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Electronic Prescription

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1. Evaluation of computerized provider order entry systems: assessing the usability of systems for electronic prescription (PubMed)

Evaluation of computerized provider order entry systems: assessing the usability of systems for electronic prescription The field of medicine has been influenced by the growth and development of information systems such as the Computerized Provider Order Entry (CPOE) System.This study aimed to evaluate the usability of CPOE systems for electronic prescription in Tehran, Iran.This was an evaluation study conducted in 2017. The research population consisted of the CPOE systems used in hospitals (...) of usability (3.42+0.10) compared to those in public hospitals (2.91+0.25).Two main functions of the studied CPOE systems i.e., decision support and prescription support should be developed to make electronic prescription safer and more intuitive. Addressing usability aspects of CPOE systems in practice could improve the usability of these systems for prescription.

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2018 Electronic physician

2. Off-label indications for antidepressants in primary care: descriptive study of prescriptions from an indication based electronic prescribing system. (PubMed)

Off-label indications for antidepressants in primary care: descriptive study of prescriptions from an indication based electronic prescribing system. Objective To examine off-label indications for antidepressants in primary care and determine the level of scientific support for off-label prescribing.Design Descriptive study of antidepressant prescriptions written by primary care physicians using an indication based electronic prescribing system.Setting Primary care practices in and around two (...) major urban centres in Quebec, Canada.Participants Patients aged 18 years or older who visited a study physician between 1 January 2003 and 30 September 2015 and were prescribed an antidepressant through the electronic prescribing system.Main outcome measures Prevalence of off-label indications for antidepressant prescriptions by class and by individual drug. Among off-label antidepressant prescriptions, the proportion of prescriptions in each of the following categories was measured: strong

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2017 BMJ

3. The past and current state of the Czech outpatient electronic prescription (eRecept). (PubMed)

The past and current state of the Czech outpatient electronic prescription (eRecept). Outpatient Electronic Prescription Systems (OEPSs) are widely used in some European states, such as Denmark, Sweden and the Netherlands. The Czech OEPS (known as eRecept) was introduced in 2011, but with limited functions and voluntary usage it was not much accepted until 2018, when its usage was made compulsory not only for pharmacies, but for physicians as well.Using data from the Czech State Institute

2019 International journal of medical informatics

4. Large-scale implementation of electronic Integrated Management of Childhood Illness (eIMCI) at the primary care level in Burkina Faso: a qualitative study on health worker perception of its medical content, usability and impact on antibiotic prescription (PubMed)

Large-scale implementation of electronic Integrated Management of Childhood Illness (eIMCI) at the primary care level in Burkina Faso: a qualitative study on health worker perception of its medical content, usability and impact on antibiotic prescription Electronic clinical decision algorithms (eCDAs) that guide clinicians during patient management are being deployed in resource-limited settings to improve the quality of care and rational use of medicines (especially antimicrobials). Little

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2019 BMC Public Health

5. The impact of electronic prescription on reducing medication errors in an Egyptian outpatient clinic. (PubMed)

The impact of electronic prescription on reducing medication errors in an Egyptian outpatient clinic. To assess the impact of electronic prescription on the types and rates of medication errors in prescribing and dispensing phases, and to formulate recommendations on the use of electronic prescriptions in Egyptian outpatient practