonio; Markham, Wolfgang A; López, Maria Luisa

    2011-07-01

    To evaluate factors associated with "Generic drug prescription" (GDP) behaviour in Spain using the ASE (Attitude, Social Influence, Self-Efficacy) Model. General Practitioners were sent a validated and anonymous questionnaire measuring the ASE and Motivation variables for GDP and their generic drug prescription percentage. Most (n=486; 61.98%) responded to this cross-sectional survey. The mean scores and the 95% confidence intervals (95% CI) were calculated. A binary logistic regression was used to identify the variables that best predict GDP behaviour. The main advantages and motivations for GDP were "saving money" and "protecting professional ethics". The greatest social influences were "doctors' personal preferences" and "authorities' pressure". GDP accounted for a scarce 15% of the total prescription. ASE and Motivation items were the best predictors: they explain 25% of being a 'high prescriber'. The highest prescribers were paediatricians (OR=5.07), workers in rural settings (OR=3.68) and professionals with high Motivation (OR=1.17) and Attitude (OR=1.11) scores. GDP percentage is very low compared with other countries. Interventions to modify the Attitudes of Primary Care doctors towards generic drugs should be implemented. Better informed patients, longer doctor appointment times and more varied dosage forms of generic drugs would also facilitate improvements in GDP. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Correlates of Prescription Opioid Legitimacy Judgments Among Community Pharmacists.

    Science.gov (United States)

    Hagemeier, Nicholas E; Alamian, Arsham; Murawski, Matthew M; Flippin, Heather; Hagy, Elizabeth J; Pack, Robert P

    2016-05-11

    Community pharmacists are legally required to evaluate and confirm the legitimacy of prescription opioids (POs) prior to dispensing. Yet, previous research has indicated community pharmacists perceive nearly 50% of dispensed POs to be issued lacking a legitimate medical purpose. To analyze correlates of PO legitimacy judgments across pharmacist and pharmacy setting characteristics. A cross-sectional study of 2000 Tennessee pharmacists was conducted during October and November of 2012. Community pharmacists' self-reported attitudes, beliefs, and behaviors specific to PO legitimacy were elicited. Step-wise multinomial logistic regression techniques were used to model correlates of PO legitimacy across low, moderate and high PO legitimacy estimations. Being female, practicing in a chain or independent practice setting, fear of employer disciplinary action if PO legitimacy is questioned, and self-confidence in one's ability to detect PO abuse increased the odds of low (vs. high) PO legitimacy estimation (p chain and independent pharmacies, having POs as a greater percent of total prescriptions filled, and having the perception of PO abuse as a problem in the practice setting were significant positive correlates of moderate (vs high) PO legitimacy estimation (p < 0.05). Both modifiable and non-modifiable correlates were statistically significantly associated with PO legitimacy judgments. Distinct correlates were noted across low and moderate as compared to high estimations of PO legitimacy. Legitimacy judgments can inform theoretical exploration of PO dispensing behaviors and inform intervention development targeted at reducing and preventing prescription drug abuse.

  1. Prescription pattern in asthma therapy at Gorakhpur hospitals

    Directory of Open Access Journals (Sweden)

    Pandey Awanish

    2010-01-01

    Full Text Available Objectives: This prescription-monitoring study was conducted to establish the drug-prescribing trend of anti-asthmatic drugs in various hospitals of Gorakhpur. Setting: The study covered three famous hospitals of Gorakhpur. Patients and Methods: Hundred patients were studied using a prescription auditing performa. Data was recorded from the patient′s attending the out patient department using a chance random sample method for two months. Patients who co- operated were interviewed and information was filled in the performa. Results: The results suggested that b-agonist (40% were the most frequently prescribed anti-asthmatic drugs followed by Methylxanthine (27%, corticosteroids (25%, leukotriene antagonist (4.4% and anti-histaminics (3.6% was the least prescribed. Analysis of prescription revealed that multiple drug therapy (81% was opted for a significant number of patients as compared to single drug therapy (19%. Contrary to popular belief, oral dosage form tablets (56.3% were preferred over inhalation (33.8%. Conclusion: It is concluded that the present prescribing pattern of anti-asthmatics in Gorakhpur does not completely meet standard guidelines of asthma treatment. Hence there is a need to encourage physicians of Gorakhpur to follow the guidelines while treating asthma.

  2. Prescription pattern in asthma therapy at Gorakhpur hospitals.

    Science.gov (United States)

    Pandey, Awanish; Tripathi, Poonam; Pandey, Rishabh Dev

    2010-01-01

    This prescription-monitoring study was conducted to establish the drug-prescribing trend of anti-asthmatic drugs in various hospitals of Gorakhpur. The study covered three famous hospitals of Gorakhpur. Hundred patients were studied using a prescription auditing performa. Data was recorded from the patient's attending the out patient department using a chance random sample method for two months. Patients who co- operated were interviewed and information was filled in the performa. The results suggested that b-agonist (40%) were the most frequently prescribed anti-asthmatic drugs followed by Methylxanthine (27%), corticosteroids (25%), leukotriene antagonist (4.4%) and anti-histaminics (3.6%) was the least prescribed. Analysis of prescription revealed that multiple drug therapy (81%) was opted for a significant number of patients as compared to single drug therapy (19%). Contrary to popular belief, oral dosage form tablets (56.3%) were preferred over inhalation (33.8%). It is concluded that the present prescribing pattern of anti-asthmatics in Gorakhpur does not completely meet standard guidelines of asthma treatment. Hence there is a need to encourage physicians of Gorakhpur to follow the guidelines while treating asthma.

  3. Therapeutic efficacy of different Hemodialysis prescriptions in canine azotemia

    Directory of Open Access Journals (Sweden)

    Ekta Atul Thakkar

    2014-12-01

    Full Text Available Aim: The aim was to determine therapeutic efficacy of different Hemodialysis prescriptions in canine azotemia. Materials and Methods: Patients (n=9 with acute onset of renal dysfunction or chronic patients with superimposed acute factor (component or patients with known chronic nature of the disease were dialyzed with Fresenius 4008S hemodialysis machine after jugular catheterization. Patients were randomly divided into two groups, one group (n=3 was dialyzed every day and second (n=4 was dialyzed on alternate days. The patients were evaluated for following parameters to compare the efficacy of the dialysis prescription: Urea reduction ratio (URR, creatinine reduction ratio (CRR, Kt/V, time averaged concentration of urea (TAC urea. Result and Discussion: Increasing both dialysis frequency and duration is the superior dialysis schedule. Patient dialyzed every day with total processed blood volume 1.79 L/Kg for 4 h 26 min/session had the lowest TAC of 36.82 mg/dl, thereby was considered it as a better prescription.

  4. Writing out prescriptions: hyperrealism and the chemical regulation of mood.

    Science.gov (United States)

    Bleakley, Alan; Jolly, Margaretta

    2012-12-01

    Using contemporary literary sources, we explore the powerful ideological framework that normalises prescription dependency as part of everyday life, focusing upon the treatment of mood disorders. Through a literary critical methodology, we read novels by American hyperrealists such as Bret Easton Ellis, David Foster Wallace and Rick Moody as symptomatic of prescription culture. Though we argue that these writers brilliantly understand the dangers of mood medication, they do not escape its logic, rather, 'writing it out' as they write against it. Indeed, we propose that their novels bear ironic similarities to medical texts such as the British National Formulary, usually seen as a neutral handbook for physicians' guidance in prescribing. We explicate their method as that of deconstruction, which, in contrast to more obvious critiques of chemical treatment, such as therapy, neither analyses nor cures. Though this method underplays the possibility of pragmatic and political resistance exemplified by alternative formularies such as the long-established feminist health manual Our Bodies, Ourselves, we argue that its very ambiguity uniquely exposes the complex determinisms associated with prescribed medication. We thus propose the value of drawing on deconstructive literature to better understand 'health' interventions such as prescription drugs for the regulation of mood.

  5. Experimental Study of Angeng Prescription for Climacteric Syndrome in Rats

    Directory of Open Access Journals (Sweden)

    CHEN Da-shuai

    2014-12-01

    Full Text Available Objective: To observe the effect of Angeng Formula on climacteric syndrome in rats. Methods: The ovaries of female SD rats were removed for the establishment of menopausal syndrome rat models. After drug delivery for 30 d, serum sex hormone levels and indexes of uterus, adrenal gland and pituitary were detected. Meanwhile, the effects of drugs on the histopathology of uterus, adrenal gland and pituitary in rats were observed. Results: Angeng prescription could increase the level of estradiol (E2 in castrated rat (P<0.01 and had a tendency to increase the level of progestin (P, lower the level of luteinizing hormone (LH and follicle-stimulating hormone (FSH as well as increase the indexes of the uterus and adrenal gland. Moreover, Angeng prescription could improve the pathologic condition of the uterus, adrenal gland and pituitary in castrated rats. Conclusion: Angeng prescription has a therapeutic effect on climacteric syndrome, the mechanism of which might be related with the function of regulating sex hormone.

  6. Antipsychotic Prescriptions for Children Aged 5 Years or Younger

    Directory of Open Access Journals (Sweden)

    Ana Lòpez-De Fede

    2014-10-01

    Full Text Available The use of antipsychotics in very young children is of concern given the lack of empirical evidence in their efficacy and long-term impact on children’s health. This study examined the prescription of antipsychotics among children aged ≤5 years enrolled in a state Medicaid program. Secondary data analysis was conducted using the Medicaid administrative data of a southeastern state. Using SAS 9.3, descriptive statistics were performed to examine socio-demographic characteristics, psychiatric diagnoses, off-label use, receipt of medications from multiple psychotropic drug classes, and receipt of non-pharmacologic psychiatric services among children aged ≤5 years who received antipsychotic prescriptions in calendar year (CY 2011. A total of 112 children in the target age group received antipsychotics in CY 2011, the most common prescription being risperidone. The most common listed psychiatric diagnosis was attention deficit hyperactivity disorder. Two in five children received antipsychotics for off-label use. Three in four children also received medications from at least one other psychotropic drug class. More than half did not receive adjunct psychiatric services. State-level policies offering specific guidance and recommendations for antipsychotic use among very young children are urgently needed. Future research is warranted to examine long-term impact of such practices on children’s growth and development.

  7. State-of-the-Art Prescriptive Criteria Weight Elicitation

    Directory of Open Access Journals (Sweden)

    Mona Riabacke

    2012-01-01

    Full Text Available Comparatively few of the vast amounts of decision analytical methods suggested have been widely spread in actual practice. Some approaches have nevertheless been more successful in this respect than others. Quantitative decision making has moved from the study of decision theory founded on a single criterion towards decision support for more realistic decision-making situations with multiple, often conflicting, criteria. Furthermore, the identified gap between normative and descriptive theories seems to suggest a shift to more prescriptive approaches. However, when decision analysis applications are used to aid prescriptive decision-making processes, additional demands are put on these applications to adapt to the users and the context. In particular, the issue of weight elicitation is crucial. There are several techniques for deriving criteria weights from preference statements. This is a cognitively demanding task, subject to different biases, and the elicited values can be heavily dependent on the method of assessment. There have been a number of methods suggested for assessing criteria weights, but these methods have properties which impact their applicability in practice. This paper provides a survey of state-of-the-art weight elicitation methods in a prescriptive setting.

  8. State prescription drug price Web sites: how useful to consumers?

    Science.gov (United States)

    Tu, Ha T; Corey, Catherine G

    2008-02-01

    To aid consumers in comparing prescription drug costs, many states have launched Web sites to publish drug prices offered by local retail pharmacies. The current push to make retail pharmacy prices accessible to consumers is part of a much broader movement to increase price transparency throughout the health-care sector. Efforts to encourage price-based shopping for hospital and physician services have encountered widespread concerns, both on grounds that prices for complex services are difficult to measure and compare accurately and that quality varies substantially across providers. Experts agree, however, that prescription drugs are much easier to shop for than other, more complex health services. However, extensive gaps in available price information--the result of relying on Medicaid data--seriously hamper the effectiveness of state drug price-comparison Web sites, according to a new study by the Center for Studying Health System Change (HSC). An alternative approach--requiring pharmacies to submit price lists to the states--would improve the usefulness of price information, but pharmacies typically oppose such a mandate. Another limitation of most state Web sites is that price information is restricted to local pharmacies, when online pharmacies, both U.S. and foreign, often sell prescription drugs at substantially lower prices. To further enhance consumer shopping tools, states might consider expanding the types of information provided, including online pharmacy comparison tools, lists of deeply discounted generic drugs offered by discount retailers, and lists of local pharmacies offering price matches.

  9. Attitudes toward drug prescription rights: a survey of Ontario chiropractors.

    Science.gov (United States)

    Emary, Peter Charles; Stuber, Kent Jason

    2015-01-01

    Several published surveys have shown that chiropractors are generally split in their opinions regarding the right to prescribe drugs in chiropractic practice. Many of these studies have been limited by low response rates, leaving the generalizability of their findings open to question. The aim of the current study was to ascertain the general attitudes of chiropractors in Ontario, Canada toward the inclusion of drug prescription rights in their scope of practice. Relationships between these attitudes and the number of years in practice including differences in philosophical orientation were also explored. A 14-item questionnaire was developed and invitations sent via e-mail to all eligible 2,677 chiropractors in active practice registered electronically with the College of Chiropractors of Ontario in February 2015. Data were collected and analyzed using descriptive and inferential statistics. 960 questionnaires were completed for a 36 % response rate. The majority of respondents agreed that chiropractors should be permitted to prescribe musculoskeletal medications such as over-the-counter and prescription-based analgesics, anti-inflammatories, and muscle relaxants. Over two-thirds also felt that with limited prescriptive authority chiropractors could help reduce patients' reliance on these types of drugs. Over three-quarters were opposed however to chiropractors having full prescribing rights. The majority indicated they recommend over-the-counter medications to acute and chronic patients to some extent in clinical practice. Nearly two-thirds perceived their knowledge of musculoskeletal medications as high or very high, while a similar proportion perceived their knowledge of drugs for non-musculoskeletal conditions to be low or very low. A majority of respondents felt that further education in pharmacology would be necessary for those in the profession wishing to prescribe medications. More recent graduates and those who espoused a broad scope of chiropractic

  10. Off-label prescriptions in Internal Medicine: difficulties involved

    Directory of Open Access Journals (Sweden)

    S. Gambetti

    2013-05-01

    Full Text Available INTRODUCTION Concern about off-label prescriptions, that is to say prescriptions of a drug for therapeutic indications and utilisations not approved in the medicine data sheet, is growing up more and more among hospital clinicians. AIM OF THE STUDY The aim of this work is to increase the consciousness that falling back upon off-label prescriptions has to be applied just in case of a validated therapeutic option missing, and provided that there are clinical evidences supporting the benefits reached by the patient through the assumption of that drug. Furthermore, it requires the patient involvement, in fact he has to be correctly informed and has to declare his acceptance to be treated with that kind of drug. The off-label prescription responsibility belongs to the prescribing clinician. The costs of these prescriptions can not be ascribed to the SSN (Servizio Sanitario Nazionale, unless the subjects treated are in-patients in the hospital or in a day-hospital service. METHODS a Understanding where the therapeutic indications arise and how to use medicines, on the basis of what is reported in the Summary of Product Characteristics (SPC following the correspondent declaration for marketing authorization. b Showing some examples of off-label utilisation. c Evaluating the current legislation that regulates and supports the possibility or impossibility to prescribe off-label. CONCLUSIONS It is always better to use offlabel drugs that are authorized: by Agenzia Italiana del Farmaco (AIFA, through the dynamic list of medicines included in the 648/96, by the Local Therapeutic Commission or by the Ethical Committee. The act of prescribing off-label drugs for out-patients has to be shared even with the patient’s general practitioner, who is responsible for the same patient territorially, knows his medical history very well and the potential chronic therapy assumed. This is important for a proper evaluation of possible interactions and incompatibilities

  11. Care management: agreement between nursing prescriptions and patients' care needs.

    Science.gov (United States)

    Faeda, Marília Silveira; Perroca, Márcia Galan

    2016-08-08

    analyze agreement between nursing prescriptions recorded in medical files and patients' care needs; investigate the correlation between the nurses' professional background and agreement of prescriptions. descriptive study with quantitative and documentary approach conducted in the medical clinic, surgical, and specialized units of a university hospital in the interior of São Paulo, Brazil. The new validated version of a Patient Classification Instrument was used and 380 nursing prescriptions written at the times of hospital admission and discharge were assessed. 75% of the nursing prescriptions items were compatible with the patients' care needs. Only low correlation between nursing prescription agreement and professional background was found. the nursing prescriptions did not fully meet the care needs of patients. The care context and work process should be analyzed to enable more effective prescriptions, while strategies to assess the care needs of patients are recommended. analisar a concordância entre prescrições de enfermagem, registradas nos prontuários, e as necessidades de cuidados dos pacientes; investigar a correlação entre o perfil profissional dos enfermeiros e a concordância das prescrições. estudo descritivo com abordagem quantitativa e documental, realizado em unidades de clínica médica, cirúrgica e especializada de um hospital de ensino, no interior do Estado de São Paulo. Foi aplicada a nova versão validada do Instrumento de Classificação de Pacientes e, posteriormente, investigadas 380 prescrições de enfermagem no momento da admissão e alta hospitalar. foi identificado que 75% dos itens das prescrições de enfermagem estavam compatíveis com as necessidades cuidativas dos pacientes. Encontrou-se baixa correlação entre a concordância da prescrição de enfermagem e o perfil profissional. as prescrições de enfermagem não estão sendo realizadas, em sua totalidade, em consonância com as necessidades dos pacientes. Para

  12. Widening consumer access to medicines: a comparison of prescription to non-prescription medicine switch in Australia and New Zealand.

    Directory of Open Access Journals (Sweden)

    Natalie J Gauld

    Full Text Available Despite similarities in health systems and Trans-Tasman Harmonization of medicines scheduling, New Zealand is more active than Australia in 'switching' (reclassifying medicines from prescription to non-prescription.To identify and compare enablers and barriers to switch in New Zealand and Australia.We conducted and analyzed 27 in-depth personal interviews with key participants in NZ and Australia and international participants previously located in Australia, and analyzed records of meetings considering switches (2000-2013. Analysis of both sets of data entailed a heuristic qualitative approach that embraced the lead researcher's knowledge and experience.The key themes identified were conservatism and political influences in Australia, and an open attitude, proactivity and flexibility in NZ. Pharmacist-only medicine schedules and individuals holding a progressive attitude were proposed to facilitate switch in both countries. A pharmacy retail group drove many switches in NZ ('third-party switch', unlike Australia. Barriers to switch in both countries included small market sizes, funding of prescription medicines and cost of doctor visits, and lack of market exclusivity. In Australia, advertising limitations for pharmacist-only medicines reportedly discouraged industry from submitting switch applications. Perceptions of pharmacy performance could help or hinder switches.Committee and regulator openness to switch, and confidence in pharmacy appear to influence consumer access to medicines. The pharmacist-only medicine schedule in Australasia and the rise of third-party switch and flexibility in switch in NZ could be considered elsewhere to enable switch.

  13. Analysis of Potential Drug-Drug Interactions and Its Clinical Manifestation of Pediatric Prescription on 2 Pharmacies in Bandung

    Directory of Open Access Journals (Sweden)

    Melisa I. Barliana

    2013-09-01

    Full Text Available The potential of Drug-Drug Interactions (DDI in prescription have high incidence around the world, including Indonesia. However, scientific evidence regarding DDI in Indonesia is not available. Therefore, in this study we have conducted survey in 2 pharmacies in Bandung against pediatric prescription given by pediatrician. These prescriptions then analyzed the potential for DDI contained in the prescription and clinical manifestation. The analysis showed that in pharmacy A, there are 33 prescriptions (from a total of 155 prescriptions that have potential DDI, or approximately 21.19% (2 prescriptions have the potential DDI major categories, 23 prescriptions categorized as moderate, and 8 prescriptions as minor. In Pharmacy B, there are 6 prescriptions (from a total of 40 prescriptions or 15% of potential DDI (4 prescriptions categorized as moderate and 2 prescriptions as minor. This result showed that potential DDI happened less than 50% in pediatric prescription from both pharmacies. However, this should get attention because DDI should not happen in a prescription considering its clinical manifestations caused by DDI. Moreover, current pharmaceutical care refers to patient oriented than product oriented. In addition, further study for the pediatric prescription on DDI incidence in large scale need to be investigated.

  14. 21 CFR 200.200 - Prescription drugs; reminder advertisements and reminder labeling to provide price information to...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Prescription drugs; reminder advertisements and... Prescription Drug Consumer Price Listing § 200.200 Prescription drugs; reminder advertisements and reminder labeling to provide price information to consumers. (a) Prescription drug reminder advertisements...

  15. 21 CFR 201.56 - Requirements on content and format of labeling for human prescription drug and biological products.

    Science.gov (United States)

    2010-04-01

    ... human prescription drug and biological products. 201.56 Section 201.56 Food and Drugs FOOD AND DRUG... human prescription drug and biological products. (a) General requirements. Prescription drug labeling... requirements in §§ 201.56(d) and 201.57. (1) The following categories of prescription drug products are...

  16. 21 CFR 1306.15 - Provision of prescription information between retail pharmacies and central fill pharmacies for...

    Science.gov (United States)

    2010-04-01

    ... prescription has been transmitted, the name of the retail pharmacy pharmacist transmitting the prescription... retail pharmacy pharmacist transmitting the prescription, and the date of transmittal must be added to... retail pharmacies and central fill pharmacies for prescriptions of Schedule II controlled...

  17. Multiple prescriptions of antibiotics for children aged 0 to 5 years in relation to type of antibiotic

    DEFF Research Database (Denmark)

    Thrane, Nana; Olesen, Charlotte; Schønheyder, Henrik Carl

    1999-01-01

    The risk of receiving more than one prescription within an antibiotic course was examined for all children aged 0 to 5 years in a Danish county during 1997. We identified 29,307 prescriptions of systemic antibiotics for 16,245 children in a prescription database. Ten per cent of the prescriptions...

  18. Drug utilization 90%: an innovative method in assessing quality of drug prescription with specific reference to non-steroidal anti-inflammatory drugs prescription

    Directory of Open Access Journals (Sweden)

    Kulkarni Dhananjay

    2016-10-01

    Conclusions: Preferential cyclooxygenase-2 (COX-2 inhibitor NSAIDs were more preferred. Number of prescribed NSAIDs constituting to DU90% is more, thus prescription pattern needs further rationalization. Further large scale study is required to bring out more details about NSAID prescription pattern and its rational use. [Int J Basic Clin Pharmacol 2016; 5(5.000: 1746-1751

  19. Longitudinal trajectories of non-medical use of prescription medication among middle and high school students

    Science.gov (United States)

    Boyd, Carol J.; Cranford, James A.; McCabe, Sean Esteban

    2016-01-01

    The non-medical use of prescription medications has been identified as a major public health problem among youth, although few longitudinal studies have examined non-medical use of prescription medications in the context of other drug use. Previous cross-sectional studies have shown gender and race differences in non-medical use of prescription medications. It was hypothesized that (1) non-medical use of prescription medications increases with age, and (2) these increases will be stronger in magnitude among female and Caucasian adolescents. Changes in non-medical use of prescription medications across 4 years were examined and compared with changes in other drug use (e.g., alcohol and marijuana). Middle and high school students enrolled in 5 schools in southeastern Michigan completed web-based surveys at 4 annual time points. The cumulative sample size was 5,217. The sample ranged from 12 to 18 years, 61% were Caucasian, 34% were African American, and 50% were female. Using a series of repeated measures latent class analyses, the trajectories of non-medical use of prescription medications were examined, demonstrating a 2-class solution: (1) the no/low non-medical use of prescription medications group had low probabilities of any non-medical use of prescription medications across all grades, and (2) the any non-medical use of prescription medications group showed a roughly linear increase in the probability of non-medical use of prescription medications over time. The probability of any non-medical use of prescription medications increased during the transition from middle school to high school. Results from this longitudinal study yielded several noteworthy findings: Participants who were classified in the any/high non-medical use of prescription medications group showed a discontinuous pattern of non-medical use of prescription medications over time, indicating that non-medical use of prescription medications is a relatively sporadic behavior that does not persist

  20. Evaluation of antibiotic prescriptions for urinary tract infections in a geriatric rehabilitation unit.

    Science.gov (United States)

    Afekouh, Hind; Baune, Patricia; De Falvelly, Diane; Guermah, Fatima; Ghitri, Saïda; Haber, Nicole

    2017-03-01

    Prescription of antibiotic in elderly patients must follow guidelines. to study the quality of antibiotic prescriptions for urinary tract infections (UTI) in the geriatric rehabilitation unit. Over a four-month period, all the antibiotics treatments prescribed for UTI in the rehabilitation ward were analyzed prospectively by medical experts and confronted with the recommendations of the local antibiotic guidelines. The methodology was based on Gyssens' algorithm. Treatments were considered appropriate if indication, choice of the molecule, duration and dose were approved by the experts, unnecessary if the indication was incorrect, and inappropriate in all other cases. The re-assessment of the prescription between 48 and 72 h was also evaluated. We reviewed 39 prescriptions. About half of all prescriptions (51.3%) was found to be unnecessary due to misdiagnosis, 16 prescriptions (41%) were considered inappropriate (2 for inadequate duration and 14 for inappropriate spectrum of activity, mainly with ceftriaxone prescriptions (9 cases)). Ten prescriptions (25.6%) were re-assessed between 48 and 72 hours after treatment initiation. According to this study, an improvement program was implemented. A diagnostic algorithm for UTI in elderly was drafted and will be integrated into the local guidelines. A supporting document for the re-assessment of the prescriptions 48-72h after treatment initiation was created. We decided to perform an evaluation of antibiotic prescriptions by the subcutaneous route.

  1. Prescription opioid use among university students: assessment of post-cue exposure craving.

    Science.gov (United States)

    Ashrafioun, Lisham; Carels, Robert A

    2014-03-01

    Despite the increasing number of prescriptions written to adolescents and young adults for opioid analgesics, the rise in non-medical use of such drugs among university students, and the potential role of craving in the misuse of opioids, there have been no published studies assessing craving for prescription opioids in this population. Therefore, the current study was designed to assess the impact of prescription opioid-related cue exposure on craving in university students. Students (n=277) recruited from a large university in the Midwestern United States were randomly assigned to two conditions to test the impact of cue exposure to either prescription opioid-related stimuli or control stimuli. Relative to the control condition, prescription opioid-related cue exposure significantly increased overall craving, desire and intention to use prescription opioids, relief from negative states by using prescription opioids, and perceived control over prescription opioid use. In addition, when assessing correlates of post-cue exposure craving, negative mood and procurement of prescription opioids from non-medical sources were the only measured variables that were significantly associated with overall craving and/or any of the craving measure's subscales. Craving may be important aspect of prescription opioid use among university students. Future research assessing craving as a function of non-medical user subtype is warranted.

  2. Assessment of prescription pattern at the public health facilities of Lucknow district

    Directory of Open Access Journals (Sweden)

    Kumari Ranjeeta

    2008-01-01

    Full Text Available Objectives: To study the prescription pattern at the different levels of public health facilities of Lucknow district and to assess the average cost of drugs prescribed. Methods: Multi-stage stratified random sampling was done to select 1625 prescriptions of the patients attending the different level of public health facilities in Lucknow district, from August 2005 to September 2006, which was used for the development of study tools, collection of data and analysis. Results: The important components of prescription viz. examination findings, weight of the child, follow up visit and the signatures of the prescribers were absent in the prescriptions at the primary level. Polypharmacy was common (3.1 ± 1.6 drugs per prescription. The prescription of drugs by generic name was low (27.1%. The prescriptions at the secondary level health facilities were incomplete with respect to mentioning the suffix/prefix of the drug, full name, dose, frequency and strength of the drugs, and directions specifying the route and duration of the treatment. The average cost of drugs/prescription/day in US$ (Mean, SD was found to be the highest at the tertiary level (0.34, 0.43, which decreased significantly at the primary level health facilities. Conclusion: The pattern of prescription in terms of completeness and rationality was poor. There is an urgent need to improve the standards of drug prescription.

  3. Prescriptive vs. performance based cook-off fire testing.

    Energy Technology Data Exchange (ETDEWEB)

    Nakos, James Thomas; Tieszen, Sheldon Robert; Erikson, William Wilding; Gill, Walter; Blanchat, Thomas K.

    2010-07-01

    In the fire safety community, the trend is toward implementing performance-based standards in place of existing prescriptive ones. Prescriptive standards can be difficult to adapt to changing design methods, materials, and application situations of systems that ultimately must perform well in unwanted fire situations. In general, this trend has produced positive results and is embraced by the fire protection community. The question arises as to whether this approach could be used to advantage in cook-off testing. Prescribed fuel fire cook-off tests have been instigated because of historical incidents that led to extensive damage to structures and loss of life. They are designed to evaluate the propensity for a violent response. The prescribed protocol has several advantages: it can be defined in terms of controllable parameters (wind speed, fuel type, pool size, etc.); and it may be conservative for a particular scenario. However, fires are inherently variable and prescribed tests are not necessarily representative of a particular accident scenario. Moreover, prescribed protocols are not necessarily adaptable and may not be conservative. We also consider performance-based testing. This requires more knowledge and thought regarding not only the fire environment, but the behavior of the munitions themselves. Sandia uses a performance based approach in assuring the safe behavior of systems of interest that contain energetic materials. Sandia also conducts prescriptive fire testing for the IAEA, NRC and the DOT. Here we comment on the strengths and weakness of both approaches and suggest a path forward should it be desirable to pursue a performance based cook-off standard.

  4. Prescription and practice of dialysis in Australia, 1988.

    Science.gov (United States)

    Disney, A P

    1990-05-01

    Facilities for provision of treatment of end-stage renal failure with hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) are available in many centers, most of which are government-funded. Medicare provides free treatment for all patients. There are no specific criteria for determining a patient's acceptance for dialysis treatment: age, quality of life, and capacity for independent living are important factors. The usual HD prescription is three dialysis periods weekly, hollow-fiber dialyzer, 1.0-1.2 m2 surface area, for 4 to 5 hours, with blood flow rate 250 mL/min and acetate-based dialysate flow rate 500 mL/min. Reuse of the dialyzer is common, but many units practice single use to reduce the expense and time necessary for processing the dialyzer and the risks of formalin exposure. There is only limited use of hemofiltration, or highly efficient dialyzers for shortened hours at higher blood flow rates. The choice of dialysis prescription is influenced by the physician's preference for the patient to be treated at home or in a self-care center with limited assistance. CAPD is preferred for home dialysis, especially for elderly or diabetic patients. There is no personal financial incentive to the physician to favor any particular form of dialysis. The costs of dialysis do influence the provision and prescription of treatment, causing the reuse of dialyzers and the limited use of bicarbonate-based HD and highly permeable dialyzers. Nevertheless, adequate dialysis should be available to all patients, and noncompliance with prescribed dialysis is infrequent. Quality-assurance programs have been developed both for nursing and medical care.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Prescription for change: accessing medication in transitional Russia.

    Science.gov (United States)

    Perlman, Francesca; Balabanova, Dina

    2011-11-01

    BACKGROUND Many Russians experienced difficulty in accessing prescription medication during the widespread health service disruption and rapid socio-economic transition of the 1990s. This paper examines trends and determinants of access in Russia during this period. METHODS Data were from nine rounds (1994-2004) of the Russia Longitudinal Monitoring Survey, a 38-centre household panel survey. Trends were measured in failing to access prescribed medication for the following reasons: unobtainable from a pharmacy, unable to afford and 'other' reasons. Determinants of unaffordability were studied in 1994, 1998 and 2004, using cross-sectional, age-adjusted logistic regression, with further multivariate analyses of unaffordability and failure to access for 'other' reasons in 2004. RESULTS After 1994, reporting of unavailability in pharmacies fell sharply from 25% to 4%. Meanwhile, unaffordability increased to 20% in 1998 but declined to 9% by 2004. In 1994, significant determinants of unaffordability were unemployment and lacking health care insurance in men. By 2004, determinants included low income and material goods in both sexes; rented accommodation and low education in men; and chronic disease and disability-related retirement in women. Not obtaining medicines for 'other' reasons was more likely amongst frequent male drinkers, and low educated or cohabiting women. Regional and gender differences were widest in 1998, coinciding with the Russian financial crisis. CONCLUSIONS Rapid improvements in drug availability in the late 1990s in Russia are a probable consequence of a more liberalized pharmaceutical sector and an improved pharmacy network, whilst later improvements in affordability may relate to expanded health care insurance coverage and economic recovery after the 1998 crash. A significant minority still finds prescription costs problematic, notably poorer and sick individuals, with inequalities apparently widening. Non-monetary determinants of affordability

  6. Assessment of prescription profile of pregnant women visiting antenatal clinics.

    Directory of Open Access Journals (Sweden)

    Eze UI

    2007-09-01

    Full Text Available Managing medical complications in pregnancy is a challenge to clinicians. Objectives: This study profiled some disease and prescription patterns for pregnant women attending antenatal clinics (ANCs in Nigeria. A risk classification of the medicines was also determined. Methods: Medical case files of 1,200 pregnant women attending antenatal clinics of 3 health facilities in Benin City, Nigeria were investigated. Disease pattern was determined from their diagnoses. The prescription pattern was assessed using WHO indicators, and the United States Food and Drug Administration classification of medicines according to risk to the foetus. Results: A total of 1,897 prescriptions of the 1,200 pregnant women attendees during the period under review were evaluated. Results indicated that malaria 554 (38% was the most prevalent disease, followed by upper respiratory tract infections (URTIs, 13% and gastrointestinal disturbances (GIT, 12%. The average number of drugs prescribed per encounter was found to be 3.0, and 2,434 (43% of medicines were prescribed by generic name. Minerals/ Vitamins 2,396 (42% were the most frequently prescribed medicines, and antibiotics occurred in 502 (8.8% of the total medicines. Of all medicines prescribed, 984 (17% were included in the foetal risk category C and 286 (5% in category D. Conclusion: The study concluded that malaria fever occurred most frequently followed by URTIs and GIT disturbances among the pregnant women. Minerals, vitamins and to a less extent anti-malarials topped the list of the prescribed medicines. The average number of medicines per encounter was much higher than WHO standards. The occurrence of contraindicated medicines was low.

  7. Off-label prescription of drugs at hospital

    Directory of Open Access Journals (Sweden)

    Vicente Arocas Casañ

    2016-03-01

    Full Text Available Objectives: To develop a procedure for management of off-label medications, and to analyze the treatments, indications, and hospital units which will request them more frequently, as well as which variables will have an impact on the authorization decision, and its economic impact. Methods: A procedure was designed where clinicians would complete request forms and the Hospital Unit would prepare reports assessing their efficacy, safety, convenience, and cost. The request forms for the past five years were analyzed. Results: A total of 834 applications were received, and 88.1% of these were accepted. The authorization rates were higher for Paediatric Units (95.7% vs. 86.6%; p<0.05. The reasons for considering prescriptions as off-label were: different indication (73.2%, different combination (10.2%, different line of treatment (8.6% and different age (8%. A 73.4% of requests were for antineoplastic drugs, and the most frequently prescribed were rituximab (120 and bevacizumab (103. The quality of evidence supporting the prescriptions was moderate-low, though no direct relationship with the likelihood of approval was demonstrated (p = 0.413. The cost of the approved medications was 8,567,537 €, and the theoretical savings for those drugs rejected was of 2,268,642 €. There was a statistically significant decrease in the authorization rate (p < 0.05, Student’s t test when spending increased. Conclusions: The responsibility for assessing off-label prescriptions has fallen on the Pharmacy Unit. It has not been demonstrated that the quality of evidence represents a decisive variable for approval of treatment; on the other hand, age and cost have demonstrated a significant impact

  8. Medical treatment of erectile dysfunction: too many medical prescriptions?

    Science.gov (United States)

    Capogrosso, Paolo; Ventimiglia, Eugenio; Oreggia, Davide; Salonia, Andrea; Montorsi, Francesco

    2017-08-01

    Erectile dysfunction (ED) is a worldwide commonly reported condition; epidemiological data showed a prevalence ranging from 2.3 to 53.4% within different population subsets. In this context, the advent of phosphodiesterase type 5 inhibitors (PDE5is) in the second mid of 1990s has deeply changed the treatment scenario of this bothersome condition. Being user-friendly compounds with an excellent overall safety profile, PDE5is emerged as the first-line treatment for ED, thus overcoming topical alprostadil and intracavernous injections (ICIs). However, available data on treatment-utilization patterns and medical prescriptions of PDE5is showed a range of as wide as 22-78% of patients reporting to purchase PDE5is even without a proper medical prescription. Moreover, an increase in the recreational use of PDE5is among young men has been observed in the last decades, with a worrisome diffusion of potential health-risky behaviours associated with this habit. Indeed, treatment of ED should carefully follow internationally based clinical guidelines to avoid inappropriate drug prescriptions, which may eventually expose treated patients to drug-related side effects. Thereof, a careful assessment of the so-called modifiable and reversible ED risk factors along with a patient-tailored screening for potential contraindications to the treatment itself should be performed in every case. Lastly, although conclusive data still lack, the potential association between life-risky PDE5is side effects (i.e. cardiovascular adverse events, melanoma skin cancer and worsening of prostate cancer outcomes) should be carefully taken into account when counselling patients for ED treatment.

  9. Exercise on Prescription: trial protocol and evaluation of outcomes

    Directory of Open Access Journals (Sweden)

    Puggaard Lis

    2007-03-01

    Full Text Available Abstract Background In many countries exercise prescriptions are used in an attempt to initiate a physically active lifestyle in sedentary populations. Previous studies have primarily evaluated low intensive exercise prescription interventions and found moderately positive effects on physical activity and aerobic fitness. In a highly intensive Danish exercise prescription scheme called 'Exercise on Prescription' (EoP the general practitioners can prescribe EoP to sedentary patients with lifestyle diseases. The aim of this randomized trial is to assess the short- and long-term effects of the EoP scheme. Thus, the aim of this paper is to describe the randomized controlled trial designed for evaluating effectiveness of EoP, and to present results from validations of outcome measures. Methods/Design EoP involves a 16-week supervised training intervention and five counselling sessions (health profiles. All patients referred to EoP were eligible for the trial and were offered participation during the baseline health profile. Comparisons between the EoP group and the control group were made at baseline, and after four and ten months. Physiological measures used were maximal oxygen uptake (VO2max, glycosylated haemoglobin (HbA1c, bodyweight, and BMI. Patient-reported measures used were physical activity, health-related quality of life, amount and intensity of exercise, compliance with national guidelines for physical activity, and physical fitness. The validation of the cycle ergometer test found a strong correlation between maximal work capacity and VO2max, and acceptable test-retest reliability at group level. Calibration of the HbA1c apparatus was stable over ten weeks with minimal use, and test-retest reliability was good. High agreement percents were found for test-retest reliability for the self-administered questionnaire. Discussion The trial is designed to provide information about the effectiveness of the EoP scheme. The trial is part of a

  10. The drug cost gap and the diagnosis-prescription connection.

    Science.gov (United States)

    Dross, David

    2008-01-01

    Although the rise in pharmacy benefit costs continues to outpace overall medical cost inflation, the gap is narrowing. Employers can improve cost and employee wellness even further with an innovative technique for drug therapy compliance called the Diagnosis-Prescription (Dx-Rx) approach. This article reports results from a 2007 national employer survey on pharmacy benefits and describes how the Dx-Rx innovation can keep patients and their doctors on track when it comes to controlling disease and driving down overall medical costs.

  11. On the demand for prescription drugs: heterogeneity in price responses.

    Science.gov (United States)

    Skipper, Niels

    2013-07-01

    This paper estimates the price elasticity of demand for prescription drugs using an exogenous shift in consumer co-payment caused by a reform in the Danish subsidy scheme for the general public. Using purchasing records for the entire Danish population, I show that the average price response for the most commonly used drug yields demand elasticities in the range of -0.36 to -0.5. The reform is shown to affect women, the elderly, and immigrants the most. Furthermore, this paper shows significant heterogeneity in the price response over different types of antibiotics, suggesting that the price elasticity of demand varies considerably even across relatively similar drugs.

  12. Prescription and use of “equivalent” drugs

    Directory of Open Access Journals (Sweden)

    Mario Eandi

    2007-06-01

    Full Text Available Three case reports, where an “equivalent” drugs is prescribed, are described: a patient treated with lanzoprazole, a man with acute myocardial infarction and a young man with epilepsy. These reports are emblematic of the doubts and problems that doctors have to afford in the choice of a generic drug instead of a branded drug. The Author examines not only clinical, legislative and economical aspects of prescription of generic drugs in the Italian context, but also common questions that patients may ask when a generic drug is prescribed.

  13. Our prescription drugs kill us in large numbers

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C

    2014-01-01

    Our prescription drugs are the third leading cause of death after heart disease and cancer in the United States and Europe. Around half of those who die have taken their drugs correctly; the other half die because of errors, such as too high a dose or use of a drug despite contraindications. Our......, widespread crime that includes corruption of the scientific evidence about drugs and bribery of doctors, and lies in drug marketing, which is as harmful as tobacco marketing and, therefore, should be banned. We should take far fewer drugs, and patients should carefully study the package inserts of the drugs...

  14. How Medicare could get better prices on prescription drugs.

    Science.gov (United States)

    Outterson, Kevin; Kesselheim, Aaron S

    2009-01-01

    Congress may reform drug pricing policies under Medicare Part D as part of a larger health reform effort. Currently, the "noninterference" provision prevents the government from negotiating drug prices on behalf of Medicare Part D prescription drug plans. Commonly considered reform proposals borrow ideas from Medicaid, either through returning dual eligibles to Medicaid drug pricing or by imposing mandatory rebates across the Part D population. We examine a menu of other options, including value-based pricing; expansion of generic and therapeutically equivalent substitution; increased formulary diversity; importation; and limited antitrust waivers. These latter options may reduce federal spending without direct government price negotiations.

  15. [Innovation and practice of component structure theory on material basis of traditional Chinese medicine prescriptions].

    Science.gov (United States)

    Feng, Liang; Zhang, Ming-Hu; Gu, Jun-Feil; Wu, Chan; Jia, Xiao-Bin

    2013-11-01

    The component structure theory on material basis of traditional Chinese medicine prescriptions provides a new research thought and method for studies on traditional Chinese medicine prescriptions in line with integrated and systemic characteristics of traditional Chinese medicine. Through years of exploration and accumulation, studies on component structures have made achievements. On the basis of summarizing the component structure development of material basis of traditional Chinese medicine prescriptions, we systematically explained the background of component structures and their roles and progress in quality control of traditional Chinese medicine prescriptions and modern innovative traditional Chinese medicine preparations. Studies on component structures promote the changes in material basis of traditional Chinese medicine prescriptions, and point out the direction for the modernization development of traditional Chinese medicine prescriptions.

  16. Prescription errors in Brazilian hospitals: a multi-centre exploratory survey.

    Science.gov (United States)

    Miasso, Adriana Inocenti; Oliveira, Regina Célia de; Silva, Ana Elisa Bauer de Camargo; Lyra Junior, Divaldo Pereira de; Gimenes, Fernanda Raphael Escobar; Fakih, Flávio Trevisan; Cassiani, Sílvia Helena De Bortoli

    2009-02-01

    In Brazil, millions of prescriptions do not follow the legal requirements necessary to guarantee the correct dispensing and administration of medication. This multi-centre exploratory study aimed to analyze the appropriateness of prescriptions at four Brazilian hospitals and to identify possible errors caused by inadequacies. The sample consisted of 864 prescriptions obtained at hospital medical clinics in January 2003. Data was collected by three nurse researchers during one week using a standard data sheet that included items about: the type of prescription; legibility; completeness; use of abbreviations; existence of changes and erasures. There were statistically significant differences between incomplete electronic prescriptions at hospital A, and handwritten ones from hospitals C (C2 = 12.703 and p system at the hospitals. Physicians, pharmacists and nurses should therefore jointly propose strategies to avoid these prescription errors.

  17. Compliance with the guidelines of prescription writing in a central hospital in the West Bank.

    Science.gov (United States)

    Tayem, Y I; Ibrahim, M A; Qubaja, M M; Shraim, R K; Taha, O B; Abu Shkhedem, E

    2013-09-01

    This retrospective, cross-sectional study was carried out to evaluate the quality of 2208 outpatient prescriptions in a central hospital in the West Bank, Palestine. The physicians' handwriting was poorly readable or illegible in one-third of the prescriptions. The prescriber's name and signature and patient's name were mentioned in almost all orders whereas the patient's age was stated in 54.9%. The vast majority of physicians (95.5%) prescribed drugs using their trade (brand) names. Drug strength, quantity and dose/frequency were stated in 61.1%, 76% and 73.8% of prescriptions respectively. Only 33 prescriptions (1.5%) contained full directions for use for all drugs. Correlation analysis revealed that the presence of certain prescription elements was statistically significantly associated with the clinic of origin and the number of drugs prescribed. The overall poor legibility and incompleteness of the prescriptions is of concern.

  18. STUDY ON DRUG COSTS ASSOCIATED WITH COPD PRESCRIPTION MEDICINE IN DENMARK

    DEFF Research Database (Denmark)

    Jakobsen, Iris Marie; Anker, Niels; Dolleru, Jens

    2012-01-01

    that the costs associated with COPD in Denmark are significant, but costs of prescription medicine for COPD were not analysed. OBJECTIVES: To analyse the societal costs associated with prescription medicine for COPD in Denmark. METHODS: The study was designed as a nationwide retrospective register study...... of the drug costs (ATC group R03) associated with COPD in the period 2001-2010. Data were retrieved from the Prescription Database, the National Patient Register and the Centralised Civil Register. The population comprised individuals (40+ years) who had at least one prescription of selected R03 drugs and who...... in 2010 with total costs of DKK 685 million (EUR 92 million). The average lifetime costs associated with COPD prescription medicine were estimated to be DKK 70,000-75,000 (EUR 9,416-10,089) per patient (2010 prices). CONCLUSION: The costs associated with prescription medicine for COPD in Denmark...

  19. Analysis of prescription database extracted from standard textbooks of traditional Dai medicine

    Directory of Open Access Journals (Sweden)

    Zhang Chuang

    2012-08-01

    Full Text Available Abstract Background Traditional Dai Medicine (TDM is one of the four major ethnomedicine of China. In 2007 a group of experts produced a set of seven Dai medical textbooks on this subject. The first two were selected as the main data source to analyse well recognized prescriptions. Objective To quantify patterns of prescriptions, common ingredients, indications and usages of TDM. Methods A relational database linking the prescriptions, ingredients, herb names, indications, and usages was set up. Frequency of pattern of combination and common ingredients were tabulated. Results A total of 200 prescriptions and 402 herbs were compiled. Prescriptions based on "wind" disorders, a detoxification theory that most commonly deals with symptoms of digestive system diseases, accounted for over one third of all prescriptions. The major methods of preparations mostly used roots and whole herbs. Conclusion The information extracted from the relational database may be useful for understanding symptomatic treatments. Antidote and detoxification theory deserves further research.

  20. Diffusion des bonnes pratiques de prescription : modélisation des interventions pharmaceutiques

    OpenAIRE

    Bedouch, Pierrick

    2008-01-01

    Medication errors in hospitals have become a major public health problem with multiple causes. The diffusion of prescription guidelines could reduce this phenomenon. The objective of this thesis is to modelize a potential vector of prescription guidelines: the pharmacists’ interventions. This work is declined in three sequences: 1.context and justification, 2.development of a tool for the documentation and the analyse of pharmacists’ interventions, 3.assessment of a model of prescription guid...

  1. The Effects of Bairesi Complex Prescription (a Uyghur Medicine Prescription and Its Five Crude Herbal Extracts on Melanogenesis in G-361 Cells

    Directory of Open Access Journals (Sweden)

    Xuedan Huang

    2016-01-01

    Full Text Available Vitiligo is considered a preimmune stage of a disease that is not well clarified. This condition is difficult to treat because there is no definite cure. Uyghur medicine is an important part of traditional Chinese medicine. There are many types of prescriptions that are used for the treatment of vitiligo. Bairesi complex prescription is one of the active prescriptions for vitiligo that is used in the clinic. However, the intensities of melanogenesis due to uses of Bairesi complex prescription and its five constituent crude herbs have not been reported yet. In the present study, we found that the hot water extracts of Bairesi complex prescription and the crude herbs were more effective in eliciting melanin production in G-361 cells than the EtOH extracts. Furthermore, the Bairesi complex prescription exhibited less cytotoxicity and was more effective in melanin formation than the five crude herbal extracts. In the present study, we also discuss the mechanisms of melanogenesis due to the use of the Bairesi complex prescription and its single crude herbal extracts.

  2. Development of an erythropoietin prescription simulator to improve abilities for the prescription of erythropoietin stimulating agents: Is it feasible?

    Directory of Open Access Journals (Sweden)

    Weibel Nadir

    2011-02-01

    Full Text Available Abstract Background The increasing use of erythropoietins with long half-lives and the tendency to lengthen the administration interval to monthly injections call for raising awareness on the pharmacokinetics and risks of new erythropoietin stimulating agents (ESA. Their pharmacodynamic complexity and individual variability limit the possibility of attaining comprehensive clinical experience. In order to help physicians acquiring prescription abilities, we have built a prescription computer model to be used both as a simulator and education tool. Methods The pharmacokinetic computer model was developed using Visual Basic on Excel and tested with 3 different ESA half-lives (24, 48 and 138 hours and 2 administration intervals (weekly vs. monthly. Two groups of 25 nephrologists were exposed to the six randomised combinations of half-life and administration interval. They were asked to achieve and maintain, as precisely as possible, the haemoglobin target of 11-12 g/dL in a simulated naïve patient. Each simulation was repeated twice, with or without randomly generated bleeding episodes. Results The simulation using an ESA with a half-life of 138 hours, administered monthly, compared to the other combinations of half-lives and administration intervals, showed an overshooting tendency (percentages of Hb values > 13 g/dL 15.8 ± 18.3 vs. 6.9 ± 12.2; P Conclusions Computer-based simulations can be a useful tool for improving ESA prescription abilities among nephrologists by raising awareness about the pharmacokinetic characteristics of the various ESAs and recognizing the factors that influence haemoglobin variability.

  3. Social Security Administration Data for Extra Help with Medicare Prescription Drug Plan Cost

    Data.gov (United States)

    Social Security Administration — This file contains information about Social Security determinations of eligibility for Extra Help with Medicare Prescription Drug Plan Costs. Specific data elements...

  4. Association between sociodemographic status and antiepileptic drug prescriptions in children with epilepsy

    National Research Council Canada - National Science Library

    Mattsson, Peter; Tomson, Torbjörn; Edebol Eeg‐Olofsson, Karin; Brännström, Lars; Ringbäck Weitoft, Gunilla

    2012-01-01

    .... We linked individual data to examine whether access by pediatric epilepsy patients to neuropediatricians and the prescription of individual AEDs differed according to gender, age, parental education...

  5. Understanding Nonprescription and Prescription Drug Misuse in Late Adolescence/Young Adulthood

    Directory of Open Access Journals (Sweden)

    Sasha A. Fleary

    2013-01-01

    Full Text Available This study explored the extent to which nonprescription and prescription drugs misuse among adolescents/young adults are related to their perception that it is safer than illicit drugs, ease of access, and lower societal stigma. Adolescents/young adults (; , completed an online survey about their nonprescription and prescription drug misuse, other substance use, and correlates of use. Perceived risk, societal stigma, and access to nonprescription and prescription drugs were predictive of misuse. Results support program planners working towards targeting perceived risk and societal stigma in reducing misuse and the need to restrict and monitor access to nonprescription and prescription drugs for adolescents/young adults.

  6. Cue-induced craving in dependence upon prescription opioids and heroin.

    Science.gov (United States)

    McHugh, R Kathryn; Park, Sara; Weiss, Roger D

    2014-01-01

    Cues associated with heroin use (eg, needles, powder) elicit robust craving responses in individuals dependent upon heroin. Elevated cue-induced craving may be a risk factor for relapse and can persist after periods of drug abstinence. Despite the growing prevalence of opioid dependence involving prescription opioids, published studies have yet to examine whether cue-induced craving is also present in prescription opioid dependence. A sample of 50 adults diagnosed with opioid dependence (20 prescription opioid users, 25 heroin users, and 5 mixed opioid users) completed a cue reactivity assessment. Participants were administered a series of 90 pictures, including heroin-specific, prescription opioid-specific, and neutral images, and were asked to rate craving and cue salience after each image. Both the prescription opioid and heroin groups experienced significantly more craving to drug than to neutral stimuli. The prescription opioid group reported significantly less craving to prescription opioid stimuli than the heroin group to heroin stimuli; however, this effect was smaller and non-significant when controlling for group differences in cue salience. This study found evidence for cue-induced craving in individuals dependent upon prescription opioids. Further research is needed to better understand the role of cue reactivity in the course and treatment of opioid dependence involving prescription opioid use. As elevated craving reactivity to drug cues may reflect a risk factor for relapse, understanding the nature of cue-induced craving in individuals with opioid dependence is important to improving treatments for this population. © American Academy of Addiction Psychiatry.

  7. Impact of prescription size on statin adherence and cholesterol levels

    Directory of Open Access Journals (Sweden)

    Mehler Phillip S

    2007-10-01

    Full Text Available Abstract Background Therapy with 3-Hydroxy-3-methylglutaryl Co-enzyme A reductase inhibitors (statins improve outcomes in a broad spectrum of patients with hyperlipidemia. However, effective therapy requires ongoing medication adherence; restrictive pharmacy policies may represent a barrier to successful adherence, particularly among vulnerable patients. In this study we sought to assess the relationship between the quantity of statin dispensed by the pharmacy with patient adherence and total cholesterol. Methods We analyzed a cohort of 3,386 patients receiving more than one fill of statin medications through an integrated, inner-city health care system between January 1, 2000 and December 31, 2002. Our measure of adherence was days of drug acquisition divided by days in the study for each patient, with adequate adherence defined as ≥ 80%. Log-binomial regression was used to determine the relative risk of various factors, including prescription size, on adherence. We also assessed the relationship between adherence and total cholesterol using multiple linear regression. Results After controlling for age, gender, race, co-payment, comorbidities, and insurance status, patients who obtained a majority of fills as 60-day supply compared with 30-day supply were more likely to be adherent to their statin medications (RR 1.41, 95% CI 1.28–1.55, P Conclusion In a healthcare system serving predominantly indigent patients, the provision of a greater quantity of statin medication at each prescription fill contributes to improved adherence and greater drug effectiveness.

  8. The fate of pediatric prescriptions in community pharmacies.

    Science.gov (United States)

    Condren, Michelle E; Desselle, Shane P

    2015-06-01

    The purpose of this study was to describe behaviors of community pharmacists related to pediatric prescriptions and examine the effect of demographic and situational factors on behaviors and confidence in performing recommended activities when dispensing medications for pediatric patients. The study employed a self-administered survey of community pharmacists in a regional chain. One intervention group attended a live continuing education session. A second intervention group received a dosing guide in the mail. One month after the intervention, both intervention groups and a control group completed the survey. Sixty pharmacists participated, for a response rate of 61%. Obtaining a weight for a pediatric prescription was reported as difficult by participants, and 60% rarely obtained a weight if one was not provided. Only 32% of participants reported calculating a dose when the weight was available. The majority (92%) of participants stated they were confident in calculating a dose and detecting a dosing error for a child. Only the pharmacist's perception of the organizational culture correlated with their behaviors and level of confidence toward performing the activities surveyed (P pharmacy culture is critical to reducing pediatric medication errors and promoting patient safety.

  9. [Evaluation of electronic drug prescriptions at a university hospital].

    Science.gov (United States)

    Cassiani, Sílvia Helena; Gimenes, Fernanda Raphael; Freire, Cláudia Câmara

    2002-01-01

    The medical orders have an important role in the prevention of medication errors. The objective of this study is to identify and to analyse the causal factors of error in the medication related to electronic prescription in two different clinics of a university hospital of the interior of the state of São Paulo. A questionnaire related to the advantages and disadvantages of electronic prescription was applied to the professionals of these clinics. The data collected was grouped in accordance with the similarity of the answers. These professionals identified causal factors of errors in the medical orders, but they also mentioned the advantages of it when compared to the manual order, such as bigger readability, rapidity and organization of the first one. As we can see, the computerized system of medical order represents a great advance considering strategies to minimize errors from orders badly formulated. However, it does not eliminate the possibility of occurrence of causal factors of errors in the medication, which asks for some modifications in the system.

  10. IMRT treatment planning based on prioritizing prescription goals.

    Science.gov (United States)

    Wilkens, Jan J; Alaly, James R; Zakarian, Konstantin; Thorstad, Wade L; Deasy, Joseph O

    2007-03-21

    Determining the 'best' optimization parameters in IMRT planning is typically a time-consuming trial-and-error process with no unambiguous termination point. Recently we and others proposed a goal-programming approach which better captures the desired prioritization of dosimetric goals. Here, individual prescription goals are addressed stepwise in their order of priority. In the first step, only the highest order goals are considered (target coverage and dose-limiting normal structures). In subsequent steps, the achievements of the previous steps are turned into hard constraints and lower priority goals are optimized, in turn, subject to higher priority constraints. So-called 'slip' factors were introduced to allow for slight, clinically acceptable violations of the constraints. Focusing on head and neck cases, we present several examples for this planning technique. The main advantages of the new optimization method are (i) its ability to generate plans that meet the clinical goals, as well as possible, without tuning any weighting factors or dose-volume constraints, and (ii) the ability to conveniently include more terms such as fluence map smoothness. Lower level goals can be optimized to the achievable limit without compromising higher order goals. The prioritized prescription-goal planning method allows for a more intuitive and human-time-efficient way of dealing with conflicting goals compared to the conventional trial-and-error method of varying weighting factors and dose-volume constraints.

  11. NEED OF CLINICAL PHARMACIST FOR RATIONALIZATION OF PRESCRIPTION

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    Naveed Muhammad

    2012-02-01

    Full Text Available A cross sectional study was conducted in the Medical ward of Hayath Abad Medical Complex (HMC, Peshawar, Pakistan from 1st June 2009 to 31st December 2009. HMC is one of the teaching hospital in KPK, Pakistan, it consist of 800 beds. The data were collected through prescribed history form and questionnaire designed from the general medical ward. The results indicates that the hepatotoxic drug prescribed in hepatic impaired patients were 5.6% of the study and about 31% drugs were found with improper dose or the frequency of dose was not mentioned. About 12.56% drugs were prescribed without mentioning the duration of therapy while, untreated conditions were found about 15.70% of our study. In the present study 21.46% drug interactions was found. The prescription containing unnecessary drugs without any indication were 7.85%. All these mentioned irrationality were due to the lack of clinical pharmacist in the whole hospital. It is concluded that the presence or involvement of a competent and qualified clinical pharmacist is very essential for the rationalization of the prescription in any hospital or health institution.

  12. [The evolution of principal drugs in prescription compatibility].

    Science.gov (United States)

    Yuan, Bing; Shi, Dong-ping

    2009-01-01

    The principal drugs of principal, adjuvant, auxiliary and conductant compatiblity in prescriptions recorded in the ancient literatures had different meaning and quantities. According to the current literatures, Zhuangzi Xu Wugui took the one can cure diseases as the principal drug; The principal, adjuvant, auxiliary and conductant drugs in Shennong Bencao Jing (Shennong's Classic of Materia Medica) can be used to differentiate the good and bad of drugs; Yaoxing Lun (Treatise on medicinal property) of Zheng quan (Tang dynasty) stipulated some drugs as principal drugs; Zazhu Bencao of Jiang Xiaowan (Tang dynasty) took the one can cure yin diseases as the principal drugs; Yixue Qiyuan (the origination of medicine) of Zhang Yuansu (Jin dynasty) took the one of maximum dosage as principal drugs; Piwei Lun (Treatise on Spleen and Stomach) of LI gao (Jin dynasty) took the powerful one as the principal drug; The principal drugs in Yi Lun (medicine treatise) of Wang Kentang (Ming dynasty) changed according to different ages. The quantities of principal drugs can had two and three ingredients even took one prescription as principal drug instead of one ingredient.

  13. IMRT treatment planning based on prioritizing prescription goals

    Science.gov (United States)

    Wilkens, Jan J.; Alaly, James R.; Zakarian, Konstantin; Thorstad, Wade L.; Deasy, Joseph O.

    2007-03-01

    Determining the 'best' optimization parameters in IMRT planning is typically a time-consuming trial-and-error process with no unambiguous termination point. Recently we and others proposed a goal-programming approach which better captures the desired prioritization of dosimetric goals. Here, individual prescription goals are addressed stepwise in their order of priority. In the first step, only the highest order goals are considered (target coverage and dose-limiting normal structures). In subsequent steps, the achievements of the previous steps are turned into hard constraints and lower priority goals are optimized, in turn, subject to higher priority constraints. So-called 'slip' factors were introduced to allow for slight, clinically acceptable violations of the constraints. Focusing on head and neck cases, we present several examples for this planning technique. The main advantages of the new optimization method are (i) its ability to generate plans that meet the clinical goals, as well as possible, without tuning any weighting factors or dose-volume constraints, and (ii) the ability to conveniently include more terms such as fluence map smoothness. Lower level goals can be optimized to the achievable limit without compromising higher order goals. The prioritized prescription-goal planning method allows for a more intuitive and human-time-efficient way of dealing with conflicting goals compared to the conventional trial-and-error method of varying weighting factors and dose-volume constraints.

  14. IMRT treatment planning based on prioritizing prescription goals

    Energy Technology Data Exchange (ETDEWEB)

    Wilkens, Jan J [Department of Radiation Oncology, Washington University School of Medicine, and Siteman Cancer Center, Saint Louis, MO (United States); Alaly, James R [Department of Radiation Oncology, Washington University School of Medicine, and Siteman Cancer Center, Saint Louis, MO (United States); Zakarian, Konstantin [Department of Radiation Oncology, Washington University School of Medicine, and Siteman Cancer Center, Saint Louis, MO (United States); Thorstad, Wade L [Department of Radiation Oncology, Washington University School of Medicine, and Siteman Cancer Center, Saint Louis, MO (United States); Deasy, Joseph O [Department of Radiation Oncology, Washington University School of Medicine, and Siteman Cancer Center, Saint Louis, MO (United States)

    2007-03-21

    Determining the 'best' optimization parameters in IMRT planning is typically a time-consuming trial-and-error process with no unambiguous termination point. Recently we and others proposed a goal-programming approach which better captures the desired prioritization of dosimetric goals. Here, individual prescription goals are addressed stepwise in their order of priority. In the first step, only the highest order goals are considered (target coverage and dose-limiting normal structures). In subsequent steps, the achievements of the previous steps are turned into hard constraints and lower priority goals are optimized, in turn, subject to higher priority constraints. So-called 'slip' factors were introduced to allow for slight, clinically acceptable violations of the constraints. Focusing on head and neck cases, we present several examples for this planning technique. The main advantages of the new optimization method are (i) its ability to generate plans that meet the clinical goals, as well as possible, without tuning any weighting factors or dose-volume constraints, and (ii) the ability to conveniently include more terms such as fluence map smoothness. Lower level goals can be optimized to the achievable limit without compromising higher order goals. The prioritized prescription-goal planning method allows for a more intuitive and human-time-efficient way of dealing with conflicting goals compared to the conventional trial-and-error method of varying weighting factors and dose-volume constraints.

  15. Environmental impact assessment of pharmaceutical prescriptions: Does location matter?

    Science.gov (United States)

    Oldenkamp, Rik; Huijbregts, Mark A J; Hollander, Anne; Ragas, Ad M J

    2014-11-01

    A methodology was developed for the assessment and comparison of the environmental impact of two alternative pharmaceutical prescriptions. This methodology provides physicians with the opportunity to include environmental considerations in their choice of prescription. A case study with the two antibiotics ciprofloxacin and levofloxacin at three locations throughout Europe showed that the preference for a pharmaceutical might show spatial variation, i.e. comparison of two pharmaceuticals might yield different results when prescribed at different locations. This holds when the comparison is based on both the impact on the aquatic environment and the impact on human health. The relative impacts of ciprofloxacin and levofloxacin on human health were largely determined by the local handling of secondary sludge, agricultural disposal practices, the extent of secondary sewage treatment, and local food consumption patterns. The relative impacts of ciprofloxacin and levofloxacin on the aquatic environment were mostly explained by the presence of specific sewage treatment techniques, as effluents from sewage treatment plants (STPs) are the most relevant emission pathway for the aquatic environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. War Medicine and Surgery, Punishment and Torture at the time of the Regiments of Renown - Chirurgie de guerre, médecine militaire, punitions et torture à l’époque des compagnies de mercenaires - Medicina e Chirurgia da guerra, Punizioni e Tortura all’epoca delle Compagnie di Ventura

    Directory of Open Access Journals (Sweden)

    Lugaresi M.

    2009-08-01

    Full Text Available This article highlights the main surgical and medical issues related to the age of the Regiments of Renown. Analyzing the main causes of death of Condottieres and Captains in the period 1300-1580, the treatment of wounds and the development of skills involved in the surgery of war, the more frequent Italian epidemic diseases in that time, the punishments and torture in force in the Republic of Venice, are described.Cet article expose les aspects les plus importants en matière de médecine et de chirurgie à l'époque des compagnies de mercenaires. En analysant les principales causes de décès des condottières et des capitaines entre 1300 et 1580, l’autrice décrit le traitement des blessures et le développement des techniques chirurgicales de guerre, les épidémies les plus fréquentes en Italie à cette époque-là, les peines et les tortures en vigueur sous la République Sérénissime de Venise.Questo articolo illustra i principali aspetti medici e chirurgici connessi all’epoca delle Compagnie di Ventura. Analizzando le principali cause di decesso dei Condottieri e dei Capitani nel periodo 1300-1580, vengono descritte la cura delle ferite e lo sviluppo delle tecniche applicate nella chirurgia da guerra, le epidemie più frequenti che colpirono l’Italia in tale epoca, le pene e la tortura in vigore nella Serenissima Repubblica di Venezia.

  17. Prescription of anorectic and benzodiazepine drugs through notification B prescriptions in Natal, Rio Grande do Norte, Brazil

    Directory of Open Access Journals (Sweden)

    Solange Aparecida Nappo

    2010-06-01

    Full Text Available A study was conducted on 22,158 special B prescriptions (notificações B containing amphetamine-type anorectic drugs or benzodiazepines, obtained from compounding pharmacies or drugstores located in the city of Natal, RN, Brazil. The data obtained were compared with those from other Brazilian cities. Results showed that compounding pharmacies dispensed 85.4% of the prescriptions, indicating that these pharmacies filled out nearly 10 times more of these prescriptions than did the drugstores. The majority (83.5% of B prescriptions issued for the compounding pharmacies were for women, where the female/male patient ratio ranged from 7.1/1.0 for mazindol to 10.3/1.0 for amfepramone. Similar results were obtained for the benzodiazepines with ratios of 1.9/1.0 for clonazepam to 15.6/1.0 for oxazepam. Omissions and mistakes were present in the B prescriptions, including missing information about the patient (in 49.6% of the documents or about the pharmacies or drugstores (50.4%. There were cases where the name and/or CRM of the physician was lacking. It was noted that one medical doctor made out 1855 B prescriptions within one year. The same patient's name appeared on 138 prescriptions, and the same RG (identification card number was present in 125 others. Comparison of Natal's data with those of several other Brazilian cities disclosed a striking similarity throughout Brazil, from Pelotas - Rio Grande do Sul State to Belem-Para State, revealing a practically identical medical/pharmaceutical behavior. This pattern of prescription/dispensation of amphetamine-type substances mostly to women for weight loss is therefore for cosmetic reasons. Consequently, there is an urgent need for an ethical review of this behavior.Foram examinadas 22.158 notificações B contendo substâncias anoréticas tipo-anfetamina ou de benzodiazepínicos, obtidas de drogarias e de farmácias de manipulação. Os dados foram comparados com os de outras cidades do Brasil, obtendo

  18. Effectiveness of Three Different Walking Prescription Durations on Total Physical Activity in Normal- and Overweight Women

    Directory of Open Access Journals (Sweden)

    Yves Schutz

    2014-08-01

    Full Text Available Objective: While there is a dose-response relationship between physical activity (PA and health benefit, little is known about the effectiveness of different PA prescriptions on total daily PA. Aim: To test, under real-life conditions and using an objective, non-invasive measurement technique (accelerometry, the effect of prescribing additional physical activity (walking only of different durations (30, 60 and 90 min/day on compliance (to the activity prescribed and compensation (to total daily PA. Participants in each group were prescribed 5 sessions of walking per week over 4 weeks. Methods: 55 normal-weight and overweight women (mean BMI 25 ± 5 kg/m2, height 165 ± 1 cm, weight 68 ± 2 kg and mean age 27 ± 1 years were randomly assigned to 3 prescription groups: 30, 60 or 90 min/day PA. Results: Walking duration resulted in an almost linear increase in the number of steps per day during the prescription period from an average of about 10,000 steps per day for the 30-min prescription to about 14,000 for the 90-min prescription. Compliance was excellent for the 30-min prescription but decreased significantly with 60-min and 90-min prescriptions. In parallel, degree of compensation subsequent to exercise increased progressively as length of prescription increased. Conclusion: A 30-min prescription of extra walking 5 times per week was well tolerated. However, in order to increase total PA further, much more than 60 min of walking may need to be prescribed in the majority of individuals. While total exercise ‘volume' increased with prescriptions longer than 30 min, compliance to the prescription decreased and greater compensation was evident.

  19. Prescription writing practices in a rural tertiary care hospital in Western Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Vaishali D Phalke

    2011-01-01

    Full Text Available BackgroundPrescription is a written order from physician to pharmacistwhich contains name of drug, its dose and its method ofdispensing and advice over consuming it. The frequency ofdrug prescription errors is high. Prescribing errorcontributes significantly towards adverse drug events. Thepresent study was undertaken to understand the currentprescription writing practices and to detect the commonerrors in them at a tertiary health care centre situated in arural area of Western Maharashtra, India.MethodA cross sectional study was conducted at a tertiary levelhospital located at a rural area of Maharashtra state, Indiaduring October 2009-March 2010. 499 prescriptions comingto medical store during period of one month wereconsidered for data analysis. Important informationregarding the patient, doctor, drug and the generaldescription of the prescription were obtained.ResultsAll the prescriptions were on the hospital pad. A significantnumber of the prescriptions (n=88, 17.6% were written inillegible handwriting and not easily readable. The name, ageand sex of the patient were mentioned is majority of theprescriptions. All the prescriptions (100% failed todemonstrate the presence of address, height and weight ofthe patient. Only the brand name of the drugs wasmentioned in all the prescriptions with none of them havingthe generic name. The strength, quantity and route ofadministration of the drug were found on 73.1%, 65.3% and75.2% prescriptions.ConclusionThere are widespread errors in prescription writing by thedoctors. Educational intervention programs and use ofcomputer can substantially contribute in the lowering ofsuch errors. A short course on prescription writing beforethe medical student enters the clinical field and strictmonitoring by the administrative authorities may also helpalleviate the problem.Word count: 2980Tables: 2

  20. Posttraumatic Stress Symptoms and Nonmedical Prescription Drug Use Among College Students With Trauma Exposure.

    Science.gov (United States)

    Ham, Lindsay S; Wiersma-Mosley, Jacquelyn D; Feldner, Matthew T; Melkonian, Alexander J; Milner, Lauren A; Lewis, Sarah F

    2016-01-01

    Nonmedical prescription drug use, defined as using the drug without a prescription or in ways for which it is not prescribed, and traumatic event exposure are highly prevalent among college students. Despite evidence that posttraumatic stress symptoms could place college students at risk for nonmedical prescription drug problems, no studies have examined this relationship. This study was a preliminary examination of posttraumatic stress symptoms, lifetime nonmedical prescription drug use, hazardous use, and dependence symptoms among college students with trauma exposure. Participants were students attending a rural college in Virginia, recruited through psychology classes, flyers, LISTSERVs, and announcements at student events. All students who reported experiencing at least one traumatic event were included (N = 119); participants' mean age was 19.7 years (SD = 1.90), about half were women (n = 63, 53%), and most were Caucasian (n = 103, 87%). Nearly 60% of participants (n = 71) reported using nonmedical prescription drugs at least once during their lifetime and were more likely than those with no use to report hazardous alcohol use (p stress symptom frequency was positively associated with hazardous nonmedical prescription drug use, after controlling for gender, depressive symptoms, and hazardous alcohol use (p stress symptom frequency was higher for those with any nonmedical prescription drug dependence symptoms (p student had ever engaged in nonmedical prescription drug use. Findings suggest that consideration of the types of behaviors and problems a college student is experiencing related to nonmedical prescription drug use may be more relevant to posttraumatic stress symptom frequency than dichotomous measures of nonmedical prescription drug use alone. Further, the association between the frequency of posttraumatic stress symptoms and both hazardous nonmedical prescription drug use and dependence symptoms among college students with a trauma history deserves

  1. Exploring the Etiologic Factors and Dynamics of Prescription Drug Abuse in Southwest Virginia

    Directory of Open Access Journals (Sweden)

    Kerry J Redican

    2012-12-01

    Full Text Available Background: Prescription drug abuse in Southwest Virginia is a serious problem affecting indi-viduals, families, and communities. The aim of this study was to characterize and understand the extent of the prescription drug abuse problem in Southwest, Virginia as well as the dynamics that surround that abuse. More specifically, the study focused on learning the extent of the problem along with which prescription drugs are typically used prior to entering treatment, reasons for prescription drug and methadone abuse, and the sources for prescription drug use, misuse and abuse.Methods: Mixed methodology was employed which included surveying methadone clinic con-sumers at two treatment clinics in Southwest, Virginia and seven focus field interviews of key community stakeholders.Results: The extent of prescription drug abuse is high and that the demographics of prescription drug users are getting younger and now involve more males than females. Oxycodone, hydroco-done, methadone, and morphine were the most commonly used drugs prior to enrollment in the clinics with over one-half of methadone-maintained consumers reporting that they had abused benzodiazepines along with opioids. Focus groups and clinic consumer data highlighted the key etiological factors in prescription drug abuse: use (due to workforce related injuries turning to abuse, wanting to get high, overprescribing and physician issues, lack of information, and cultural acceptance of drug taking as problem solving behavior. The two most common sources for the abused prescription drugs were physicians and street dealers.Conclusions: A constellation of conditions have led to the epidemic of prescription drug abuse in Southwest Virginia, including poverty, unemployment and work-related injuries, besides, public health education programs on the dangers of prescription opiate misuse and abuse are urgently needed.

  2. Bibliotherapy and information prescriptions: a summary of the published evidence-base and recommendations from past and ongoing Books on Prescription projects.

    Science.gov (United States)

    Chamberlain, D; Heaps, D; Robert, I

    2008-01-01

    This paper summarizes the published evidence and reports from ongoing and completed projects that used Bibliotherapy and Information Prescription to deliver patient care. A literature search was conducted and relevant papers were summarized into: type of study, type of Bibliotherapy, client group and recommendations. In total, 65 papers were considered with 57 reviewed. A survey was also sent to Library Authorities subscribing to national survey standards asking for details about delivery of Information Prescription projects. There were 21 returned surveys. The experiences and recommendations were then summarized. The aim of the paper is to collate the evidence-base of written research and the experience and recommendations of projects into an easy format so that practitioners interested in using Bibliotherapy/Information Prescription/Books on Prescription have an understanding what they are, the extent of the evidence-base to inform practice, and highlight gaps in the research.

  3. Rates of inappropriate antiretroviral prescription among injection drug users

    Directory of Open Access Journals (Sweden)

    Bonner Simon

    2007-01-01

    Full Text Available Abstract Background Although the survival benefits of antiretroviral therapy (ART for the treatment of HIV infection are well established, the clinical management of HIV disease continues to present major challenges. There are particular concerns regarding access to appropriate HIV treatment among HIV-infected injection drug users (IDU. Methods In a prospective cohort study of HIV-infected IDU in Vancouver, Canada, we examined initial ART regimens vis-à-vis the provincial government's therapeutic guidelines at the time ART was initiated. Briefly, there have been four sets of guidelines: Era 1 (1992 to November 1995; double-drug (dual NRTIs ART for patients with a CD4 cell count of 350 or less; Era 2 (December 1995 to May 1996; double-drug therapy for patients with a CD4+ cell count of 500 or less; Era 3 (June 1996 to June 1997; triple-drug therapy (dual NRTIs with a PI or NNRTI for patients who had a plasma viral load of > 100,000 HIV-1 RNA copies/mL; dual therapy with two NRTIs for those with a plasma viral load of 5,000 to 100,000 HIV-1 RNA copies/mL; Era 4 (since July 1997; universal use of triple drug therapy as first-line treatment. Results Between May 1996 and May 2003, 431 HIV-infected individuals were enrolled into the cohort. By May 31, 2003, 291 (67.5% individuals had initiated ART. We noted instances of inappropriate antiretroviral prescription in each guideline era, with 9 (53% in Era 1, 3 (12% in Era 2, 22 (28% in Era 3, and 23 (15% in Era 4. Of the 57 subjects who received an inappropriate ART regimen initially, 14 never received the appropriate therapy; among the remaining 43, the median time to the initiation of a guideline-appropriate ART regimen was 12 months (inter-quartile range 5 – 20. Conclusion The present study identified measurable rates of guideline-inappropriate ART prescription for patients who were injection drug users. Rates were highest in the era of dual therapy, although high rates persisted into the triple

  4. The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study

    Science.gov (United States)

    Franklin, Bryony Dean; Reynolds, Matthew; Sadler, Stacey; Hibberd, Ralph; Avery, Anthony J; Armstrong, Sarah J; Mehta, Rajnikant; Boyd, Matthew J; Barber, Nick

    2014-01-01

    Objectives To compare prevalence and types of dispensing errors and pharmacists’ labelling enhancements, for prescriptions transmitted electronically versus paper prescriptions. Design Naturalistic stepped wedge study. Setting 15 English community pharmacies. Intervention Electronic transmission of prescriptions between prescriber and pharmacy. Main outcome measures Prevalence of labelling errors, content errors and labelling enhancements (beneficial additions to the instructions), as identified by researchers visiting each pharmacy. Results Overall, we identified labelling errors in 5.4% of 16 357 dispensed items, and content errors in 1.4%; enhancements were made for 13.6%. Pharmacists also edited the label for a further 21.9% of electronically transmitted items. Electronically transmitted prescriptions had a higher prevalence of labelling errors (7.4% of 3733 items) than other prescriptions (4.8% of 12 624); OR 1.46 (95% CI 1.21 to 1.76). There was no difference for content errors or enhancements. The increase in labelling errors was mainly accounted for by errors (mainly at one pharmacy) involving omission of the indication, where specified by the prescriber, from the label. A sensitivity analysis in which these cases (n=158) were not considered errors revealed no remaining difference between prescription types. Conclusions We identified a higher prevalence of labelling errors for items transmitted electronically, but this was predominantly accounted for by local practice in a single pharmacy, independent of prescription type. Community pharmacists made labelling enhancements to about one in seven dispensed items, whether electronically transmitted or not. Community pharmacists, prescribers, professional bodies and software providers should work together to agree how items should be dispensed and labelled to best reap the benefits of electronically transmitted prescriptions. Community pharmacists need to ensure their computer systems are promptly updated

  5. Extent of dispensing prescription-only medications without a prescription in community drug retail outlets in Addis Ababa, Ethiopia: a simulated-patient study

    OpenAIRE

    Erku DA; Mekuria AB; Surur AS; Gebresillassie BM

    2016-01-01

    Daniel Asfaw Erku,1 Abebe Basazn Mekuria,2 Abdrrahman Shemsu Surur,1 Begashaw Melaku Gebresillassie3 1Department of Pharmaceutical Chemistry, 2Department of Pharmacology, 3Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia Purpose: This study was aimed at assessing the extent of dispensing prescription-only medications without a prescription in community drug retail outlets (CDROs) of Addis Ababa, Ethiopia.Methods: A descriptive cross-sectional observa...

  6. Preventing Prescription Drug Misuse in Work Settings: Efficacy of a Brief Intervention in Health Consciousness.

    Science.gov (United States)

    Lucas, Gale; Neeper, Michael; Linde, Brittany; Bennett, Joel

    2017-07-06

    It is becoming more commonplace for employees to use prescription medication outside of intended use. Opioid and other prescription misuse has implications for the health and productivity of workers. Easy-to-access webinars that help employees learn about alternatives to prescription use may decrease risk. The aim of this study was to examine the efficacy of an interactive but brief health consciousness and prescription drug intervention for a diverse sample of employees and show effectiveness via both Internet-delivered webinar and classroom delivery. Employees from a variety of workplaces filled out pre- and post-questionnaires upon completion of a one-hour long intervention. A total of 114 participants completed the pre- and post-questionnaires. Results showed that, compared with before the training, participants reported significantly more knowledge about prescription drug misuse and alternatives to prescription drug use after the training (t113=7.91, P<.001). Moreover, the medium of presentation (ie, face-to-face vs webinar) did not significantly impact effectiveness of the training (F1,98=1.15, P=.29). In both webinar and classroom formats, participants gained knowledge about alternatives to prescription drug use. This intervention appears to be beneficial to employees and assists in the awareness of prescription drug use in general and in the workplace.

  7. 21 CFR 1311.145 - Digitally signing the prescription with the individual practitioner's private key.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Digitally signing the prescription with the individual practitioner's private key. 1311.145 Section 1311.145 Food and Drugs DRUG ENFORCEMENT... key may be transmitted to a pharmacy without the digital signature. (f) If the electronic prescription...

  8. The use and abuse of prescription medication to facilitate or enhance sexual behavior among adolescents.

    Science.gov (United States)

    Apodaca, T R; Moser, N C

    2011-01-01

    Adolescents naturally experience an increased interest in sexual behavior, but they usually lack much experience. Thus, any prescription medication that holds the potential to ease or facilitate sexual matters holds a unique allure. Widespread cultural awareness of medications to treat erectile dysfunction (ED) has combined with a recent trend toward increased adolescent prescription drug abuse to create unique challenges for industry, clinicians, and researchers.

  9. Prescriptive Statements and Educational Practice: What Can Structural Equation Modeling (SEM) Offer?

    Science.gov (United States)

    Martin, Andrew J.

    2011-01-01

    Longitudinal structural equation modeling (SEM) can be a basis for making prescriptive statements on educational practice and offers yields over "traditional" statistical techniques under the general linear model. The extent to which prescriptive statements can be made will rely on the appropriate accommodation of key elements of research design,…

  10. [Establishment of prescription research technology system in Chinese medicine secondary exploitation based on "component structure" theory].

    Science.gov (United States)

    Cheng, Xu-Dong; Feng, Liang; Gu, Jun-Fei; Zhang, Ming-Hua; Jia, Xiao-Bin

    2014-11-01

    Chinese medicine prescriptions are the wisdom outcomes of traditional Chinese medicine (TCM) clinical treatment determinations which based on differentiation of symptoms and signs. Chinese medicine prescriptions are also the basis of secondary exploitation of TCM. The study on prescription helps to understand the material basis of its efficacy, pharmacological mechanism, which is an important guarantee for the modernization of traditional Chinese medicine. Currently, there is not yet dissertation n the method and technology system of basic research on the prescription of Chinese medicine. This paper focuses on how to build an effective system of prescription research technology. Based on "component structure" theory, a technology system contained four-step method that "prescription analysis, the material basis screening, the material basis of analysis and optimization and verify" was proposed. The technology system analyzes the material basis of the three levels such as Chinese medicine pieces, constituents and the compounds which could respect the overall efficacy of Chinese medicine. Ideas of prescription optimization, remodeling are introduced into the system. The technology system is the combination of the existing research and associates with new techniques and methods, which used for explore the research thought suitable for material basis research and prescription remodeling. The system provides a reference for the secondary development of traditional Chinese medicine, and industrial upgrading.

  11. Investigating the exercise-prescription practices of nurses working in inpatient mental health settings.

    Science.gov (United States)

    Stanton, Robert; Happell, Brenda; Reaburn, Peter

    2015-04-01

    Nurses working in mental health are well positioned to prescribe exercise to people with mental illness. However, little is known regarding their exercise-prescription practices. We examined the self-reported physical activity and exercise-prescription practices of nurses working in inpatient mental health facilities. Thirty-four nurses completed the Exercise in Mental Illness Questionnaire - Health Practitioner Version. Non-parametric bivariate statistics revealed no relationship between nurses' self-reported physical activity participation and the frequency of exercise prescription for people with mental illness. Exercise-prescription parameters used by nurses are consistent with those recommended for both the general population and for people with mental illness. A substantial number of barriers to effective exercise prescription, including lack of training, systemic issues (such as prioritization and lack of time), and lack of consumer motivation, impact on the prescription of exercise for people with mental illness. Addressing the barriers to exercise prescription could improve the proportion of nurses who routinely prescribe exercise. Collaboration with exercise professionals, such as accredited exercise physiologists or physiotherapists, might improve knowledge of evidence-based exercise-prescription practices for people with mental illness, thereby improving both physical and mental health outcomes for this vulnerable population.

  12. 47 CFR 65.101 - Initiation of unitary rate of return prescription proceedings.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Initiation of unitary rate of return...) COMMON CARRIER SERVICES (CONTINUED) INTERSTATE RATE OF RETURN PRESCRIPTION PROCEDURES AND METHODOLOGIES Procedures § 65.101 Initiation of unitary rate of return prescription proceedings. (a) Whenever...

  13. Alternate Routes of Administration and Risk for HIV among Prescription Opioid Abusers

    OpenAIRE

    Surratt, Hilary; Kurtz, Steven P.; Cicero, Theodore J.

    2011-01-01

    Route of administration is an important contributor to the adverse health consequences of prescription medication abuse. The present study examines characteristics associated with non-oral routes of administration among a large sample of prescription opioid abusers, and explores needle related

  14. 78 FR 53152 - Prescription Drug User Fee Rates for Fiscal Year 2014; Correction

    Science.gov (United States)

    2013-08-28

    .... This document corrects those errors. FOR FURTHER INFORMATION CONTACT: David Miller, Office of Financial... HUMAN SERVICES Food and Drug Administration Prescription Drug User Fee Rates for Fiscal Year 2014... Administration is correcting a notice entitled ``Prescription Drug User Fee Rates for Fiscal Year 2014''...

  15. A population-based prescription study of asthma drugs during pregnancy

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Thrane, Nana; Nielsen, G.L.

    2001-01-01

    . Methods: The Birth Registry was used to identify all 15,756 primiparous women who gave birth in the County of North Jutland between 1991 and 1996. According to the North Jutland Prescription Database, 303 of these women received prescriptions for asthma drugs during pregnancy. Women who did not purchase...

  16. [Prescription and drug expenditure in gynecology and obstetrics in Northwest medical units from IMSS].

    Science.gov (United States)

    Torres Gómez, Luis Guillermo; Canales Muñoz, José Luis

    2006-08-01

    Drug prescription is the most frequent medical intervention in Gynecology and Obstetrics; however, studies of prescription profile are limited. In this study, we analyzed differences of expense by drug prescription for gynecologic and obstetrics health problems. It was performed a cross sectional study for one year analysis in each medical area that shape IMSS western district. We calculated spending and consumption coefficients for each drug and therapeutic groups. User coefficients were ordered to compare consumption differences. Besides the statistical ratio of consumption between drugs groups, we described the differences found and analyzed the prescription profile among medical regions. Data related to the expenses in each one of the regions show important differences in each one of the drugs and therapeutic groups. The most common expense for drugs is related to the treatment of osteoporosis, menopause and fertility problems. We also found differences in prescription drug preferences in each therapeutic subgroup. Drug prescription studies are useful as a basis for further specific studies in each pharmacologic subgroup. There are few studies that analyze the drug prescription profile on Gynecology and Obstetrics. In this study it is possible to suppose that medical prescription was not based on known medical evidences; therefore, we must reconsider the need of a permanent actualization and systematic medical evaluation.

  17. 21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG MARKETING Wholesale Distribution § 203.50 Requirements for wholesale distribution of prescription drugs. (a) Identifying statement for sales by... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Requirements for wholesale distribution...

  18. Prescription of Protective Paternalism for Men in Romantic and Work Contexts

    Science.gov (United States)

    Sarlet, Marie; Dumont, Muriel; Delacollette, Nathalie; Dardenne, Benoit

    2012-01-01

    Behavioral prescription specifies how people ought to act. Five studies investigated prescription for men of protective paternalism, a particular form of benevolent sexism, depending on contextual and individual factors. In Studies 1 and 2, female participants prescribed for men more protective paternalistic behavior toward women in a romantic…

  19. How Parents of Teens Store and Monitor Prescription Drugs in the Home

    Science.gov (United States)

    Friese, Bettina; Moore, Roland S.; Grube, Joel W.; Jennings, Vanessa K.

    2013-01-01

    Qualitative interviews were conducted with parents of teens to explore how parents store and monitor prescription drugs in the home. Most parents had prescription drugs in the house, but took few precautions against teens accessing these drugs. Strategies for monitoring included moving the drugs to different locations, remembering how many pills…

  20. Nonmedical Use of Prescription Drugs by College Students with Minority Sexual Orientations

    Science.gov (United States)

    Duryea, Daniel G.; Calleja, Nancy G.; MacDonald, Douglas A.

    2015-01-01

    Results from the 2009 "National College Health Assessment" were analyzed by gender and sexual orientation for college students' nonmedical use of prescription drugs. Male and female students identified as having a minority sexual orientation (gay or bisexual) were significantly more likely to use nonmedical prescription drugs than…

  1. Risk factors for medication errors in the electronic and manual prescription 1

    Science.gov (United States)

    Volpe, Cris Renata Grou; de Melo, Eveline Maria Magalhães; de Aguiar, Lucas Barbosa; Pinho, Diana Lúcia Moura; Stival, Marina Morato

    2016-01-01

    ABSTRACT Objective: to compare electronic and manual prescriptions of a public hospital of Brasilia, identifying risk factors for the occurrence of medication errors. Method: descriptive-exploratory, comparative and retrospective study. Data collection occurred from July 2012 to January 2013, using an instrument for the review of the information contained in medical records related to the medication process. A total of 190 manual and 199 electronic records composed the sample, with 2027 prescriptions each. Results: compared to the manual prescription, a significant reduction was observed in the risk factors after implantation of the electronic prescription, in items such as "lack of the form of dilution" (71.1% to 22.3%) and "prescription with brand name" (99.5% to 31.5%). Conversely, the risk factors "no check" and "lack of CRM of the prescriber" increased. The lack of the allergy registration and the occurrences related to medication were the same for both groups. Conclusion: generally, the use of the electronic prescription system was associated with a significant reduction in risk factors for medication errors, concerning the following aspects: illegibility, prescription with brand name and presence of essential items that provide a safe and effective prescription. PMID:27508913

  2. 21 CFR 201.22 - Prescription drugs containing sulfites; required warning statements.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Prescription drugs containing sulfites; required... Prescription drugs containing sulfites; required warning statements. (a) Sulfites are chemical substances that.... Examples of specific sulfites used to inhibit this oxidation process include sodium bisulfite, sodium...

  3. Monetary Value of a Prescription Assistance Program Service in a Rural Family Medicine Clinic

    Science.gov (United States)

    Whitley, Heather P.

    2011-01-01

    Purpose: To quantify the monetary value of medications provided to rural Alabamians through provision of pharmaceutical manufacturer-sponsored prescription assistance programs (PAPs) provided by a clinical pharmacist in a private Black Belt family medicine clinic during 2007 and 2008. Methods: Patients struggling to afford prescription medications…

  4. Nonmedical Prescription Drug Use among Adolescents: The Influence of Bonds to Family and School

    Science.gov (United States)

    Ford, Jason A.

    2009-01-01

    There has been a tremendous increase in the prevalence of nonmedical prescription drug use among adolescents in recent years. Research now indicates that the prevalence of nonmedical prescription drug use is greater than the prevalence of other illicit drug use, excluding marijuana. Despite these recent trends, there is a dearth of research in the…

  5. 77 FR 74827 - Working Group on Access to Information on Prescription Drug Container Labels

    Science.gov (United States)

    2012-12-18

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD Working Group on Access to Information on Prescription Drug Container... container labels accessible to people who are blind or visually impaired. The working group will hold its... working group to develop best practices for making information on prescription drug container...

  6. Nonmedical Use of Prescription Drugs by College Students with Minority Sexual Orientations

    Science.gov (United States)

    Duryea, Daniel G.; Calleja, Nancy G.; MacDonald, Douglas A.

    2015-01-01

    Results from the 2009 "National College Health Assessment" were analyzed by gender and sexual orientation for college students' nonmedical use of prescription drugs. Male and female students identified as having a minority sexual orientation (gay or bisexual) were significantly more likely to use nonmedical prescription drugs than…

  7. Could adverse reactions of antibiotic drugs in children be detected in a prescription database?

    NARCIS (Netherlands)

    de Jong, Josta; Bos, Jens H J; de Vries, Tjalling W; de Jong-van den Berg, Lolkje T W

    2011-01-01

    Purpose To explore the possibility to detect adverse drug reactions (ADRs) from a pharmacy prescription database by examining the use of proxy-drugs during the treatment. Methods From a pharmacy prescription database we selected all children of 0-6 years old who started an antibiotic drug between 19

  8. Prescription opiate medications: medical uses and consequences, laws and controls.

    Science.gov (United States)

    Miller, Norman S

    2004-12-01

    The proposed analysis and evaluation of the data elements in the OPP and other similar regulatory programs will support the following potential impact on the patients and physicians in Michigan and other states: Reduced rates of addictive use of prescriptions of Schedule II medications. Reduced rates of addictive patterns of prescribing of Schedule II medications. Improved the prescribing of Schedule II medication for pain disorders. Improved the prescribing of Schedule II medications in addictive disorders. Establish the need and direction for development of curriculum for Schedule II drugs for undergraduate medical education and continuing medical education. Establish the need and direction for development of curriculum for use of Schedule II medications in patients with addictive and pain disorders. Explore the need and direction for development of the monitoring system medical curriculum for Schedule III, IV, and V drugs. Demonstrate link between diversion and adverse effects on health caused by an addictive pattern of use and prescribing of Schedule II drugs

  9. Prescription-Event Monitoring. Recent experience with 5 NSAIDs.

    Science.gov (United States)

    Rawson, N S; Inman, W H

    1986-01-01

    The principles and methods of Prescription-Event Monitoring (PEM) are presented and illustrated by a study of general practice notes of 55,642 patients, who were prescribed one of five non-steroidal anti-inflammatory drugs (NSAIDs). PEM showed the expected side effects and a low incidence of serious adverse reactions. The general pattern of events during and following treatment was, with few exceptions, very similar. The incidence of side effects that have led to the withdrawal of three of the drugs from the market was extremely low. Complications of peptic ulcer were uncommon and deaths from this cause were rare. No difference was apparent in the incidence of serious gastrointestinal complications during or after stopping treatment or changing to another NSAID.

  10. Creole Practices as Prescriptive Guidelines for Language Didactics?

    DEFF Research Database (Denmark)

    Bojsen, Heidi

    2014-01-01

    . In the following section, the author introduces different sociolinguistic studies of language practices in Martinique and the Caribbean giving a particular attention to the school system. The section ends with a brief discussion of how didactics in language teaching intersects with Glissant’s thinking......This article presents some of Glissant’s thoughts about the status and usage of the Creole language in relation to French and the consequences for the social imaginary in Martinique and in the Caribbean. The author formulates three thematic focal points: Archipelagic thinking, creolisation...... and dynamic changes of language forms in a context of power and resistance and, as a third point, the right to remain ‘opaque’ and the distinction between language form and ‘langage’. The author argues that we may detect a descriptive and a prescriptive dimension in Glissant’s thinking about language...

  11. The connected prescription for form factors in twistor space

    CERN Document Server

    Brandhuber, Andreas; Panerai, Rodolfo; Spence, Bill; Travaglini, Gabriele

    2016-01-01

    We propose a connected prescription formula in twistor space for all tree-level form factors of the stress tensor multiplet operator in $\\mathcal{N}=4$ super Yang-Mills, which is a generalisation of the expression of Roiban, Spradlin and Volovich for superamplitudes. By introducing link variables, we show that our formula is identical to the recently proposed four-dimensional scattering equations for form factors. Similarly to the case of amplitudes, the link representation of form factors is shown to be directly related to BCFW recursion relations, and is considerably more tractable than the scattering equations. We also discuss how our results are related to a recent Grassmannian formulation of form factors, and comment on a possible derivation of our formula from ambitwistor strings.

  12. An evidence-based policy prescription for an aging population.

    Science.gov (United States)

    Chappell, Neena L; Hollander, Marcus J

    2011-01-01

    In this paper, the authors provide a policy prescription for Canada's aging population. They question the appropriateness of predictions about the lack of sustainability of our healthcare system. The authors note that aging per se will only have a modest impact on future healthcare costs, and that other factors such as increased medical interventions, changes in technology and increases in overall service use will be the main cost drivers. They argue that, to increase value for money, government should validate, as a priority, integrated systems of care delivery for older adults and recognize such systems as a major component of Canada's healthcare system, along with hospitals, primary care and public/population health. They also note a range of mechanisms to enhance such systems going forward. The authors present data and policy commentary on the following topics: ageism, healthy communities, prevention, unpaid caregivers and integrated systems of care delivery.

  13. Evidence for determining the exercise prescription in patients with osteoarthritis.

    Science.gov (United States)

    Gaught, Amber M; Carneiro, Kevin A

    2013-02-01

    Osteoarthritis (OA) is a chronic joint disease that affects more than one-third of older adults (age > 65 years), most often involving the hip and knee. Osteoarthritis causes pain and limits mobility, thereby reducing patient quality of life. Conservative, nonsurgical, nonpharmacologic treatment strategies include weight reduction, orthotics, physical therapy modalities, acupuncture, massage, and exercise. The breadth of the current literature on OA can make determining the appropriate exercise prescription challenging. Aerobic exercise, strengthening exercise, Tai chi, and aquatic exercise can all alleviate pain and improve function in patients with OA. The choice of the specific type and mode of delivery of the exercise should be individualized and should consider the patient's preferences. Ongoing monitoring and supervision by a health care professional are essential for patients to participate in and benefit from exercise.

  14. Time for food - training physiatrists in nutritional prescription.

    Science.gov (United States)

    Polak, Rani; Dacey, Marie; Phillips, Edward M

    2017-01-31

    Sub-optimal nutrition is a leading factor in all-cause mortality, the preponderance of non-communicable chronic diseases, and various health conditions that are treated by physiatrists, such as stroke and musculoske-letal disorders. Furthermore, patients with chronic pain have a high prevalence of nutritional deficiencies, and malnutrition has been associated with limited rehabilitation outcomes in elderly patients with hospital-associated deconditioning. Thus, physiatrists may find it valuable to include nutrition in their patient services. However, discussion of nutritional counselling in the physiatry literature is rare. To inform physiatrists about including nutritional counselling as part of the treatment they provide. The paper reviews recommended communication skills, behavioural change strategies, and opportunities for inter-professional collaboration. Further resources to educate physiatrists both in nutritional prescription and in improving their own personal health behaviours are provided. Training physiatrists to address nutrition is a step-wise process, described here.

  15. Elaboration and Validation of the Medication Prescription Safety Checklist.

    Science.gov (United States)

    Pires, Aline de Oliveira Meireles; Ferreira, Maria Beatriz Guimarães; Nascimento, Kleiton Gonçalves do; Felix, Márcia Marques Dos Santos; Pires, Patrícia da Silva; Barbosa, Maria Helena

    2017-08-03

    to elaborate and validate a checklist to identify compliance with the recommendations for the structure of medication prescriptions, based on the Protocol of the Ministry of Health and the Brazilian Health Surveillance Agency. methodological research, conducted through the validation and reliability analysis process, using a sample of 27 electronic prescriptions. the analyses confirmed the content validity and reliability of the tool. The content validity, obtained by expert assessment, was considered satisfactory as it covered items that represent the compliance with the recommendations regarding the structure of the medication prescriptions. The reliability, assessed through interrater agreement, was excellent (ICC=1.00) and showed perfect agreement (K=1.00). the Medication Prescription Safety Checklist showed to be a valid and reliable tool for the group studied. We hope that this study can contribute to the prevention of adverse events, as well as to the improvement of care quality and safety in medication use. elaborar e validar um instrumento tipo checklist para identificar a adesão às recomendações na estrutura das prescrições de medicamentos, a partir do Protocolo do Ministério da Saúde e Agência Nacional de Vigilância Sanitária. pesquisa metodológica, conduzida por meio do processo de validade e análise de confiabilidade, com amostra de 27 prescrições eletrônicas. análises realizadas confirmaram a validade de conteúdo e a confiabilidade da versão do instrumento. A validade de conteúdo, obtida por meio da avaliação de juízes, foi considerada satisfatória por contemplar itens que representam a adesão às recomendações na estrutura das prescrições de medicamentos. A confiabilidade, avaliada por interobservadores, apresentou-se excelente (ICC=1,00) e de concordância perfeita (K=1,00). o instrumento Lista de Verificação de Segurança na Prescrição de Medicamentos demonstrou-se válido e confiável para o grupo estudado. Espera

  16. The connected prescription for form factors in twistor space

    Science.gov (United States)

    Brandhuber, A.; Hughes, E.; Panerai, R.; Spence, B.; Travaglini, G.

    2016-11-01

    We propose a connected prescription formula in twistor space for all tree-level form factors of the stress tensor multiplet operator in {N} = 4 super Yang-Mills, which is a generalisation of the expression of Roiban, Spradlin and Volovich for superamplitudes. By introducing link variables, we show that our formula is identical to the recently proposed four-dimensional scattering equations for form factors. Similarly to the case of amplitudes, the link representation of form factors is shown to be directly related to BCFW recursion relations, and is considerably more tractable than the scattering equations. We also discuss how our results are related to a recent Grassmannian formulation of form factors, and comment on a possible derivation of our formula from ambitwistor strings.

  17. Creole Practices as Prescriptive Guidelines for Language Didactics?

    DEFF Research Database (Denmark)

    Bojsen, Heidi

    2014-01-01

    This article presents some of Glissant’s thoughts about the status and usage of the Creole language in relation to French and the consequences for the social imaginary in Martinique and in the Caribbean. The author formulates three thematic focal points: Archipelagic thinking, creolisation...... and dynamic changes of language forms in a context of power and resistance and, as a third point, the right to remain ‘opaque’ and the distinction between language form and ‘langage’. The author argues that we may detect a descriptive and a prescriptive dimension in Glissant’s thinking about language....... In the following section, the author introduces different sociolinguistic studies of language practices in Martinique and the Caribbean giving a particular attention to the school system. The section ends with a brief discussion of how didactics in language teaching intersects with Glissant’s thinking...

  18. EGG: hatching a mock Universe from empirical prescriptions

    CERN Document Server

    Schreiber, C; Pannella, M; Merlin, E; Castellano, M; Fontana, A; Bourne, N; Boutsia, K; Cullen, F; Dunlop, J; Ferguson, H C; Michalowski, M J; Okumura, K; Santini, P; Shu, X W; Wang, T; White, C

    2016-01-01

    This paper introduces EGG, the Empirical Galaxy Generator, a tool designed within the ASTRODEEP collaboration to generate arbitrarily large mock galaxy catalogs with realistic fluxes and morphologies. The simulation procedure is based exclusively on empirical prescriptions -- rather than first principles -- to provide the most accurate match with the observations. In particular, we consider that galaxies can be either quiescent or star-forming, and use their stellar mass (M*) and redshift (z) as the fundamental properties from which all the other observables can be statistically derived. Drawing z and M* from the observed galaxy stellar mass functions, we then associate a star formation rate (SFR) to each galaxy from the tight SFR-M* main sequence, while dust attenuation, optical colors and morphologies (including bulge-to-total ratios, sizes and aspect ratios) are obtained from empirical relations that we establish from the high quality Hubble and Herschel observations available in the CANDELS fields. Random...

  19. Visualization of patient prescription history data in emergency care.

    Science.gov (United States)

    Ozturk, Selcuk; Kayaalp, Mehmet; McDonald, Clement J

    2014-01-01

    Interpreting patient's medication history from long textual data can be unwieldy especially in emergency care. We developed a real-time software application that converts one-year-long patient prescription history data into a visually appealing and information-rich timeline chart. The chart can be digested by healthcare providers quickly; hence, it could be an invaluable clinical tool when the rapid response time is crucial as in stroke or severe trauma cases. Furthermore, the visual clarity of the displayed information may help providers minimize medication errors. The tool has been deployed at the emergency department of a trauma center. Due to its popularity, we developed another version of this tool. It provides more granular drug dispensation information, which clinical pharmacists find very useful in their routine medication-reconciliation efforts.

  20. LIDAR Metrology for Prescription Characterization and Alignment of Large Mirrors

    Science.gov (United States)

    Eegholm, B.; Eichhorn, W.; von Handorf, R.; Hayden, J.; Ohl, R.; Wenzel, G.

    2011-01-01

    We describe the use of LIDAR, or "laser radar," (LR) as a fast, accurate, and non-contact tool for the measurement of the radius of curvature (RoC) of large mirrors. We report the results of a demonstration of this concept using a commercial laser radar system. We measured the RoC of a 1.4m x 1m spherical mirror with a nominal RoC of 4.6 m with a manufacturing tolerance of 4600mm +/- 6mm. The prescription of the mirror is related to its role as ground support equipment used in the test of part of the James Webb Space Telescope (JWST). The RoC of such a large mirror is not easily measured without contacting the surface. From a position near the center of curvature of the mirror, the LIDAR scanned the mirror surface, sampling it with 1 point per 3.5 sq cm. The measurement consisted of 3983 points and lasted only a few minutes. The laser radar uses the LIDAR signal to provide range, and encoder information from angular azimuth and elevation rotation stages provide the spherical coordinates of a given point. A best-fit to a sphere of the measured points was performed. The resulting RoC was within 20 ppm of the nominal RoC, also showing good agreement with the results of a laser tracker-based, contact metrology. This paper also discusses parameters such as test alignment, scan density, and optical surface type, as well as future possible application for full prescription characterization of aspherical mirrors, including radius, conic, off-axis distance, and aperture.

  1. Refining Prescription Warning Labels Using Patient Feedback: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Olayinka O Shiyanbola

    Full Text Available The complexity of written medication information hinders patients' understanding and leads to patient misuse of prescribed medications. Incorporating patient feedback in designing prescription warning labels (PWLs is crucial in enhancing patient comprehension of medication warning instructions. This qualitative study explored patient feedback on five newly designed PWLs. In-depth semi-structured face-to-face interviews were conducted with 21 patients, who were 18 years and older, spoke English, and took a prescription medication. These patients were shown different variations of the five most commonly used PWLs-Take with Food, Do not Drink Alcohol, Take with a Full glass of Water, Do not Chew or Break, and Protect from Sunlight. The 60-minute interviews explored feedback on patient comprehension of the PWL instructions and their suggestions for improving the clarity of the PWLs. At the end of the interview, patient self-reported socio-demographic information was collected with a 3-minute survey and a brief health literacy assessment was completed using the Newest Vital Sign. Twenty-one patients completed the interviews. Most patients were female (n = 15, 71.4% with ages ranging from 23 to 66 years old (mean: 47.6 ± 13.3. The mean health literacy score was 2.4 on a scale of 0-6. Qualitative content analysis based on the text, pictures, and placement of the PWLs on the pill bottle showed preferences for including 'WARNING' on the PWL to create alertness, inclusion of a picture together with the text, yellow color highlighting behind the text, and placement of the PWL on the front of the pill bottle. Although patients had positive opinions of the redesigned PWLs, patients wanted further improvements to the content and design of the PWLs for enhanced clarity and understandability.

  2. [Prescription of Benzodiazepines and Z-Drugs by German General Practitioners: A Cross-Sectional Study].

    Science.gov (United States)

    Moßhammer, Dirk; Haumann, Hannah; Muche, Rainer; Scheub, David; Joos, Stefanie; Laux, Gunter

    2017-07-03

    Background Due to their addictive potential, benzodiazepine (BZ) and non-benzodiazepine-agonists (NBZ, so-called Z-drugs) should be taken no longer than 6 weeks. BZ and NBZ are primarily prescribed by general practitioners (GPs). Therefore, we aimed to analyze GPs' data on the patients collective, the amount of BZ/NBZ prescribed and the rate of private prescriptions. Methods We analyzed person years of 2-year intervals from 2009 to 2014 of the primary care CONTENT register that contains routine data from 31 general practitioners' practices. We classified BZ/NBZ prescriptions according to risk groups. The association of BZ/NBZ prescription and potential influencing factors was analyzed by calculating the odds ratio with 95% confidence interval (and corresponding p-value) on the basis of a multiple logistic regression model (adjusted by age, sex and type of health insurance). All patients with drug prescription with and without BZ/NBZ-prescription were compared. Results Almost 5% of patients with drug prescriptions received at least one prescription of BZ/NBZ during 1 year of observation. On average these patients were older (67.5 vs. 48 years respectively) and the proportion of women was higher than in the comparison group (69 vs. 58%). About one-third of these patients received more than 600 mg diazepam equivalent dose per person year (according to a 2-month daily intake of more than 10 mg diazepam). About one-third of the prescriptions were private prescriptions. A number of variables were significantly associated with the prescription of BZ/NBZ (e. g. age, gender, diagnosis codes, practices). Conclusion The results provide valuable information about BZ/NBZ prescription routines in general practice. For continuous medical education as well as the development of interventions to reduce the use of BZ/NBZ, patient characteristics (e. g. sex, age, comorbidities, type of insurance) as well as different prescription routines (e. g. private prescriptions

  3. Alternate routes of administration and risk for HIV among prescription opioid abusers.

    Science.gov (United States)

    Surratt, Hilary; Kurtz, Steven P; Cicero, Theodore J

    2011-10-01

    Route of administration is an important contributor to the adverse health consequences of prescription medication abuse. The current study examines characteristics associated with non-oral routes of administration among a large sample of prescription opioid abusers and explores needle-related human immunodeficiency virus (HIV) risk behaviors as well. In the study, 791 opioid abusers completed a one-time structured interview, including complete histories of illicit and prescription drug abuse and route of drug administration. The most common method of pill use was oral (91%), followed by intranasal (53.1%), injection (23.8%), and smoking (14.5%). The youngest prescription opioid abusers, ages 18-24, displayed significantly higher odds of using alternate routes of administration and of reusing nonsterile needles for injection. HIV prevention programming should be developed for young prescription opioid injectors.

  4. Act your (old) age: prescriptive, ageist biases over succession, consumption, and identity.

    Science.gov (United States)

    North, Michael S; Fiske, Susan T

    2013-06-01

    Perspectives on ageism have focused on descriptive stereotypes concerning what older people allegedly are. By contrast, we introduce prescriptive stereotypes that attempt to control how older people should be: encouraging active Succession of envied resources, preventing passive Consumption of shared resources, and avoidance of symbolic, ingroup identity resources. Six studies test these domains, utilizing vignette experiments and simulated behavioral interactions. Across studies, younger (compared with middle-aged and older) raters most resented elder violators of prescriptive stereotypes. Moreover, these younger participants were most polarized toward older targets (compared with middle-aged and younger analogues)--rewarding elders most for prescription adherences and punishing them most for violations. Taken together, these findings offer a novel approach to ageist prescriptions, which disproportionately target older people, are most endorsed by younger people, and suggest how elders shift from receiving the default prejudice of pity to either prescriptive resentment or reward.

  5. Comparisons of anti-diabetic prescriptions of private practitioners and hospital prescribers: A survey

    Directory of Open Access Journals (Sweden)

    Ananya Mandal

    2013-01-01

    Full Text Available Monotherapy as well as effective and safe combination therapy for diabetes is practiced widely by both private and government hospital prescribers. This study attempted to compare the prescriptions of government and private practitioners to obtain a fair idea of the trends of diabetes management in either group. Prescriptions for diabetic patients from both private practitioners and government medical college prescribers were collected. These were analyzed for parameters such as number and type of drugs, cost, and generic prescription. Private prescribers were not significantly different from hospital prescribers in terms of number of drugs per prescription, cost of therapy, and treatment regimens. However, there was a dearth of generic prescriptions from private consultants (33% vs. 9%. Metformin and Glimepiride were the most prescribed drugs in both groups. However, private practitioners preferred Gliclazide, Glipizide, and Glibenclamide more than hospital prescribers.

  6. Income and the use of prescription drugs for near retirement individuals

    DEFF Research Database (Denmark)

    Leth-Petersen, Søren; Skipper, Niels

    Understanding how demand for prescription drugs responds to changes in income is important for assessing the welfare consequences of reforms affecting income. This becomes more imminent as age progresses, because the use of prescription drugs and the associated budgetary burden increases...... dramatically from about age 55. In this paper we estimate how demand for prescription drugs varies with income for a sample of near retirement individuals. Estimating the prescription drug demand response to income changes is complicated because an important explanatory variable, the health capital......, is unobserved, and because demand is potentially dynamic, for example because some drugs are habitual. The analysis is based on a novel panel data set with information about purchase of prescription drug demand for a very large number of Danish individuals over the period 1995-2003. Our preferred model...

  7. Poverty, health care, and problems of prescription medication: a case study.

    Science.gov (United States)

    Anglin, M K; White, J C

    1999-12-01

    Through the use of ethnographic research methods the authors examine the relationship between poverty, limited access to health care, and prescription medication use/misuse in rural eastern Kentucky. Four patterns of prescription drug misuse are documented in this study: 1) overuse of medications, often by means of multiple prescriptions obtained from different physicians; 2) the acquisition of prescription drugs for the purpose of resale through illegal channels; 3) borrowing or "swapping" medications through informal exchange; and 4) under- or nonuse of prescription drugs. Of the four patterns, the last is the one reported as having the highest prevalence due to residents' inability to afford the costs of medications prescribed by physicians. The public health implications of these findings are briefly discussed.

  8. Referrals and Treatment Completion for Prescription Opioid Admissions: Five Years of National Data

    Science.gov (United States)

    St Marie, Barbara; Sahker, Ethan; Arndt, Stephan

    2016-01-01

    This study examines sources of referral for prescription opioid admission to substance use disorder treatment facilities and their relative completion success rates using secondary analysis of an existing data set (Treatment Episode Datasets – Discharge). Five years of data from public and private treatment facilities were extracted for client discharges with no prior treatment (N = 2,909,884). Healthcare professionals account for very few referrals to treatment (<10%). Prescription opioid clients referred into treatment had lower treatment success compared to other substance clients and when referred by healthcare providers had lower success rates (OR = 0.72, 95% CI 0.70 – 0.75) than clients from other referral sources. Fewer treatment referrals for prescription opioid misuse by healthcare providers and lower success rates are significant and timely findings due to the prevalence of prescription opioid misuse. Healthcare providers are well positioned to refer early for prescription opioid misuse and continue support of their patients during treatment. PMID:26362002

  9. Do coxibs reduce prescription of gastroprotective agents? Results of a record linkage study

    Directory of Open Access Journals (Sweden)

    Violante Andrea

    2006-03-01

    Full Text Available Abstract Background Coxibs are claimed to be cost-effective drugs and reduced prescription of gastroprotective agents is assumed to be one of their major benefits. Real life prescription of these drugs may be substantially different than that considered in pharmacoeconomic analyses or claimed by drug companies, yet. Our objective was to evaluate whether coxibs were associated with reduced prescription of gastro-protective agents (GPAs, specifically proton pump inhibitors, H2 blockers and misoprostol compared to non selective NSAIDs. Methods A record-linkage study was performed using 2001 outpatient prescription data from the province of Modena (about 632,000 inhabitants, in Northern Italy. Logistic regression was used to calculate the odds ratio of GPA prescription for coxib and non-selective NSAID adult users (> 14 years. Three categories of users were further investigated: "acute", "chronic and "incident or new". Main outcome measures were same-day co-prescription and 30 days prescription of GPAs in coxibs and non selective NSAIDs users. To limit selection bias, data were adjusted for age, sex, DDD of coxibs and non selective NSAIDs received during 2001, DDD of GPAs and (for non-incident users DDD of NSAIDs received during the previous 4 years Results Same day co-prescription rates were similar considering the overall population and "acute" users. Chronic coxibs users instead showed higher co-prescription rates than chronic NSAIDs users (OR = 1.2, p Conclusion Assumptions made in pharmacoeconomic analyses on coxibs (lower GPA prescription associated with coxibs use may be overly optimistic. Claims made through cost-effectiveness data should be carefully interpreted, and mechanisms for attributing drug prices revised accordingly.

  10. How patients understand the term "nonmedical use" of prescription drugs: insights from cognitive interviews.

    Science.gov (United States)

    McNeely, Jennifer; Halkitis, Perry N; Horton, Ariana; Khan, Rubina; Gourevitch, Marc N

    2014-01-01

    With rising rates of prescription drug abuse and associated overdose deaths, there is great interest in having accurate and efficient screening tools that identify nonmedical use of prescription drugs in health care settings. The authors sought to gain a better understanding of how patients interpret questions about misuse of prescription drugs, with the goal of improving the accuracy and acceptability of instruments intended for use in primary care. A total of 27 English-speaking adult patients were recruited from an urban safety net primary care clinic to complete a cognitive interview about a 4-item screening questionnaire for tobacco, alcohol, illicit drugs, and misuse of prescription drugs. Detailed field notes were analyzed for overall comprehension of the screening items on illicit drug use and prescription drug misuse, the accuracy with which participants classified drugs into these categories, and whether the screening response correctly captured the participant's substance use behavior. Based on initial responses to the screening items, 6 (22%) participants screened positive for past-year prescription drug misuse, and 8 (30%) for illicit drug use. The majority (26/27) of participants correctly interpreted the item on illicit drug use, and appropriately classified drugs in this category. Eleven (41%) participants had errors in their understanding of the prescription drug misuse item. The most common error was classifying use of medications without abuse potential as nonmedical use. All cases of misunderstanding the prescription drug misuse item occurred among participants who screened negative for illicit drug use. The results suggest that terminology used to describe misuse of prescription medications may be misunderstood by many primary care patients, particularly those who do not use illicit drugs. Failure to improve upon the language used to describe prescription drug misuse in screening questionnaires intended for use in medical settings could

  11. Assessment of medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Dilnasheen Sheikh

    2017-06-01

    Full Text Available The objective of the study is to assess the medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital. A prospective observational study was carried out for a period of 8 months from June 2015 to February 2016 at tertiary care hospital. At inpatient department regular chart review of patient case records was carried out to assess the medication errors. The observed medication errors were assessed for level of harm by using NCCMERP index. The outpatient prescriptions were screened for adherence to WHO prescription writing guidelines. Out of 200 patients, 40 patients developed medication errors. Most of the medication errors were observed in the age group above 61 years (40%. Majority of the medication errors were observed with drug class of antibiotics 9 (22.5% and bronchodilators 9 (22.5%. Most of the errors were under the NCCMERP index category C. Out of 545 outpatient prescriptions, 51 (9.37% prescriptions did not have prescriber’s name and all of the prescriptions lack prescriber’s personal contact number. Eighteen prescriptions did not have patient’s name and 426 (78.2% prescriptions did not have patient’s age. The prevalence of medication errors in this study was relatively low (20% without any fatal outcome. Omission error was the most frequently observed medication errors 31 (77.5%. In the present study, the patient’s age was missing in 78.2% of the prescriptions and none of the prescriptions had patient’s address and the drug names were not mentioned by their generic names.

  12. Surveillance of broad-spectrum antibiotic prescription in Singaporean hospitals: a 5-year longitudinal study.

    Directory of Open Access Journals (Sweden)

    Yi-Xin Liew

    Full Text Available BACKGROUND: Inappropriate prescription of antibiotics may contribute towards higher levels antimicrobial resistance. A key intervention for improving appropriate antibiotic prescription is surveillance of prescription. This paper presents the results of a longitudinal surveillance of broad-spectrum antibiotic prescription in 5 public-sector hospitals in Singapore from 2006 to 2010. METHODOLOGY/PRINCIPAL FINDINGS: Quarterly antibiotic prescription data were obtained and converted to defined daily doses (DDDs per 1,000 inpatient-days. The presence of significant trends in antibiotic prescription over time for both individual and combined hospitals was tested by regression analysis and corrected for autocorrelation between time-points. Excluding fluoroquinolones, there was a significant increase in prescription of all monitored antibiotics from an average of 233.12 defined daily doses (DDD/1,000 inpatient-days in 2006 to 254.38 DDD/1,000 inpatient-days in 2010 (Coefficient = 1.13, 95%CI: 0.16-2.09, p = 0.025. Increasing utilization of carbapenems, piperacillin/tazobactam, and Gram-positive agents were seen in the majority of the hospitals, while cephalosporins were less prescribed over time. The combined expenditure for 5 hospitals increased from USD9.9 million in 2006 to USD16.7 million in 2010. CONCLUSIONS/SIGNIFICANCE: The rate of prescription of broad-spectrum antibiotics in Singaporean hospitals is much higher compared to those of European hospitals. This may be due to high rates of antimicrobial resistance. The increase in expenditure on monitored antibiotics over the past 5 years outstripped the actual increase in DDD/1,000 inpatient-days of antibiotics prescribed. Longitudinal surveillance of antibiotic prescription on a hospital and countrywide level is important for detecting trends for formulating interventions or policies. Further research is needed to understand the causes for the various prescription trends and to act on these where

  13. 门诊电子处方系统的处方差错分析%Analysis of prescription errors made by outpatient electronic prescription system

    Institute of Scientific and Technical Information of China (English)

    蔡志波; 林艳; 吴妙莲

    2008-01-01

    处方差错是临床医生在开具处方时普遍存在的现象,随着信息技术在医疗领域的发展应用,电子处方系统被认为是有效预防处方差错的最佳解决方案.对该院1年的门诊电子处方的回顾分析显示,它可以明显地减少传统手写处方容易出现的差错,但是并不能有效地减少与剂量有关的差错.主要的原因是医生处方行为的改变以及人机交互缺陷而导致的新类型的处方差错发生.具备基本功能的电子处方系统并不能完全有效杜绝处方差错,病人的用药安全仍存在着潜在的威胁.如何完善电子处方系统的功能、提高人机交互的友好性,减少由系统错误而产生的差错是目前急待解决的问题.%Errors in prescriptions are common phenomena in prescriptions produced by clinicians. With development and application of information technology in medical fields, electronic prescription system has been regarded as the best resolution for effective prevention of errors in prescriptions. A retrospective study of the prescriptions made by the electronic prescription system of the hospital studied over one year showed that this system could reduce errors easily made in manual prescriptions significantly, but it failed to reduce the errors related to dosages. Those dosage-related errors were mainly caused by change of physician prescribing behavior and defective man-machine interaction. Electronic prescription system, though functions basically, can not avoid prescription errors effectively, which poses a potential threat to safe use of medicines in patients. It is urgent at the moment to perfect the functions of electronic prescription system, promote a friendly man-machine interaction and reduce errors made by system errors.

  14. 50 CFR 221.73 - How will NMFS analyze a proposed alternative and formulate its modified prescription?

    Science.gov (United States)

    2010-10-01

    ... MAMMALS PRESCRIPTIONS IN FERC HYDROPOWER LICENSES Alternatives Process § 221.73 How will NMFS analyze a... project works for electricity production. (c) When NMFS files with FERC the prescription that NMFS adopts...

  15. A retrospective study of prescription pattern of antimicrobials in an Urban Health Centre run by a medical college

    National Research Council Canada - National Science Library

    Bala, Sharmin S; Chincholkar, Aparna S; Wagh, Ranjit J; Mutalik, Madhav M

    2014-01-01

    .... Materials and Methods: A retrospective prescription audit was done of all 655 prescriptions issued between 01/01/2012 and 31/12/2012 at the outpatient department of Urban Health Centre attached to a medical college...

  16. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men.

    Directory of Open Access Journals (Sweden)

    William D Finkle

    Full Text Available BACKGROUND: An association between testosterone therapy (TT and cardiovascular disease has been reported and TT use is increasing rapidly. METHODS: We conducted a cohort study of the risk of acute non-fatal myocardial infarction (MI following an initial TT prescription (N = 55,593 in a large health-care database. We compared the incidence rate of MI in the 90 days following the initial prescription (post-prescription interval with the rate in the one year prior to the initial prescription (pre-prescription interval (post/pre. We also compared post/pre rates in a cohort of men prescribed phosphodiesterase type 5 inhibitors (PDE5I; sildenafil or tadalafil, N = 167,279, and compared TT prescription post/pre rates with the PDE5I post/pre rates, adjusting for potential confounders using doubly robust estimation. RESULTS: In all subjects, the post/pre-prescription rate ratio (RR for TT prescription was 1.36 (1.03, 1.81. In men aged 65 years and older, the RR was 2.19 (1.27, 3.77 for TT prescription and 1.15 (0.83, 1.59 for PDE5I, and the ratio of the rate ratios (RRR for TT prescription relative to PDE5I was 1.90 (1.04, 3.49. The RR for TT prescription increased with age from 0.95 (0.54, 1.67 for men under age 55 years to 3.43 (1.54, 7.56 for those aged ≥ 75 years (p trend = 0.03, while no trend was seen for PDE5I (p trend = 0.18. In men under age 65 years, excess risk was confined to those with a prior history of heart disease, with RRs of 2.90 (1.49, 5.62 for TT prescription and 1.40 (0.91, 2.14 for PDE5I, and a RRR of 2.07 (1.05, 4.11. DISCUSSION: In older men, and in younger men with pre-existing diagnosed heart disease, the risk of MI following initiation of TT prescription is substantially increased.

  17. Prescription auditing and drug utilization pattern in a tertiary care teaching hospital of western UP

    Directory of Open Access Journals (Sweden)

    Afroz Abidi

    2012-06-01

    Full Text Available Background: In India, a proper reporting of medication errors in the hospital is not available. Drugs worth crores of rupee are consumed every year but a substantial part of these drugs are irrationally prescribed. In order to promote rational drug usage standard policies on use of drugs must be set, and this can be done only after the current prescription practices have been audited. The prescriptions were analyzed based on the objectives of the study in order to promote rational use of drugs in a population. Methods: The study was carried out prospectively over a period of two months and 15 days in general medicine OPD of our tertiary care hospital. A specially designed performa was used with pre-inserted carbons. Results: Two hundred and thirty seven prescriptions were analyzed. Total no. of drugs in 237 prescriptions were 1001. Therefore average number of drugs/prescription is 4.22. Drugs were prescribed by generic names in 3.79% of cases, drugs on EDL are only 53.25% and fixed dose combinations are 26.87% of total drugs. Dosage forms used were mostly oral -93.51%. Injectables were only 6.19% and topical forms were least 0.299%. Doctors profile indicates that maximum number i.e. 93.67% were general practitioners. Basic information of patient was written in 72.57% prescriptions. Complete diagnoses were written in 70.04% prescriptions. Only 88.61% prescriptions were legible and only 76.79% prescriptions were complete in terms of dose, route, strength, frequency and dosage forms. Disease pattern seen was variable. Diseases of respiratory system were maximum 44.72 % followed by infectious and parasitic diseases - 16.03 % and diseases of digestive system - 13.92 %. The most common drug groups prescribed were NSAIDs± serratiopeptidases, antibiotics, antihistaminics, multivitamins, minerals, enzymes and expectorants & bronchodilators. The incidence of polypharmacy was also common with maximum number of drugs which were prescribed per prescription

  18. Using Simulation to Improve First-Year Pharmacy Students' Ability to Identify Medication Errors Involving the Top 100 Prescription Medications.

    Science.gov (United States)

    Atayee, Rabia S; Awdishu, Linda; Namba, Jennifer

    2016-06-25

    Objective. To evaluate first-year pharmacy students' ability to identify medication errors involving the top 100 prescription medications. Design. In the first quarter of a 3-quarter pharmacy self-care course, a didactic lecture on the most common prescribing and dispensing prescription errors was presented to first-year pharmacy students (P1) in preparation for a prescription review simulation done individually and as a group. In the following quarter, they were given a formal prescription review workshop before a second simulation involving individual and group review of a different set of prescriptions. Students were evaluated based on the number of correctly checked prescriptions and a self-assessment of their confidence in reviewing prescriptions. Assessment. All 63 P1 students completed the prescription review simulations. The individual scores did not significantly change, but group scores improved from 79 (16.2%) in the fall quarter to 98.6 (4.7%) in the winter quarter. Students perceived improvement of their prescription checking skills, specifically in their ability to fill a prescription on their own, identify prescribing and dispensing errors, and perform pharmaceutical calculations. Conclusion. A prescription review module consisting of a didactic lecture, workshop and simulation-based methods to teach prescription analysis was successful at improving first year pharmacy students' knowledge, confidence, and application of these skills.

  19. 21 CFR 1306.27 - Provision of prescription information between retail pharmacies and central fill pharmacies for...

    Science.gov (United States)

    2010-04-01

    ... retail pharmacy pharmacist transmitting the prescription, and the date of transmittal; (2) Ensure that... retail pharmacies and central fill pharmacies for initial and refill prescriptions of Schedule III, IV... Provision of prescription information between retail pharmacies and central fill pharmacies for initial...

  20. Comparison of standardized versus individualized caloric prescriptions in the nutritional rehabilitation of inpatients with anorexia nervosa

    Science.gov (United States)

    Haynos, Ann F.; Snipes, Cassandra; Guarda, Angela; Mayer, Laurel E.; Attia, Evelyn

    2015-01-01

    Objective Sparse research informs how caloric prescriptions should be advanced during nutritional rehabilitation of inpatients with anorexia nervosa (AN). This study compared the impact of a standardized caloric increase approach, in which increases occurred on a predetermined schedule, to an individualized approach, in which increases occurred only following insufficient weight gain, on rate, pattern, and cumulative amount of weight gain and other weight restoration outcomes. Method This study followed a natural experiment design comparing AN inpatients consecutively admitted before (n = 35) and after (n = 35) an institutional change from individualized to standardized caloric prescriptions. Authors examined the impact of prescription plan on weekly weight gain in the first treatment month using multilevel modeling. Within a subsample remaining inpatient through weight restoration (n = 40), multiple regressions examined the impact of caloric prescription plan on time to weight restoration, length of hospitalization, maximum caloric prescription, discharge BMI, and incidence of activity restriction and edema. Results There were significant interactions between prescription plan and quadratic time on average weekly weight gain (p = .03) and linear time on cumulative weekly weight gain (p < .001). Under the standardized plan, patients gained in an accelerated curvilinear pattern (p = .04) and, therefore, gained cumulatively greater amounts of weight over time (p < .001). Additionally, 30% fewer patients required activity restriction under the standardized plan. Discussion Standardized caloric prescriptions may confer advantage by facilitating accelerated early weight gain and lower incidence of bed rest without increasing the incidence of refeeding syndrome. PMID:26769581

  1. Prescription pattern of benzodiazepines for inpatients at a tertiary care university hospital in Pakistan.

    Science.gov (United States)

    Khawaja, Muhammad Rizwanulhaq; Khawaja, Muhammad Rizwanullah; Majeed, A; Malik, F; Merchant, K A; Maqsood, M; Malik, R; Mazahir, S; Naqvi, H

    2005-06-01

    To determine the point prevalence of benzodiazepine prescriptions for inpatients at a tertiary care university hospital in Pakistan and to correlate it with prescription patterns of various specialties, indications and demographic variables of the patients. This 24-hours point prevalence study was done at The Aga Khan University Hospital, Karachi. By convenient random sampling, 208 inpatients were interviewed. Patients' files were also studied to record the drugs administered. Data was entered into questionnaires and analyzed by SPSS 10.0. The point prevalence of the benzodiazepines was 21.2%. It was higher among males than females and among surgical than non-surgical patients. Midazolam was the most commonly used benzodiazepine, followed by Alprazolam and Lorazepam. Pre-anesthesia and psychiatric symptoms were the two most common indications. Oral route was used in 84% patients for drug administration and mean Valium equivalent dosage was 4.86 mg/day. Mean length of prescription was 3 days. Longer duration of hospitalization was a significant predictor of the requirement of benzodiazepine prescription (p-value = 0.020). Prescription pattern of benzodiazepines at a tertiary care university hospital is similar to that reported in the developed countries through monitoring at various levels by physicians, clinical pharmacist and nursing staff. Data regarding the prescription pattern of benzodiazepines is scarce, and it needs to be expanded to formulate clear guidelines regarding their prescription.

  2. Overview of Medicare Part D prescription drug benefit: potential implications for patients with psychotic disorders.

    Science.gov (United States)

    Rosenberg, Jack M

    2007-01-15

    Medicare Part D prescription drug benefits are reviewed. Potential implications for patients with psychotic disorders in relation to Medicare Part D are discussed. The newly created Medicare Part D provides prescription drug benefits to many individuals formerly without prescription benefits and, possibly, lower-cost benefits to those who previously relied on other benefits. Participating prescription plans use a variety of pharmacy management tools to minimize costs while providing benefit plans that meet Part D requirements for composition and coverage. Patients then have the challenge of choosing a prescription drug plan that will best satisfy their prescriptions needs. The rollout of Part D has not been without problems, and although more Medicare participants are receiving prescription drug benefits at a greater savings, there are concerns that Part D may not provide adequate coverage for all patients or for patients requiring certain types of medications, especially some psychotropic medications. Pharmacists have voiced concerns about the Medicare Part D drug plan in regard to both the degree of coverage it provides to enrollees and the difficulty in administering the benefit.

  3. Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients

    Directory of Open Access Journals (Sweden)

    Dube Shanta R

    2008-06-01

    Full Text Available Abstract Background Prescription drugs account for approximately 11% of national health expenditures. Prior research on adverse childhood experiences (ACEs, which include common forms of child maltreatment and related traumatic stressors, has linked them to numerous health problems. However, data about the relationship of these experiences to prescription drug use are scarce. Method We used the ACE Score (an integer count of 8 different categories of ACEs as a measure of cumulative exposure to traumatic stress during childhood. We prospectively assessed the relationship of the Score to prescription drug use in a cohort of 15,033 adult HMO patients (mean follow-up: 6.1 years and assessed mediation of this relationship by documented ACE-related health and social problems. Results Nearly 1.2 million prescriptions were recorded; prescriptions rates increased in a graded fashion as the ACE Score increased (p for trend Conclusion ACEs substantially increase the number of prescriptions and classes of drugs used for as long as 7 or 8 decades after their occurrence. The increases in prescription drug use were largely mediated by documented ACE-related health and social problems.

  4. Misuse of prescription stimulants for weight loss, psychosocial variables, and eating disordered behaviors.

    Science.gov (United States)

    Jeffers, Amy; Benotsch, Eric G; Koester, Stephen

    2013-06-01

    In recent years there has been a dramatic increase in the non-medical use of prescription drugs among young adults including an increase in the use of prescription stimulants normally used to treat ADHD. Reported motivations for the non-medical use of prescription stimulants (NPS) include enhancing academic performance and to get high. Although a common side effect of these medications is appetite suppression, research examining weight loss as a motivation for NPS among young adults is sparse. In the present study, undergraduate students (n=705) completed an online survey assessing weight loss behaviors, motivations for weight loss, and eating behaviors. Nearly 12% of respondents reported using prescription stimulants to lose weight. Participants who reported using prescription stimulants for weight loss had greater appearance-related motivations for weight loss, greater emotion and stress-related eating, a more compromised appraisal of their ability to cope, lower self-esteem, and were more likely to report engaging in other unhealthy weight loss and eating disordered behaviors. Results suggest some young adults are misusing prescription stimulants for weight loss and that this behavior is associated with other problematic weight loss strategies. Interventions designed to reduce problematic eating behaviors in young adults may wish to assess the misuse of prescription stimulants.

  5. Improving acute medical management: Junior Doctor Emergency Prescription Cards.

    Science.gov (United States)

    Hutton, Joe; Gingell, Megan; Hutchinson, Lisa

    2016-01-01

    Doctors commencing Foundation Year (FY) training face many stresses and challenges. FY doctors are often the first point of contact for acutely unwell and deteriorating patients. Trust guidelines are used to aid acute medical management. Accessing guidelines is often fraught with barriers. Evidence suggests aide-memoire cards can provide easier access to guidelines and management pathways. We aimed to improve prescribing accuracy and efficiency of FY doctors for acute medical conditions within Gloucestershire trust by improving access to and usability of trust guidelines. Questionnaires were distributed to FY doctors to identify acute medical conditions to include on the emergency prescription cards (EPCs). Two small double-sided cards were created containing bullet pointed trust guidelines for: hyper/hypokalaemia, status epilepticus, diabetic emergencies, arrhythmias, myocardial infarction, acute asthma, pulmonary oedema, anaphylaxis and a ward-round checklist. Feedback was used to improve EPCs prior to distribution. Pre (N=53) and post-intervention (N=46) written questionnaires were completed by FY doctors. These assessed acute clinical management including use of guidance, confidence in management, speed of prescribing and EPC "usability". To assess prescribing accuracy, prescriptions for acute medical conditions were reviewed pre (N=8) and post-intervention (N=12). The EPCs were well received (80% quite/very useful) and found "easy to use" (83%). The introduction of EPCs increased guidance use (pre-intervention 58.8%, post-intervention 71.7%), increased confidence (pre-intervention 79%, post-intervention 89%) and significantly improved prescribing speed (p=0.05). There was a significant correlation with confidence and prescribing speed (p = 0.023). The accuracy of prescribed doses improved (pre-intervention 62.5%, post-intervention 87.5% accurate) as did details regarding route / additional required information (pre-intervention 75%, post-intervention 97

  6. Surveillance and correlation of antibiotic prescription and resistance of Gram-negative bacteria in Singaporean hospitals.

    Science.gov (United States)

    Hsu, Li-Yang; Tan, Thean-Yen; Tam, Vincent H; Kwa, Andrea; Fisher, Dale Andrew; Koh, Tse-Hsien

    2010-03-01

    A surveillance study was performed in four Singapore public hospitals from 2006 to 2008 to determine the correlation between antibiotic prescription and Gram-negative bacterial antimicrobial resistance. Targeted organisms included ceftriaxone- and ciprofloxacin-resistant Escherichia coli and Klebsiella pneumoniae, as well as imipenem-resistant Pseudomonas aeruginosa and Acinetobacter spp. Antibiotic prescription data were collated in the WHO anatomical therapeutic chemical (ATC)/defined daily dose (DDD) format, while antibiotic resistance was expressed as incidence density adjusted for total inpatient-days every quarter. Individual trends were determined by linear regression, while possible associations between antibiotic prescription and resistance were evaluated via cross-correlation analysis. Results over 3 years indicated significantly rising incidence densities of ceftriaxone- and ciprofloxacin-resistant E. coli and imipenem-resistant Acinetobacter spp. (blood isolates only). Antimicrobial-resistant Klebsiella pneumoniae rates declined. The prescription rates of piperacillin-tazobactam, ertapenem, meropenem, ciprofloxacin, and levofloxacin increased significantly, while imipenem and moxifloxacin prescription decreased. Cross-correlation analysis demonstrated possible associations between prescription of fluoroquinolones and ciprofloxacin-resistant E. coli (R(2) = 0.46), fluoroquinolones and ceftriaxone-resistant E. coli (R(2) = 0.47), and carbapenems and imipenem-resistant Acinetobacter spp. (R(2) = 0.48), all at zero time lag. Changes in meropenem prescription were associated with a similar trend in imipenem-resistant Acinetobacter blood isolates after a 3-month time lag. No correlation was found between cephalosporin use and resistance. In conclusion, our data demonstrated correlation between prescription of and Gram-negative bacterial resistance to several, but not all, key antimicrobial agents in Singapore hospitals. In areas where Gram-negative bacterial

  7. Increase in the prescription rate of antidepressants after the Sewol Ferry disaster in Ansan, South Korea.

    Science.gov (United States)

    Han, Kyu-Man; Kim, Kyoung-Hoon; Lee, Mikyung; Lee, Sang-Min; Ko, Young-Hoon; Paik, Jong-Woo

    2017-09-01

    Previous pharmaco-epidemiological studies have reported increases in the prescription of psychotropic medications after a disaster, reflecting post-disaster changes in psychiatric conditions and mental health service utilization. We investigated changes in the prescription of psychotropic medications in the Danwon district of Ansan city (Ansan Danwon) compared to a control community before and after the Sewol Ferry disaster on April 16, 2014. Data was collected from the Korean Health Insurance Review and Assessment Service database. We analyzed the prescription rates of psychotropic medications including antidepressants, anxiolytics, and sedatives/hypnotics, and investigated whether the time-series pattern of monthly prescriptions per 100,000 people was different in Ansan Danwon compared to that in Cheonan city after the Sewol Ferry disaster through difference-in-differences regression analysis. Ansan Danwon showed a significantly greater increase (5.6%) in the prescription rate of antidepressants compared to Cheonan city following the Sewol Ferry disaster. There were no significant differences in changes in the prescription rates of anxiolytics or sedatives/hypnotics. In the secondary analysis, a significantly greater increase in the prescription rate of antipsychotics was observed in Ansan Danwon compared to a control community after the disaster. We could not exclude the possibility that other events influenced changes in the prescription rates of psychotropic medications during the study period. Pharmaco-epidemiological studies on psychotropic medication prescription after a disaster provide important information about population-level mental health. Our results suggest that the Sewol Ferry disaster exerted a harmful effect on the mental health status of the affected community. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Validity of the Prescriber Information in the Danish National Prescription Registry

    DEFF Research Database (Denmark)

    Rasmussen, Lotte; Valentin, Julie; Gesser, Katarina Margareta

    2016-01-01

    The aim of this study was to measure the validity of the prescriber information recorded in the Danish National Prescription Registry (DNPR). The prescriber information recorded in the pharmacies' electronic dispensing system was considered to represent the prescriber information recorded...... in the DNPR. Further, the problem of validity of the prescriber information pertains only to non-electronic prescriptions, as these are manually entered into the dispensing system. The recorded prescriber information was thus validated against information from a total of 2,000 non-electronic prescriptions...

  9. Quantitative and qualitative evaluation of drug prescriptions in south Tehran, Shahre Rey and Islamshahr

    Directory of Open Access Journals (Sweden)

    Aslesoleymani H

    1998-05-01

    Full Text Available Improper drug prescription by physicians due to wrong diagnosis, wrong drug choise or other causes will waste national funds. The annual drug costs in Iran is 900 billions Rials. With approvement of prescription, it can be reduced to 500 billions Rials. Effective factors in costs reduction are: 1 Increasing medical knowledge and persistent education of physicians. 2 Spending more time for each visit. 3 Giving more information to physicians about pharmacological compounds. 4 Teaching symptoms and signs of the common diseases and proper diagnosis of them. 5 Checking the prescriptions of physicians.

  10. Prescription drug abuse as a public health problem in Ohio: a case report.

    Science.gov (United States)

    Winstanley, Erin L; Gay, Joe; Roberts, Lisa; Moseley, Judi; Hall, Orman; Beeghly, B Christine; Winhusen, Theresa; Somoza, Eugene

    2012-11-01

    Prescription drug overdose is the leading cause of injury death in Ohio, as well as in 16 other states. Responding to the prescription drug epidemic is particularly challenging given the fragmentation of the health care system and that the consequences of addiction span across systems that have not historically collaborated. This case study reports on how Ohio is responding to the prescription drug epidemic by developing cross-system collaboration from local public health nurses to the Governor's office. In summary, legal and regulatory policies can be implemented relatively quickly whereas changing the substance abuse treatment infrastructure requires significant financial investments.

  11. Awareness of and attitudes toward direct-to-consumer prescription drug advertising among young adults.

    Science.gov (United States)

    Alperstein, Neil M

    2014-01-01

    This study examines awareness and knowledge of and attitudes toward direct-to-consumer (DTC) prescription drug advertising among young adults between 18 and 24 years of age. The study finds that young adults are not as aware of prescription drug advertising as older consumers, however, they are aware of specific heavily advertised drugs, especially those for allergy medications, birth control, and sleep aids. Young adults hold mixed to negative views about advertising in general, and they do not view DTC prescription drug advertising as a beneficial source of information, nor do they believe such advertising serves to educate consumers.

  12. Income and the use of prescription drugs for near retirement individuals

    DEFF Research Database (Denmark)

    Leth-Petersen, Søren; Skipper, Niels

    2014-01-01

    In this paper, we estimate how demand for prescription drugs varies with income for a sample of near retirement individuals. The analysis is based on a novel panel data set with information about the purchase of prescription drugs for a large number of Danish individuals over the period 1995–2003......–2003. Our preferred model performs better in an external validation test than models that can be estimated on cross section data. Results indicate that demand does respond to variations in income and that reforms affecting income will therefore affect the use of prescription drugs....

  13. Prescription opioid analgesic use among adults: United States, 1999-2012.

    Science.gov (United States)

    Frenk, Steven M; Porter, Kathryn S; Paulozzi, Leonard J

    2015-02-01

    Prescription opioid analgesics are used to treat pain from surgery, injury, and health conditions such as cancer. Opioid dependence and opioid-related deaths are growing public health problems. Opioid analgesic sales (in kilograms per 10,000) quadrupled from 1999 to 2010 (1), and from 1999 to 2012, opioid-related deaths (per 100,000) more than tripled (2). During 1999–2002, 4.2% of persons aged 18 and over used a prescription opioid analgesic in the past 30 days (3). This report provides updated estimates and trends in prescription opioid analgesic use among adults aged 20 and over, overall and by selected subgroups.

  14. Dispensing behaviour of pharmacies in prescription drug markets.

    Science.gov (United States)

    Guhl, Dennis; Stargardt, Tom; Schneider, Udo; Fischer, Katharina E

    2016-02-01

    We aim to investigate pharmacies' dispensing behaviour under the existing dispensing regulations in Germany. Using administrative data, we performed a cross-sectional retrospective study to analyse whether the competitive environment and pharmacy characteristics, i.e., organisation, lead to dispensing choices aimed at by third-party payers. We specified generalised linear models with the share of imported pharmaceuticals, generic share, and share of preferred brands as dependent variables. The final dataset contained 49,260,902 prescriptions from 16,797 pharmacies. The average share of imported pharmaceuticals across the pharmacies was 18.4% (standard deviation (SD) 8.8), the average generic share was 92.8% (SD 2.1), and compliance with preferred brands was 81.3% (SD 5.9). Pharmacies with little competition used fewer imported pharmaceuticals (ppharmacies yielded similar results. The difference in outcomes between pharmacies in the first and 4th quartiles of the pharmacy organisation variable is 17.4% vs. 17.0% for share of imported pharmaceuticals, 92.8% vs. 92.7% for generic share and 81.9% vs. 81.1% for compliance with preferred brands. We show that pharmacies' dispensing choices meet the aims of payers at high levels. However, dispensing behaviour varies between pharmacies. Increasing competition among pharmacies and targeting pharmacies with high shares of bill auditing seem viable options to improving dispensing behaviour as defined by payers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Prescription drug brand Web sites: Guidance where none exists

    Directory of Open Access Journals (Sweden)

    Lewis Glinert, Ph.D

    2010-01-01

    Full Text Available This paper applies insights from linguistics and discourse analysis to prescription drug brand Web sites, with special reference to the 100 top-selling drugs. Such sites give the outward appearance of being a place to go for straightforward information about a specific brand. In reality, they present a confused mix of brand information, health information and hype, muddled organization, and poor indication of authority, creating an imbalance between benefit and risk content. In so doing, they breach the letter and spirit of the regulations governing direct-to-consumer advertising, which the FDA has by default applied to such Web sites but which were not designed for this special type of discourse. The many communicative difficulties proven to be caused by Web sites in general, in particular for the elderly and less literate, also pose ethical problems. A rethinking of the verbal and visual design of these drug sites is needed -- and new regulatory guidance, for which this paper offers recommendations. At stake is not just the quality of health information at brand drug sites but also their credibility.

  16. Prescription drug monitoring program utilization in Kentucky community pharmacies.

    Science.gov (United States)

    Wixson, Sarah E; Blumenschein, Karen; Goodin, Amie J; Talbert, Jeffery; Freeman, Patricia R

    2015-01-01

    Identify characteristics of Kentucky community pharmacists and community pharmacists' practice environment associated with utilization of the Kentucky All Schedule Prescription Electronic Reporting Program (KASPER). Surveys were mailed to all 1,018 Kentucky pharmacists with a KASPER account and an additional 1,000 licensed pharmacists without an account. Bivariate analyses examined the association between KASPER utilization and practice type (independent or chain) and practice location (rural or urban). A multivariate Poisson regression model with robust error variance estimated risk ratios (RR) of KASPER utilization by characteristics of pharmacists' practice environment. Responses were received from 563 pharmacists (response rate 27.9%). Of these, 402 responses from community pharmacists were included in the analyses. A majority of responding pharmacists (84%) indicated they or someone in their pharmacy had requested a patient's controlled substance history since KASPER's inception. Bivariate results showed that pharmacists who practiced in independent pharmacies reported greater KASPER utilization (94%) than pharmacists in chain pharmacies (75%; pcommunity pharmacists with those who practiced in an urban location (RR: 1.11; [1.01-1.21]) or at an independent pharmacy (RR: 1.27; [1.14-1.40]) having an increased likelihood of KASPER utilization. Utilization of KASPER differs by community pharmacists' practice environment, predominantly by practice type and location. Understanding characteristics of community pharmacists and community pharmacists' practice environment associated with PDMP use is necessary to remove barriers to access and increase utilization thereby increasing PDMP effectiveness.

  17. An Evidence Practice Gap in Antiemetic Prescription with Chemotherapy

    Directory of Open Access Journals (Sweden)

    Chepsy C-Philip

    2015-10-01

    Full Text Available Background: Chemotherapy induced nausea and vomiting is an added distress to patients burdened by the illness. In an effort to tackle the emetogenic potential of the agents, guidelines have been proposed to maintain uniformity in prescription and improvement in patient tolerance; but their utility and practice is not consistent. The aim of this clinical audit was to assess the antiemetic.practice and investigate the adherence to antiemetic clinical practice guidelineMethods: We performed an audit of the antiemetic practices in our tertiary referral centre. A.questionnaire based interview was completed at the outpatient visit to tabulate the dataResults: 99 (81.8% patients received chemotherapy of at least low emetogenic risk. 83 (84% patients received prophylaxis which was appropriate in 65% based on the our centre’s antiemetic regimen. This was however inappropriate in 76% of patients based on the international practice.parametersConclusions: Guidelines are not uniformly representative of all populations and modifications toguidelines based on local data are required to ensure success of such policies. There exist evidence-.practice gaps in antiemetic policies

  18. Foot structure and footwear prescription in diabetes mellitus.

    Science.gov (United States)

    Bus, Sicco A

    2008-01-01

    Foot structure abnormalities such as foot deformity and limited joint mobility are common and well established components of the diabetic foot which are associated with increased levels of mechanical stress on the foot and the development of ulcers. Our understanding of foot structure abnormality in diabetes has improved recently, mainly through the findings from in vivo imaging studies. Several examples will be discussed in this review. A limited understanding, however, still exists about several aspects related to the assessment, etiology, and consequences of change in foot structure in diabetes. Knowledge on these matters is needed if we are to better deal with the implications of foot structure change in diabetes. Diabetic patients with neuropathy and foot deformity are commonly prescribed with custom footwear, in particular after ulcer healing. The goal of this footwear is to redistribute and reduce plantar foot pressures, and to prevent ulcer recurrence. However, the available evidence for the effectiveness of custom footwear in secondary ulcer prevention is not yet strong. This may be associated with several factors, including a lack of standardized or systematic approach (a set of guidelines) in footwear prescription and evaluation or with the significant variability that exists across patients in the offloading effect of different footwear interventions, which increases the difficulty of predicting what works for a given patient. Objective evaluation tools such as in-shoe plantar pressure analysis can be helpful in this regard in order to ensure efficacy of an intervention. This provides a more optimal footwear solution that may lower the risk for ulceration.

  19. Optimizing Canadian public immunization programs: a prescription for action.

    Science.gov (United States)

    Scheifele, David W; Naus, Monika; Crowcroft, Natasha S; Dobson, Simon; Halperin, Scott A; Bjornson, Gordean

    2011-01-01

    Recent expansion of public vaccination programs for children and youth offers new health benefits but at substantially increased cost. As with other large public investments, immunization programs ought to be systematically evaluated for safety, effectiveness and economic value. At present, program evaluations are suboptimal in most provinces and territories. Experts in public health and vaccinology who attended a workshop in 2009 reviewed the shortcomings and produced "prescriptions for action" to improve matters. Six key recommendations were made: 1) a formal requirement should exist to evaluate all public vaccination programs appropriately; 2) greater voluntary harmonization of programs will facilitate evaluations; 3) a mechanism is needed to prioritize and coordinate program-specific evaluations; 4) new funding mechanisms are needed for basic jurisdictional studies and joint studies of broad relevance; 5) strong emphasis is needed on capacity development and training; and 6) administrative barriers to accessing health information systems and publishing evaluation studies need to be overcome. The expert group considered the need to improve program evaluations as urgent and compelling, with success achievable with dedicated funding and effective leadership. Demonstrating that Canadian immunization programs are among the world's best and safest is a sound strategy for maintaining public participation in those programs.

  20. [Suicide, antidepressant prescription and unemployment in Andalusia (Spain)].

    Science.gov (United States)

    Alameda-Palacios, José; Ruiz-Ramos, Miguel; García-Robredo, Beatriz

    2014-01-01

    To analyze the trend in suicide mortality in Andalusia from 1975 to 2012 and its relationship with unemployment and the use of antidepressants. Poisson's segmented regression models were used to estimate changes over time. The association between suicide and the factors examined was measured using Spearman's correlation coefficient. Suicide mortality patterns in men and women are rising. The largest increase was found in people aged from 15 to 44 years, with an annual percentage rate change of 1.21 (95%CI: 0.7-1.7) for men and 0.93 (95%CI: 0.4-1.4) for women. Mortality by suicide has increased in Andalusia since 1975 in all age and gender groups except for women aged 65 years or above. During the last few decades, an upward trend has been observed in young people and a stable or falling trend in the remaining population. Temporary variations in suicide rates are not associated with unemployment rates or with changes in antidepressant prescription. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  1. A Prescription for List-Mode Data Processing Conventions

    Energy Technology Data Exchange (ETDEWEB)

    Beddingfield, David H. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Swinhoe, Martyn Thomas [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Huszti, Jozsef [Hungarian Academy of Sciences (Hungary). Centre For Energy Research; Newell, Matthew R. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-10-08

    There are a variety of algorithmic approaches available to process list-mode pulse streams to produce multiplicity histograms for subsequent analysis. In the development of the INCC v6.0 code to include the processing of this data format, we have noted inconsistencies in the “processed time” between the various approaches. The processed time, tp, is the time interval over which the recorded pulses are analyzed to construct multiplicity histograms. This is the time interval that is used to convert measured counts into count rates. The observed inconsistencies in tp impact the reported count rate information and the determination of the error-values associated with the derived singles, doubles, and triples counting rates. This issue is particularly important in low count-rate environments. In this report we will present a prescription for the processing of list-mode counting data that produces values that are both correct and consistent with traditional shift-register technologies. It is our objective to define conventions for list mode data processing to ensure that the results are physically valid and numerically aligned with the results from shift-register electronics.

  2. Influence of psychotropic drugs prescription on body weight increase

    Directory of Open Access Journals (Sweden)

    Blanca E. Martínez de Morentin-Aldabe

    2013-03-01

    Full Text Available Obesity has become a major public health burden, not only by the rising prevalence but also because of the associated complications. Furthermore there is a number of diseases whose risk and onset is increased in subjects with overweight such as type 2 diabetes, dislipemias, tumors (endometrial, colon, breast, cancer, etc, skeletal disorders, digestive disturbances, cardiovascular diseases, respiratory disorders, psychological problems, obstetric and gynecological disorders.The prescription of psychotropic drugs is important and, in most countries, consumption has been increased in recent years. Indeed, several drugs used in the treatment of anxiety, depression, bipolar disorder, schizophrenia or epilepsy, can increase body weight and fat deposition or eventually decrease it. These side effects could make a previous situation of obesity to worsen, and it can even cause excessive weight gain in patients with a normal weight at the beginning of the treatment. This increase in adiposity may also contribute to the lack of adherence to the medication and thus a possible relapse of the patients.In this review we report the links between psychotropic drugs administration and weight gain as well as the potential mechanisms that are involved.DOI: http://dx.doi.org/10.14306/renhyd.17.1.4

  3. Analytic dimensions of a prescription-medication benefit in medicare.

    Science.gov (United States)

    Vogel, R J; Cox, E R

    2000-04-01

    Many analysts believe that the lack of coverage for outpatient prescription medications represents a conspicuous deficiency in the Medicare benefits package. This paper uses insurance theory to design and estimate the costs of a Medicare catastrophic-medication outpatient benefit. For efficiency and equity purposes, and to accommodate the tradeoff between the cost to the federal government and the insurance value of such a benefit to Medicare enrollees, we favor a benefit that would be means-tested by employing deductibles, coinsurance rates, and catastrophic limits, all of which would be progressively graduated for 7 household income classes. For equity reasons, we propose that the government's share of the medication benefit be financed from the general tax fund, using the progressive income tax. Another source of potential savings within the Medicare program that could pay for a medication benefit would be elimination of fraud, waste, and abuse. Because our proposal addresses both the efficiency and equity dimensions of a Medicare outpatient medication benefit, we believe it is worthy of serious consideration by both policymakers and Congress.

  4. Drive to Marry and Social Prescription in Chinese Online Daters

    Directory of Open Access Journals (Sweden)

    Rense Lange

    2015-12-01

    Full Text Available Individuals’ eagerness or desire to get married was investigated in a sample of online daters in China (n = 3,389 using a 6-item version of the Drive to Marry (DTM Scale, which was modified with new questions about normative pressures to marry given the cultural emphasis on social prescription in Eastern versus Western culture. The questionnaire items conformed to a unidimensional Rasch scale with interval-level measurement, although two themes seemed inherent to DTM – positive feelings of excitement or anticipation and negative feelings of urgency or desperation. Consistent with previous theory and research, women exhibited stronger DTM than men and normative pressures resulted in greater perceived DTM. Finally, significant response biases by sex were found, indicating that men and women differ in their qualitative experience of DTM. The results offer a preliminary cross-cultural validation and perspective on DTM and expand the present conceptualization and measurement of the construct to guide future research and theory-building.

  5. Electronic prescriptions and disruptions to the jurisdiction of community pharmacists.

    Science.gov (United States)

    Motulsky, Aude; Sicotte, Claude; Lamothe, Lise; Winslade, Nancy; Tamblyn, Robyn

    2011-07-01

    The practice of community pharmacists is being challenged by the appearance of electronic prescription (e-Rx) technology. This article examines the disruptions caused by e-Rx technology to the jurisdiction of community pharmacists based on a model developed from work by Abbott (1988). The main disruptions to professional activities were investigated by qualitative methods in a series of interviews with pharmacists and physicians separated in two groups: practitioners who tested a typical e-Rx technology and stakeholders involved in the implementation of this large-scale e-Rx project in Quebec, Canada. The findings suggest that the technology may disrupt the jurisdiction of community pharmacists, mainly by changing the distribution of information among physicians and community pharmacists. More specifically, the technology represents both a threat to community pharmacists - by supporting the dominant position held by physicians if it gives them access to information held exclusively by pharmacists - and an opportunity - by redistributing information to the pharmacists' benefit, allowing them to improve the quality of their inferences about medication. However, it would appear that the opportunities offered by the technology generate concerns and tensions, both between physicians and pharmacists and between the pharmacists themselves. This phenomenon may well work against the implementation and use of available tools.

  6. Adherence to a new oral anticoagulant treatment prescription: dabigatran etexilate

    Directory of Open Access Journals (Sweden)

    L Bellamy

    2009-07-01

    Full Text Available L Bellamy1, N Rosencher1, BI Eriksson21Anaesthesiology Department, Hôpital Cochin (AP-HP, René Descartes University, Paris 75014 France; 2Orthopaedic Department, University Hospital Sahlgrenska/Ostra, Gothenburg, SwedenAbstract: The recent development of new oral anticoagulants, of which dabigatran etexilate is currently at the most advanced stage of development, is the greatest advance in the provision of convenient anticoagulation therapy for many years. A new oral anticoagulation treatment, dabigatran etexilate, is already on the market in Europe. The main interest probably will be to improve the prescription and the adherence to an effective thromboprophylaxis in medical conditions such as atrial fibrillation without bleeding side effects, without the need for monitoring coagulation, and without drug and food interactions such as vitamin K anticoagulant (VKA treatment. Dabigatran is particularly interesting for extended thromboprophylaxis after major orthopedic surgery in order to avoid daily injection for a month. However, oral long-term treatments such as VKA are not systematically associated with a higher compliance level than injected treatments such as low-molecular-weight heparins. Indeed, adherence to an oral treatment, instead of the usual daily injection in major orthopedic surgery, is complex, and based not only on the frequency of dosing but also on patient motivation, understanding, and socio-economic status. New oral anticoagulants may be useful in this way but education and detection of risk factors of nonadherence to treatment are still essential.Keywords: oral anticoagulant, adherence, compliance, education, dabigatran

  7. On the Ideal Quality Control Specification of Compound Prescription -- Taking thought for the New Ingredients Produced in the Single Drugs Combining Process in Compound Prescription

    Institute of Scientific and Technical Information of China (English)

    刘建利

    2002-01-01

    @@ Effectiveness, safety and quality controllability are the three basic and most important premises for evaluating the quality of drugs. Having undergone clinical tests and been verified in thousands of years, the effectiveness and safety of compound prescription, the chief form of medication in TCM, have been proved reliable. Sometimes due to the lack of quality controllability, incorrect drug or method of preparing being used, so poor therapeutic effect can be seen, though diagnosis and prescription are correct. Quality uncontrollability is also one of the important reasons that causes difficulty for TCM preparation to enter international market. In order to ensure the effectiveness and safety of TCM compound prescription and the entering of TCM preparation into international market, strict quality control specifications should be defined. Although wide attention has been paid to this task, how to define the specifications is still under discussion.

  8. Defining small-for-gestational-age: prescriptive versus descriptive birthweight standards

    NARCIS (Netherlands)

    Hoftiezer, L.; Hukkelhoven, C.W.P.M.; Hogeveen, M.; Straatman, H.M.; Lingen, R.A. van

    2016-01-01

    Descriptive population-based birthweight standards possess low sensitivity in detecting infants with growth impairment. A prescriptive birthweight standard based on a 'healthy' subpopulation without risk factors for intrauterine growth restriction might be superior. We created two birthweight

  9. Forest habitat management prescription: Compartment #1: Panther Swamp National Wildlife Refuge: FY '86

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Panther Swamp National Wildlife Refuge's forest habitat management prescription for compartment 1 is the first time this area has been entered under the new...

  10. Changing physician behavior: interventions to improve prescription writing practices in a secondary level hospital in Delhi

    Directory of Open Access Journals (Sweden)

    Dipanweeta Routray

    2014-10-01

    Conclusion: Combining different intervention seems a noble approach to improve the prescription writing practices with respect to completeness and inclusion of generic drugs, drugs from EDL. [Int J Basic Clin Pharmacol 2014; 3(5.000: 840-844

  11. Environmental Assessment : Emergency use of prescriptive grazing at the Benton Lake National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Environmental Assessment (EA) documents the purpose of and the issues, alternatives, and analysis associated with allowance of emergency use of prescriptive...

  12. Prescription drug samples--does this marketing strategy counteract policies for quality use of medicines?

    Science.gov (United States)

    Groves, K E M; Sketris, I; Tett, S E

    2003-08-01

    Prescription drug samples, as used by the pharmaceutical industry to market their products, are of current interest because of their influence on prescribing, and their potential impact on consumer safety. Very little research has been conducted into the use and misuse of prescription drug samples, and the influence of samples on health policies designed to improve the rational use of medicines. This is a topical issue in the prescription drug debate, with increasing costs and increasing concerns about optimizing use of medicines. This manuscript critically evaluates the research that has been conducted to date about prescription drug samples, discusses the issues raised in the context of traditional marketing theory, and suggests possible alternatives for the future.

  13. [Prescription for diazepam 5 mg tablets in Vestfold 1989 and 1995].

    Science.gov (United States)

    Otterstad, H K; Sundene, G

    1996-04-30

    During the last five years, the prescription of tranquillizers has been reduced by 26% in Vestfold County compared with 19% in the country as a whole. This is probably a result of two initiatives: a common strategy to reduce prescription in the county, and monitoring prescription rate of the individual general practitioners. We examined the prescription of diazepam 5 mg tablets and found a reduction of more than 30% from 1989 to 1995. The reduction was greatest among the younger age groups and decreased with increasing age. The most probable reason for this pattern is a more restrictive attitude among general practitioners towards using diazepam to treat the young and middle-aged. The results for 1995 show that women still receive about 60% more diazepam than men, and women aged 70-79 years receive 117% more than women aged 40-49 years.

  14. Disease Information in Direct-to-Consumer Prescription Drug Print Ads.

    Science.gov (United States)

    Aikin, Kathryn J; Sullivan, Helen W; Betts, Kevin R

    2016-01-01

    Direct-to-consumer (DTC) prescription drug advertisements sometimes include information about the disease condition in addition to information about the advertised product. Although the intent of such information is to educate about the disease condition, in some cases consumers may mistakenly assume that the drug will address all of the potential consequences of the condition mentioned in the ad. We investigated the effects of adding disease information to DTC prescription drug print ads on consumer product perceptions and understanding. Participants (4,064 adults) viewed 1 of 15 DTC print ads for fictitious prescription drugs indicated to treat chronic obstructive pulmonary disease, anemia, or lymphoma that varied in disease information presence, type, and format. Participants answered questions that assessed risk and benefit memory, perception, and behavioral intention. Results indicate that exposure to disease information as part of DTC prescription drug ads can promote the impression that the drug addresses consequences of the condition that are not part of the drug's indication.

  15. Misuse of Prescription Pain Relievers: The Buzz Takes Your Breath Away. Permanently.

    Science.gov (United States)

    ... Seniors Tips for Parents En Español Prescription Drug Advertising Information for Healthcare Professionals (Drugs) FDA Drug Info ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  16. 75 FR 996 - Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Section 1013: Request for...

    Science.gov (United States)

    2010-01-07

    ... committees. ] Healthcare, industry, and professional organizations. Academic researchers (including, but not... HUMAN SERVICES Agency for Healthcare Research and Quality Medicare Prescription Drug, Improvement, and... AGENCY: Agency for Healthcare Research and Quality (AHRQ), DHHS. ACTION: Notice of invitation to...

  17. Contraceptive counselling and self-prescription of contraceptives of German gynaecologists : Results of a nationwide survey

    NARCIS (Netherlands)

    Buhling, Kai J.; Klovekorn, Lisa; Daniels, Benita; Studnitz, Friederike S. G.; Eulenburg, Christine; Mueck, Alfred O.

    2014-01-01

    Objective To evaluate the attitude toward contraceptive methods of gynaecologists who, in Germany, are the sole prescribers of contraceptives. Methods An anonymous questionnaire was sent to 9545 gynaecologists inquiring about factors involved in their prescription of contraceptives, the contraceptiv

  18. The Danish National Prescription Registry in studies of a biological pharmaceutical

    DEFF Research Database (Denmark)

    Haerskjold, Ann; Henriksen, Lonny; Way, Susanne

    2015-01-01

    BACKGROUND: National prescription databases are important tools in pharmacoepidemiological studies investigating potential long-term adverse events after drug use. Palivizumab is a biological pharmaceutical used as passive prophylaxis against severe infection with respiratory syncytial virus in h...

  19. Prescription in patients with chronic heart failure and multimorbidity attended in primary care

    NARCIS (Netherlands)

    Frigola Capell, E.; Verdu-Rotellar, J.M.; Comin-Colet, J.; Davins-Miralles, J.; Hermosilla, E.; Wensing, M.; Sunol, R.

    2013-01-01

    BACKGROUND: Multimorbidity and polypharmacy pose challenges to improving the quality of care. OBJECTIVES: To determine the association between prescription of recommended treatment in ambulatory patients with chronic heart failure and multiple comorbidities and hospitalisation events. DESIGN: A popu

  20. Improving Information on Maternal Medication Use by Linking Prescription Data to Congenital Anomaly Registers

    DEFF Research Database (Denmark)

    de Jonge, Linda; Garne, Ester; Gini, Rosa;

    2015-01-01

    INTRODUCTION: Research on associations between medication use during pregnancy and congenital anomalies is significative for assessing the safe use of a medicine in pregnancy. Congenital anomaly (CA) registries do not have optimal information on medicine exposure, in contrast to prescription...... databases. Linkage of prescription databases to the CA registries is a potentially effective method of obtaining accurate information on medicine use in pregnancies and the risk of congenital anomalies. METHODS: We linked data from primary care and prescription databases to five European Surveillance....... CONCLUSION: Linkage of primary care or prescription databases to CA registries improved the quality of information on maternal use of medicines in pregnancy, especially for medicine groups that are less fully registered in CA registries....

  1. Contraceptive counselling and self-prescription of contraceptives of German gynaecologists : Results of a nationwide survey

    NARCIS (Netherlands)

    Buhling, Kai J.; Klovekorn, Lisa; Daniels, Benita; Studnitz, Friederike S. G.; Eulenburg, Christine; Mueck, Alfred O.

    2014-01-01

    Objective To evaluate the attitude toward contraceptive methods of gynaecologists who, in Germany, are the sole prescribers of contraceptives. Methods An anonymous questionnaire was sent to 9545 gynaecologists inquiring about factors involved in their prescription of contraceptives, the contraceptiv

  2. Pharmaceutical Promotion and Its Influence on Prescription Behavior: Ethical Issues and Legal Framework in India

    National Research Council Canada - National Science Library

    Agarwal, Pankhuri; Kaur, Sharon

    2017-01-01

    .... The latter category of promotional techniques may unduly influence the prescribing behavior of physicians leading to irrational prescription of drugs that are not in the best interests of the patient...

  3. The impact of science education games on prescription drug abuse attitudes among teens: a case study.

    Science.gov (United States)

    Klisch, Yvonne; Bowling, Kristi G; Miller, Leslie M; Ramos, Miguel A

    2013-01-01

    Two online science education games, in which players learn about the risks of prescription drug abuse in the context of investigating crimes, were evaluated to determine shifts of prescription drug abuse attitudes attributable to game exposure. High school students from grades 11 and 12 (n = 179) were assigned to one of the games and participated in a pretest, two game-play sessions, and a delayed posttest. Students in both groups demonstrated more negative attitudes toward prescription drug abuse after playing the game, driven by changes of students' normative beliefs and their ability to make the connection between prescription drug abuse and illicit drugs. A secondary aim was to assess gains in science knowledge; however, due to low internal consistency reliabilities of content measures, students' knowledge acquisition could not be determined.

  4. Inappropriate antibiotic prescription for respiratory tract indications : most prominent in adult patients

    NARCIS (Netherlands)

    Dekker, Anne R. J.; Verheij, Theo J. M.|info:eu-repo/dai/nl/126027668; van der Velden, Alike W.|info:eu-repo/dai/nl/20448295X

    2015-01-01

    Background. Numerous studies suggest overprescribing of antibiotics for respiratory tract indications (RTIs), without really authenticating inappropriate prescription; the strict criteria of guideline recommendations were not taken into account as information on specific diagnoses, patient character

  5. What kind of patients and physicians value direct-to-consumer advertising of prescription drugs.

    Science.gov (United States)

    Gönül, F F; Carter, F; Wind, J

    2000-06-01

    Direct-to-consumer (DTC) advertising of prescription drugs can enhance the physician-patient relationship, as well as benefiting its sponsor. However, overall benefits can only occur if the patients value the information enough to discuss it with their physicians and the physicians are not predisposed against the DTC information. We investigate the impact of demographics and exposure to marketing on consumers' and physicians' receptiveness to DTC advertising of prescription drugs, using data from two nationwide surveys. We find that consumers who have an ongoing need for health care, that is, those with children or with a chronic condition requiring medication, value prescription drug advertising more highly, while older consumers, consumers who have been sick recently, or more educated consumers are more likely to trust their physicians instead. We find that more experienced physicians, physicians who see more patients, or those who have more exposure to pharmaceutical advertisements are more accepting of DTC advertising of prescription drugs.

  6. Potential prescription patterns and errors in elderly adult patients attending public primary health care centers in Mexico City

    Science.gov (United States)

    Corona-Rojo, José Antonio; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Vázquez-Cervantes, Laura; Pérez-Montoya, Edilberto; Rubio-Poo, Consuelo

    2009-01-01

    Introduction Six out of every 10 elderly persons live in developing countries. Objective To analyze and assess the drug prescription patterns and errors in elderly outpatients attending public health care centers in Mexico City, Mexico. Materials and methods A descriptive and retrospective study was conducted in 2007. Fourteen hundred prescriptions were analyzed. Prescriptions of ambulatory adults aged >70 years who were residents of Mexico City for at least two years were included. Prescription errors were divided into two groups: (1) administrative and legal, and (2) pharmacotherapeutic. In group 2, we analyzed drug dose strength, administration route, frequency of drug administration, treatment length, potential drug–drug interactions, and contraindications. Variables were classified as correct or incorrect based on clinical literature. Variables for each drug were dichotomized as correct (0) or incorrect (1). A Prescription Index (PI) was calculated by considering each drug on the prescription. SPSS statistical software was used to process the collected data (95% confidence interval; p <0.05). Results The drug prescription pattern in elderly outpatients shows that 12 drugs account for 70.72% (2880) of prescribed drugs. The most prescribed drugs presented potential pharmacotherapeutic errors (as defined in the present study). Acetylsalicylic acid–captopril was the most common potential interaction (not clinically assessed). Potential prescription error was high (53% of total prescriptions). Most of the prescription errors were due to omissions of dosage, administration route, and length of treatment and may potentially cause harm to the elderly outpatients. Conclusions A high number of potential prescription errors were found, mainly due to omissions. The drug prescription pattern of the study population is mainly constituted by 12 drugs. The results indicate that prescription quality depends on the number of prescribed drugs per prescription (p < 0

  7. Calculation rule for Aoyama-Tamra's prescription for path integral with quantum tunneling

    CERN Document Server

    Suzuki, H

    1995-01-01

    We derive a simple calculation rule for Aoyama--Tamra's prescription for path integral with degenerated potential minima. Non-perturbative corrections due to the restricted functional space (fundamental region) can systematically be computed with this rule. It becomes manifest that the prescription might give Borel summable series for finite temperature (or volume) system with quantum tunneling, while the advantage is lost at zero temperature (or infinite volume) limit.

  8. Typologies of prescription opioid use in a large sample of adults assessed for substance abuse treatment.

    Directory of Open Access Journals (Sweden)

    Traci C Green

    Full Text Available BACKGROUND: As a population, non-medical prescription opioid users are not well-defined. We aimed to derive and describe typologies of prescription opioid use and nonmedical use using latent class analysis in an adult population being assessed for substance abuse treatment. METHODS: Latent class analysis was applied to data from 26,314 unique respondents, aged 18-70, self-reporting past month use of a prescription opioid out of a total of 138,928 cases (18.9% collected by the Addiction Severity Index-Multimedia Version (ASI-MV®, a national database for near real-time prescription opioid abuse surveillance. Data were obtained from November 2005 through December 2009. Substance abuse treatment, criminal justice, and public assistance programs in the United States submitted data to the ASI-MV database (n = 538. Six indicators of the latent classes derived from responses to the ASI-MV, a version of the ASI modified to collect prescription opioid abuse and chronic pain experience. The latent class analysis included respondent home ZIP code random effects to account for nesting of respondents within ZIP code. RESULTS: A four-class adjusted latent class model fit best and defined clinically interpretable and relevant subgroups: Use as prescribed, Prescribed misusers, Medically healthy abusers, and Illicit users. Classes varied on key variables, including race/ethnicity, gender, concurrent substance abuse, duration of prescription opioid abuse, mental health problems, and ASI composite scores. Three of the four classes (81% of respondents exhibited high potential risk for fatal opioid overdose; 18.4% exhibited risk factors for blood-borne infections. CONCLUSIONS: Multiple and distinct profiles of prescription opioid use were detected, suggesting a range of use typologies at differing risk for adverse events. Results may help clinicians and policy makers better focus overdose and blood-borne infection prevention efforts and intervention strategies

  9. Issuance of multiple prescriptions for schedule II controlled substances. Final rule.

    Science.gov (United States)

    2007-11-19

    The Drug Enforcement Administration (DEA) is finalizing a Notice of Proposed Rulemaking published on September 6, 2006 (71 FR 52724). In that document, DEA proposed to amend its regulations to allow practitioners to provide individual patients with multiple prescriptions, to be filled sequentially, for the same schedule II controlled substance, with such multiple prescriptions having the combined effect of allowing a patient to receive over time up to a 90-day supply of that controlled substance.

  10. Counterterms for the Dirichlet Prescription of the AdS/CFT Correspondence

    CERN Document Server

    Mück, W

    1999-01-01

    We illustrate the Dirichlet prescription of the AdS/CFT correspondence using the example of a massive scalar field and argue that it is the only entirely consistent regularization procedure known so far. Using the Dirichlet prescription, we then calculate the divergent terms for gravity in the cases $d=2,4,6$, which give rise to the Weyl anomaly in the boundary conformal field theory.

  11. Nonmedical Use of Prescription Medications Among Medical Students in Greece: Prevalence of and Motivation for Use.

    Science.gov (United States)

    Papazisis, Georgios; Tsakiridis, Ioannis; Pourzitaki, Chryssa; Apostolidou, Eirini; Spachos, Dimitrios; Kouvelas, Dimitrios

    2017-08-04

    Non-medical use of prescription medications has risen to unprecedented levels over the past decade worldwide; however, studies assessing misuse across medical students are sparse. The purpose of this study was to1) estimate the lifetime and the past-year prevalence of non-medical use of prescription medications among medical students in Greece 2) identify the motivation for use. 591 medical students completed an anonymous, self-administered, web-based survey assessing lifetime and past-year prevalence of non-medical use of four classes of prescription drugs (opioid painkillers, tranquillizers, sleeping and stimulant medications). According to the motivation to use the responders were classified into three subtypes (selftreatment, recreational, and mixed). The prevalence of lifetime use was 10.7% for at least one of the four prescription drug classes and 9% of the respondents reported lifetime misuse of multiple categories of prescription drugs. The past-year prevalence was approximately 7.7% for at least one of the four prescription drug classes, while the majority misused the drugs "1-2 times per year". Senior students used tranquilizers more than junior students. Self-treatment and mixed subtypes of tranquillizers misuse was more prevalent among women than men while the self-treatment subtype was the most prevalent subtype in all the four drug classes. This is the first study investigating non-medical use of prescription medications among Greek medical students and indicates a high prevalence of misuse of some categories of prescription drugs, mostly for self-treatment purposes.

  12. Validity of the Prescriber Information in the Danish National Prescription Registry.

    Science.gov (United States)

    Rasmussen, Lotte; Valentin, Julie; Gesser, Katarina Margareta; Hallas, Jesper; Pottegård, Anton

    2016-10-01

    The aim of this study was to measure the validity of the prescriber information recorded in the Danish National Prescription Registry (DNPR). The prescriber information recorded in the pharmacies' electronic dispensing system was considered to represent the prescriber information recorded in the DNPR. Further, the problem of validity of the prescriber information pertains only to non-electronic prescriptions, as these are manually entered into the dispensing system. The recorded prescriber information was thus validated against information from a total of 2000 non-electronic prescriptions at five Danish community pharmacies. The validity of the recorded prescriber information was measured at the level of the individual prescriber and the prescriber type, respectively. The proportion of non-electronic prescriptions with incorrect registrations was 22.4% (95% confidence interval (CI): 20.6-24.3) when considering individual prescriber identifiers and 17.8% (95% CI: 16.1-19.5) when considering prescriber type. When excluding prescriptions specifically registered as 'missing prescriber identifier', the proportions decreased to 9.5% (95% CI: 8.2-11.0) and 4.1% (95% CI: 3.2-5.1), respectively. The positive predictive values for the classification of prescriber types were in the range of 94.0-99.2%, while the sensitivity ranged between 64.6% and 91.8%. With a maximum of 14% non-electronic prescriptions of all prescriptions in the DNPR in 2015, this corresponds to correct classification of prescriber types in the DNPR of at least 97.5%. In conclusion, the prescriber information in the DNPR was found to be valid, especially in recent years. Researchers should be aware of the low sensitivity towards prescriptions from private practicing specialists.

  13. Real-time Prescription Surveillance and its Application to Monitoring Seasonal Influenza Activity in Japan

    Science.gov (United States)

    Ohkusa, Yasushi; Ibuka, Yoko; Kawanohara, Hirokazu; Taniguchi, Kiyosu; Okabe, Nobuhiko

    2012-01-01

    Background Real-time surveillance is fundamental for effective control of disease outbreaks, but the official sentinel surveillance in Japan collects information related to disease activity only weekly and updates it with a 1-week time lag. Objective To report on a prescription surveillance system using electronic records related to prescription drugs that was started in 2008 in Japan, and to evaluate the surveillance system for monitoring influenza activity during the 2009–2010 and 2010–2011 influenza seasons. Methods We developed an automatic surveillance system using electronic records of prescription drug purchases collected from 5275 pharmacies through the application service provider’s medical claims service. We then applied the system to monitoring influenza activity during the 2009–2010 and 2010–2011 influenza seasons. The surveillance system collected information related to drugs and patients directly and automatically from the electronic prescription record system, and estimated the number of influenza cases based on the number of prescriptions of anti-influenza virus medication. Then it shared the information related to influenza activity through the Internet with the public on a daily basis. Results During the 2009–2010 influenza season, the number of influenza patients estimated by the prescription surveillance system between the 28th week of 2009 and the 12th week of 2010 was 9,234,289. In the 2010–2011 influenza season, the number of influenza patients between the 36th week of 2010 and the 12th week of 2011 was 7,153,437. The estimated number of influenza cases was highly correlated with that predicted by the official sentinel surveillance (r = .992, P prescription surveillance system produced a good approximation of activity patterns. Conclusions Our prescription surveillance system presents great potential for monitoring influenza activity and for providing early detection of infectious disease outbreaks. PMID:22249906

  14. The stigma of low opioid prescription in the hospitalized multimorbid elderly in Italy.

    Science.gov (United States)

    Marengoni, Alessandra; Nobili, Alessandro; Corli, Oscar; Djade, Codjo Djignefa; Bertoni, Diana; Tettamanti, Mauro; Pasina, Luca; Corrao, Salvatore; Salerno, Francesco; Marcucci, Maura; Mannucci, Pier Mannuccio

    2015-04-01

    The primary aim of this study was to evaluate the prevalence of opioid prescriptions in hospitalized geriatric patients. Other aims were to evaluate factors associated with opioid prescription, and whether or not there was consistency between the presence of pain and prescription. Opioid prescriptions were gathered from the REgistro POliterapie Societa` Italiana di Medicina Interna (REPOSI) data for the years 2008, 2010 and 2012. 1,380 in-patients, 65+ years old, were enrolled in the first registry run, 1,332 in the second and 1,340 in the third. The prevalence of opioid prescription was calculated at hospital admission and discharge. In the third run of the registry, the degree of pain was assessed by means of a numerical scale. The prevalence of patients prescribed with opioids at admission was 3.8% in the first run, 3.6% in the second and 4.1% in the third, whereas at discharge rates were slightly higher (5.8, 5.3, and 6.6%). The most frequently prescribed agents were mild opioids such as codeine and tramadol. The number of total prescribed drugs was positively associated with opioid prescription in the three runs; in the third, dementia and a better functional status were inversely associated with opioid prescription. Finally, as many as 58% of patients with significant pain at discharge were prescribed no analgesic at all. The conservative attitude of Italian physicians to prescribe opioids in elderly patients changed very little between hospital admission and discharge through a period of 5 years. Reasons for such a low opioid prescription should be sought in physicians' and patients' concerns and prejudices.

  15. Study of Potential Drug-Drug Interactions in Prescriptions of University- Based Pharmacies

    Directory of Open Access Journals (Sweden)

    Sarah Mousavi

    2015-10-01

    Full Text Available Background: Drug-Drug Interactions (DDIs are adverse reactions caused by a combination of drugs; they are often predictable and therefore avoidable or manageable. The objective of this study was to evaluate the nature, type and prevalence of potential DDIs in prescriptions dispensed in university-based community pharmacies in Tehran, Iran.Methods: From July 2012 to February 2014, sample of 1260 prescriptions were collected from community and outpatient hospital pharmacies affiliated to Tehran University of Medical Sciences (TUMS, Iran. The prescriptions were assessed using the reference text “drug interaction facts”. The identified DDIs were categorized according to their level of significance into three classes (minor, moderate, major.Results: At least one drug-drug interaction was present in 339 (26.9% of prescriptions and a total of 751 cases of interactions were found in prescriptions. Major DDIs represented 7.3% of all DDIs detected, whereas moderate DDIs were 75% of all DDIs. The mean number of drugs per prescriptions was 3.2, with a median of 4 (range, 2-10.There was a positive association between number of prescribed drugs and occurrence of DDIs (OR: 2.14, 95% CI: 1.9-2.4. The prescriptions of medical specialist had greater risk of occurrence of moderate severity DDIs than general practitioners (OR: 1.52, 95%CI: 1.08-2.15.Conclusion: Despite the prescriptions were collected from university-based pharmacies, but the overall prevalence of potential DDIs were high among patients. Physicians should be aware of potentially harmful DDIs. Meanwhile Pharmacists can contribute to the detection and prevention of drug-related injuries. Appropriate education, collaborating drug selection and pharmaceutical care are strongly recommended for physicians and pharmacists.

  16. Changing physician behavior: interventions to improve prescription writing practices in a secondary level hospital in Delhi

    OpenAIRE

    Dipanweeta Routray; Jyotiranjan Sahoo; Prateek Singh; Kulen Das; Satyavir Singh

    2014-01-01

    Background: According to a report by World Health Organization (WHO) in 2003, approximately 50% of all patients fail to take their medicine correctly. This is due to errors in prescription, underuse or misuse of medicines and ignorance of prescribers, dispensers, and patients. Methods: It is a hospital-based interventional-study carried out in a secondary level multispecialty hospital of Delhi. Investigators collected 536 prescriptions from the outpatient department of various departments ...

  17. Attentional Bias For Prescription Opioid Cues Among Opioid Dependent Chronic Pain Patients

    OpenAIRE

    Garland, Eric L.; Froeliger, Brett; Passik, Steven D.; Howard, Matthew O.

    2012-01-01

    Recurrent use of prescription opioid analgesics by chronic pain patients may result in opioid dependence, which involves implicit neurocognitive operations that organize and impel craving states and compulsive drug taking behavior. Prior studies have identified an attentional bias (AB) towards heroin among heroin dependent individuals. The aim of this study was to determine whether opioid-dependent chronic pain patients exhibit an AB towards prescription opioidrelated cues. Opioid-dependent c...

  18. Current attitudes on self-use and prescription of hormone therapy among New York City gynaecologists

    DEFF Research Database (Denmark)

    Devi, Gayatri; Sugiguchi, Fumitaka; Pedersen, Anette Tønnes

    2013-01-01

    The results of the Women's Health Initiative studies dramatically altered hormone therapy use around the world. In countries outside the United States, self-use in physicians remained unaltered while prescription use declined, implying that physicians may not concur with the findings. We wished t...... to explore prevailing attitudes among American physicians by examining New York City obstetrician-gynaecologists' self-use and prescription use of hormone therapy....

  19. ADHD medication prescription: effects of child, sibling, parent and general practice characteristics.

    OpenAIRE

    Heins, M.J.; Bruggers, I.; van Dijk, L; Korevaar, J.C.

    2016-01-01

    Many children receive attention-deficit hyperactivity disorder (ADHD) medication, but factors that determine medication prescription are largely unknown. This study aimed to determine the relative impact of factors on the child, family and general practitioner (GP) practice level on ADHD medication prescription. We included 1259 Dutch children aged 6-18 years with a diagnostic code of ADHD or related behavioural problems (ICPC codes P20-P22) in NIVEL primary care database. Using multilevel an...

  20. Attentional Bias For Prescription Opioid Cues Among Opioid Dependent Chronic Pain Patients

    OpenAIRE

    Garland, Eric L.; Froeliger, Brett; Passik, Steven D.; Howard, Matthew O.

    2012-01-01

    Recurrent use of prescription opioid analgesics by chronic pain patients may result in opioid dependence, which involves implicit neurocognitive operations that organize and impel craving states and compulsive drug taking behavior. Prior studies have identified an attentional bias (AB) towards heroin among heroin dependent individuals. The aim of this study was to determine whether opioid-dependent chronic pain patients exhibit an AB towards prescription opioidrelated cues. Opioid-dependent c...

  1. Influence of pharmacists' opinions on their dispensing medicines without requirement of a doctor's prescription

    OpenAIRE

    Francisco Caamaño; Manuel Tomé-Otero; Bahi Takkouche; Juan Jesús Gestal-Otero

    2005-01-01

    Objective: To assess the influence of pharmacists' opinions on their dispensing medicines with a «medical prescription only» label without requiring a doctor's prescription. Methods: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a) physicians' prescribing practices; b) the pharmacist's qualifications to prescribe; c) the responsibility of the ...

  2. Adherence with capecitabine: A population-based analysis based on prescription refill data.

    Science.gov (United States)

    Kovacic, Laurel; de Haan, Neil; de Lemos, Mário L; Schaff, Kimberly; Walisser, Susan

    2017-06-01

    Background Patient adherence is important with the increasing use of oral anticancer drugs. Recent studies reported different capecitabine adherence rates based on self-reporting and microelectronic monitoring of the medication bottle. Patient's awareness of being monitored may confound these results. Prescription records provide a larger and more objective dataset for adherence investigation. We report the use of computer algorithm and manual review of prescription and medical documentation to determine the rate of capecitabine adherence. Methods Two years of capecitabine prescription records from five ambulatory cancer centres were reviewed. Prescription data were extracted using a custom Java-based software tool to compare the predicted vs. actual dispensing date. The difference between the dates was the primary adherence measure (altered treatment date incident) and estimated using a computer algorithm and by manual review of medical charts. Results Of 4412 refill prescriptions, 45.2% was associated with an altered treatment date incident based on the initial computer algorithm. This was reduced to 29.5% after adjusting for clinic scheduling processes and 10.2% after manual chart review to adjust for valid reasons for delay. The reasons for altered treatment date incident were not identified in 52.2% of prescriptions. Conclusions Adherence rate of capecitabine based on refill data seem to be high and consistent with other findings based on patient self-report. Population analysis of prescription data with custom computer algorithm may identify trends in capecitabine adherence with some efficiency. Manual review would likely be required to verify these results. The accuracy of using altered prescription refill dates as an adherence measure requires further studies.

  3. Human Errors May Explain a False Epide Prescription Pain Medication Overdose Deaths

    Directory of Open Access Journals (Sweden)

    Alen J Salerian

    2016-01-01

    Full Text Available This study reviews the validity of a public perception promoted by Centers Control that prescription pain medications have contributed to an epidem deaths and illicit use of heroin. No scientific evidence has been found to su causative link between prescription pain medications and an epidemic of deaths and illicit use of heroin. The study results suggest highly complex m medical and psychosocial influences to be predominant in the increasing overdose deaths.

  4. Commercial Speech & Prescription Drug Promotion: Where Have We Been & Are We Going Anywhere?

    OpenAIRE

    Larson, Adam

    2005-01-01

    Recent decisions have caused the FDA to question whether its regulations of prescription drug promotion comply with the First Amendment. This paper argues that those recent decisions do not compel the FDA to change its prescription drug promotion regulations and that they cannot be considered in isolation from the historical development of the commercial speech doctrine. When this historical development is considered, two competing interests emerge from commercial speech cases. On one hand, a...

  5. Prescription, Description, Reflection: the shape of the software process improvement field

    DEFF Research Database (Denmark)

    Hansen, Bo; Rose, Jeremy; Tjørnehøj, Gitte

    2004-01-01

    This article reviews 322 representative contributions to the the Software Process Improvement (SPI) literature. The contributions are categorised according to a simple framework: whether their primary goal is (to tell SPI professionals what to do), (to report actual instances of SPI programs...... in software organisations), or   prescriptive descriptive reflective (theoretically analytical). The field is found to be rather dominated by one approach (the Capability Maturity Model (CMM)) and heavily biased towards prescriptive contributions. Neither of these trends is necessarily beneficial...

  6. Inclusion of cool roofs in nonresidential Title 24 prescriptive requirements

    Energy Technology Data Exchange (ETDEWEB)

    Levinson, Ronnen; Akbari, Hashem; Konopacki, Steve; Bretz, Sarah

    2002-12-15

    24, Pa rt 6 of the California Code of Regulations) for nonresidential buildings with low-sloped roofs include a cool-roof prescriptive requirement in all California climate zones. Buildings with roofs that do not meet prescriptive requirements may comply with the code via an ''overall-envelope'' approach (non-metal roofs only), or via a performance approach (all roof types).

  7. Development of clinical application for a nutritional prescription support system for total parenteral/enteral nutrition.

    Science.gov (United States)

    Masuda, Syuzo; Oka, Ryusho; Uwai, Koji; Matsuda, Yumi; Shiraishi, Tadashi; Nakagawa, Yoshito; Shoji, Tohru; Mihara, Chie; Takeshita, Mitsuhiro; Ozawa, Koichiro

    2009-09-01

    One of the important roles of pharmacists as members of a nutrition support team is nutritional prescription support. We developed a nutritional prescription support system (NPSS) that facilitates prescription support and analysis and evaluated its usefulness in nutritional therapy. An NPSS for prescription support and the management of patient information was created. With this NPSS, the nutritional status was assessed, and, on the basis of the results, such variables as the total energy expenditure were calculated. This system allows prescription support for parenteral nutrition (PN) therapy, enteral nutrition (EN) therapy, and the transition period between them. This system was used for 2 representative patients and evaluated. In a malnourished patient receiving oral warfarin, EN solutions were compared by means of the NPSS, and an appropriate EN solution was selected. In addition, the prothrombin time-international normalized ratio was monitored, and favorable results were obtained regarding the adjustment of the warfarin dose and nutritional management. In a patient with aspiration pneumonia, continuous nutritional management to EN from PN therapy was straightforwardly performed with the NPSS. This NPSS allows rapid, comprehensive nutritional management during the transition period to EN from PN therapy, despite these therapies being considered separately in conventional nutritional management. The NPSS is useful for simplifying prescription support and facilitating information sharing among members of a nutrition support team.

  8. Oncology medications prescription in a cancer service: appropriateness to clinical practice guidelines

    Directory of Open Access Journals (Sweden)

    Valeria Palchik

    2016-12-01

    Full Text Available Objective: To assess prescription of oncology medications in municipal public health network of Rosario for its appropriateness to clinical practice guidelines. Methods: Descriptive pharmacoepidemiological study in adult patients in an Oncology Service between January and June 2012. Compliance requirements with clinical practice guidelines were evaluated. Results: 51.8% of diagnoses had at least one prescription medication that did not match recommendation by at least one of the guides considered. Prescriptions of doxorrubicine and ifosfamide did not agree with the recommendation of any reference guides. 5.4% of prescriptions weren´t considered by local guides, nor 7.7% by national on es. Regarding comparison with international guidelines: 4.2% of prescriptions weren ´t considered by the European Society for Medical Oncology guidelines, 2.3% not considered by the American Cancer Society and only 1.9% were not considered by the National Comprehensive Cancer Network ones. Conclusions: Prescription of oncology treatments is closer to international reference guides. One reason could be that there is still no standard definition in the management of tumor diseases by the National State.

  9. Management by objectives and its impact on specialist prescription quality at discharge and in external consultations.

    Science.gov (United States)

    Olmo, M; Galvan, L; Capdevila, J; Serna, C; Mangues, I; Schoenenberger, J A

    2011-01-01

    To verify that implementing a policy of management by objectives, based on collaboration between hospital pharmacy, primary care and specialised medical managers, improves prescription quality indicators in specialised care and reduces unwanted "induced" prescriptions (i.e. those issued by specialists, hospital doctors or the patients themselves) in primary care. A four year quasi-experimental controlled intervention study on prescription at discharge and in outpatient hospital consultations was conducted. In hospital A, a quality cycle was applied: assessment, identifying improvement opportunities, implementing corrective actions and re-assessment. However, it was not applied in control hospital B. The indicators chosen were the percentage of generic medicines prescribed, the percentage of prescriptions for new therapies with no added value and the percentage of prescriptions for ACE inhibitors recommended. In hospital A, an increase in indicators 1 and 3 has been observed, both being statistically significant, between the last year of intervention and the year previous to intervention. Hospital A managed to reduce indicator 2 to 4.5%, while this indicator increased in hospital B to 8.8%. Furthermore, a statistically significant difference in indicators between the two hospitals has been registered. Pay-for-Performance programs in prescription practices of hospital physicians are effective actions to improve quality indicators of medication use. Copyright © 2010 SEFH. Published by Elsevier Espana. All rights reserved.

  10. Evaluation of the NCPDP Structured and Codified Sig Format for e-prescriptions.

    Science.gov (United States)

    Liu, Hangsheng; Burkhart, Q; Bell, Douglas S

    2011-01-01

    To evaluate the ability of the structure and code sets specified in the National Council for Prescription Drug Programs Structured and Codified Sig Format to represent ambulatory electronic prescriptions. We parsed the Sig strings from a sample of 20,161 de-identified ambulatory e-prescriptions into variables representing the fields of the Structured and Codified Sig Format. A stratified random sample of these representations was then reviewed by a group of experts. For codified Sig fields, we attempted to map the actual words used by prescribers to the equivalent terms in the designated terminology. Proportion of prescriptions that the Format could fully represent; proportion of terms used that could be mapped to the designated terminology. The fields defined in the Format could fully represent 95% of Sigs (95% CI 93% to 97%), but ambiguities were identified, particularly in representing multiple-step instructions. The terms used by prescribers could be codified for only 60% of dose delivery methods, 84% of dose forms, 82% of vehicles, 95% of routes, 70% of sites, 33% of administration timings, and 93% of indications. The findings are based on a retrospective sample of ambulatory prescriptions derived mostly from primary care physicians. The fields defined in the Format could represent most of the patient instructions in a large prescription sample, but prior to its mandatory adoption, further work is needed to ensure that potential ambiguities are addressed and that a complete set of terms is available for the codified fields.

  11. Effects of a primary care intervention to improve the quality of zolpidem prescriptions in elderly patients.

    Science.gov (United States)

    López-Sepúlveda, Rocío; García Lirola, María Ángeles; Espínola García, Esther; Martín Sances, Salvadora; Anaya Ordóñez, Sonia; Jurado Martínez, José María; Cabeza Barrera, José

    2017-04-01

    The objective of this study was to measure the impact of an intervention on the prescription habits of general practitioners (GPs) in order to improve the quality of zolpidem prescriptions in patients aged 75 or older. A prospective multicentric non-randomized trial was performed in the Metropolitan Granada Primary Healthcare Area (Andalusian Public Healthcare Service, Spain), which serves a total population of approximately 675,000 inhabitants. All health centers volunteering to participate in the trial were included. The intervention consisted of training sessions, individualized feedback, clinical information, and financial incentives. A daily dose over 5 mg was considered non-safe. Reduction in non-safe prescriptions of zolpidem in the elderly population became a quality prescribing indicator in a pay-for-performance scheme. Statistically significant differences versus baseline were found between the intervention and control groups in mean zolpidem prescription prevalence (28.5 vs. 37.5‰, respectively; p = 0.008) and mean non-safe zolpidem prescription prevalence (16.5 vs. 34.2‰, respectively; p safe prescriptions was 1309, 35% lower versus baseline, with a significant difference of p GPs who receive no financial incentive are required to evaluate the relative importance of an economic reward in achieving this improvement.

  12. [Exploration on eighteen incompatible medicaments of chest pain prescriptions based on association rules mining].

    Science.gov (United States)

    Zhang, Yuhua; Hua, Haoming; Fan, Xinsheng; Wang, Chongjun; Duan, Jinao

    2011-12-01

    To investigate the laws of eighteen incompatible medicaments of the chest pain prescriptions based on association rules mining. The database of chest pain prescription was established and then the chest pain prescriptions composed of eighteen incompatible medicaments were screened. The dynasty, couplet medicines, the property and flavor of drugs and preparation form were analyzed with the frequent item sets and corresponding analysis methods. Eight hundred and fifty chest pain prescriptions were collected, and 88 of them contained eighteen incompatible medicaments, taking 10.3% of all; the applications of ancient and modern chest pain prescriptions containing eighteen incompatible medicaments are significant difference (P dynasty and tang dynasty, are more often used than the modern formulas. The most common anti-drugs is on the Fuzi-Pinellia, Chuanwu-Pinellia; the property and flavor of drugs is bitter cold most closely; the decoction of the formulas is mostly used. Eighteen incompatible medicaments account for about ten percent of the chest pain prescription, not an uncommon side. There are certain rules for application of anti-drug compatibility to treat chest pain.

  13. Business pluralism of electronic prescriptions: state of development in Europe and the USA.

    Science.gov (United States)

    Salmivalli, Lauri; Hilmola, Olli-Pekka

    2006-01-01

    In this paper, we analyse the current state of the development of electronic prescriptions in Europe and the USA. These two places have different approaches to the healthcare sector, since in the former one national social insurance usually provides treatment for all of the people (most often only with friction from total costs), but in the latter one the healthcare sector is under free market forces. As our analysis shows in this paper, electronic prescriptions in both of the places have developed in recent years quite favourably, but this development has not produced consistent results, whether electronic prescriptions should be provided by for-profit companies or should they be under strict control of governmental authorities. We base this finding in two empirical observations: (1) in Europe saving potential from electronic prescriptions is estimated to be high, and contains many abstract national economy accounts and (2) leading US companies (providing electronic prescription services) have went been able to increase their revenues significantly, but still their profitability is questionable. We argue that the situation of electronic prescriptions is similar with airline or credit card industry. Both of these are vital for international and local economies, but the business models have developed well after the initial idea.

  14. Benzodiazepines: a major component in unintentional prescription drug overdoses with opioid analgesics.

    Science.gov (United States)

    Jann, Michael; Kennedy, William Klugh; Lopez, Gaylord

    2014-02-01

    The misuse and abuse of prescription medications in the United States continues to increase despite interventions by health care professionals, regulatory, and law enforcement agencies. Opioid analgesics are the leading class of prescription drugs that have caused unintentional overdose deaths. Benzodiazepines when taken alone are relatively safe agents in overdose. However, a 5-fold increase in deaths attributed to benzodiazepines occurred from 1999 to 2009. Emergency department visits related to opioid analgesics increased by 111% followed by benzodiazepines 89%. During 2003 to 2009, the 2 prescriptions drugs with the highest increase in death rates were oxycodone 264.6% and alprazolam 233.8%. Therefore, benzodiazepines have a significant impact on prescription drug unintentional overdoses second only to the opioid analgesics. The combination prescribing of benzodiazepines and opioid analgesics commonly takes place. The pharmacokinetic drug interactions between benzodiazepines and opioid analgesics are complex. The pharmacodynamic actions of these agents differ as their combined effects produce significant respiratory depression. Physician and pharmacy shopping by patients occurs, and prescription drug-monitoring programs can provide important information on benzodiazepine and opioid analgesic prescribing patterns and patient usage. Health care professionals need to inform patients and work closely with regulatory agencies and legislatures to stem the increasing fatalities from prescription drug unintentional overdoses.

  15. Prescription drug monitoring program utilization in Kentucky community pharmacies

    Directory of Open Access Journals (Sweden)

    Wixson SE

    2015-06-01

    Full Text Available Objective: Identify characteristics of Kentucky community pharmacists and community pharmacists’ practice environment associated with utilization of the Kentucky All Schedule Prescription Electronic Reporting Program (KASPER. Methods: Surveys were mailed to all 1,018 Kentucky pharmacists with a KASPER account and an additional 1,000 licensed pharmacists without an account. Bivariate analyses examined the association between KASPER utilization and practice type (independent or chain and practice location (rural or urban. A multivariate Poisson regression model with robust error variance estimated risk ratios (RR of KASPER utilization by characteristics of pharmacists’ practice environment. Results: Responses were received from 563 pharmacists (response rate 27.9%. Of these, 402 responses from community pharmacists were included in the analyses. A majority of responding pharmacists (84% indicated they or someone in their pharmacy had requested a patient’s controlled substance history since KASPER’s inception. Bivariate results showed that pharmacists who practiced in independent pharmacies reported greater KASPER utilization (94% than pharmacists in chain pharmacies (75%; p<0.001. Multivariate regression results found utilization of KASPER varied significantly among practice environments of community pharmacists with those who practiced in an urban location (RR: 1.11; [1.01–1.21] or at an independent pharmacy (RR: 1.27; [1.14–1.40] having an increased likelihood of KASPER utilization. Conclusion: Utilization of KASPER differs by community pharmacists’ practice environment, predominantly by practice type and location. Understanding characteristics of community pharmacists and community pharmacists’ practice environment associated with PDMP use is necessary to remove barriers to access and increase utilization thereby increasing PDMP effectiveness.

  16. Medication in the elderly - considerations and therapy prescription guidelines

    Directory of Open Access Journals (Sweden)

    Josip Anđelo Borovac

    2015-11-01

    Full Text Available The aim of this study was to integrate and present pertinent findings from the literature dealing with the treatment of the elderly within a primary care setting. Medical care for the elderly is an integral part of a general practitioner’s (GPs everyday work and is challenging for many reasons. Older people often experience multiple chronic diseases concurrently (comorbidity, multimorbidity and they often have deteriorated organ function and decreased physiological reserves due to the natural aging process. The choice of appropriate medication for each particular disease is a complex process and can cause “therapeutic confusion”, especially among younger GPs in the field. Elderly people are prone to develop adverse side-effects to usual dosages of medications and the side-effects are even 7 times more frequent in elderly than in younger patients. Moreover, in therapy for elder patients, a responsible clinician always needs to think about potential drug to drug interactions and possible compromised pharmacokinetic dynamics in the aging body. Professional geriatric societies in many countries (USA, Germany, UK have developed lists of potentially inappropriate medications for the elderly, and they update them systematically. Lists such as The Beers Criteria list and STOPP/START criteria should always be consulted when administering therapy to elderly patients. In this paper we emphasized the importance of medication lists as an important practical support in a GP’s everyday work. Implementation of such therapeutic aids reduces the possibility of medical error and minimizes the chance of an inappropriate prescription for this vulnerable population stratum. Conclusion. When prescribing drugs for the elderly, GPs should take into account the specificities of the elderly, their biological and chronological framework and should always apply the principles of rational, conservative and evidence-based pharmacotherapy.

  17. Overuse of non-prescription analgesics by dental clinic patients

    Directory of Open Access Journals (Sweden)

    Zallen Richard D

    2008-12-01

    Full Text Available Abstract Background Many patients present to dental clinics for treatment of painful conditions. Prior to seeking treatment, many of these patients will self-medicate with non-prescription analgesics (NPA, and some will unintentionally overdose on these products. The objective of this study is to describe the use of NPA among dental patients. Methods All adult patients presenting to an urban dental clinic during a two-week period in January and February of 2001 were approached to participate in this research project. Trained research assistants using a standardized questionnaire interviewed patients. Patient demographics and the NPA usage over the 3 days preceding the office visit were recorded. We defined a supra-therapeutic dose as any dose greater than the total recommended daily dose stated on package labeling. Results We approached 194 patients and 127 participated. The mean age of participants was 35.5 years, 52% were male. Analgesic use preceding the visit was reported by 99 of 127 patients, and most (81/99 used a NPA exclusively. Fifty-four percent of NPA users were taking more than one NPA. NPA users reported using ibuprofen (37%, acetaminophen (27%, acetaminophen/aspirin combination product (8%, naproxen (8%, and aspirin (4%. Sixteen patients reported supra-therapeutic use of one or more NPA (some ingested multiple products: ibuprofen (14, acetaminophen (3, and naproxen (5. Conclusion NPA use was common in patients presenting to a dental clinic. A significant minority of patients reported excessive dosing of NPA. Ibuprofen was the most frequently misused product, followed by naproxen and acetaminophen. Though mostly aware of the potential toxicity of NPA, many patients used supra-therapeutic dosages.

  18. E-prescription as a tool for improving services and the financial viability of healthcare systems: the case of the Greek national e-prescription system.

    Science.gov (United States)

    Pangalos, G; Sfyroeras, V; Pagkalos, I

    2014-01-01

    E-prescription systems can help improve patient service, safety and quality of care. They can also help achieve better compliance for the patients and better alignment with the guidelines for the practitioners. The recently implemented national e-prescription system in Greece already covers approximately 85% of all prescriptions prescribed in Greece today (approximately 5.5 million per month). The system has not only contributed already in significant changes towards improving services and better monitoring and planning of public health, but also substantially helped to contain unnecessary expenditure related to medication use and improve transparency and administrative control. Such issues have gained increasing importance not only for Greece but also for many other national healthcare systems that have to cope with the continuous rise of medication expenditure. Our implementation has, therefore, shown that besides their importance for improving services, national e-prescription systems can also provide a valuable tool for better utilisation of resources and for containing unnecessary healthcare costs, thus contributing to the improvement of the financial stability and viability of the overall healthcare system.

  19. Review and Analysis of Outpatient Prescriptions%门诊处方点评与分析

    Institute of Scientific and Technical Information of China (English)

    斌兰

    2013-01-01

    目的通过处方点评了解北京市石景山医院门诊患者用药的基本情况,并进行分析以完善处方合理用药。方法随机抽取2012年1月~7月门诊处方共14000张,进行点评。结果平均每张处方用药品种数为2.4,平均每张处方金额为214.26元。抗菌药物使用百分率为28.4%,注射剂使用百分率为19.1%,国家基本药物占处方用药的比例为39.9%,药品通用名使用率为100%,不合理用药处方1767张,占总处方的12.6%,主要为处方前记缺项和用法、用量不适宜。结论严格处方点评制度,提高合理用药水平。%Objective Understanding the patient's drug use situation in Beijing Shi Jing Shan Hospital through the prescription comments. Then, analyze this situation for bet er prescription and rational drug use. Method Randomly drawing and comments on 14000 outpatient prescriptions from January to July in 2012. Result Among these prescriptions, in average, the number of drug type is 2.4, prescription charges is 214.26 RMB, antibacterial drug use percentage is 28.4%, injection using percentage is 19.1%, the national essential drugs accounted for 39.9%in the proportion of prescription drugs, the utilization rate of drug generic name was 100%. In addition, irrational drug use prescription was 1767 copies, accounting for 12.6% of the total prescription, which were mainly for the imperfect records and unreasonable usage or dosage before the prescription. Conclusion Consummate the prescription comment systems strictly in order to enhance the level of reasonable drug use.

  20. Prevalence and predictors of antibiotic prescription errors in an emergency department, Central Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Alanazi MQ

    2015-06-01

    Full Text Available Menyfah Q Alanazi,1 Majed I Al-Jeraisy,2,3 Mahmoud Salam2 1Drug Policy and Economic Center, 2King Abdullah International Medical Research Center (KAIMRC, 3King Saud bin Abdulaziz University for Health Sciences (KSAU-HS, Riyadh, Saudi Arabia Background: Inappropriate antibiotic (ATB prescriptions are a threat to patients, leading to adverse drug reactions, bacterial resistance, and subsequently, elevated hospital costs. Our aim was to evaluate ATB prescriptions in an emergency department of a tertiary care facility. Methods: A cross-sectional study was conducted by reviewing charts of patients complaining of infections. Patient characteristics (age, sex, weight, allergy, infection type and prescription characteristics (class, dose, frequency, duration were evaluated for appropriateness based on the AHFS Drug Information and the Drug Information Handbook. Descriptive and analytic statistics were applied. Results: Sample with equal sex distribution constituted of 5,752 cases: adults (15 years =61% and pediatrics (<15 years =39%. Around 55% complained of respiratory tract infections, 25% urinary tract infections (UTIs, and 20% others. Broad-spectrum coverage ATBs were prescribed for 76% of the cases. Before the prescription, 82% of pediatrics had their weight taken, while 18% had their weight estimated. Allergy checking was done in 8% only. Prevalence of inappropriate ATB prescriptions with at least one type of error was 46.2% (pediatrics =58% and adults =39%. Errors were in ATB selection (2%, dosage (22%, frequency (4%, and duration (29%. Dosage and duration errors were significantly predominant among pediatrics (P<0.001 and P<0.0001, respectively. Selection error was higher among adults (P=0.001. Age stratification and binary logistic regression were applied. Significant predictors of inappropriate prescriptions were associated with: 1 cephalosporin prescriptions (adults: P<0.001, adjusted odds ratio [adj OR] =3.31 (pediatrics: P<0.001, adj OR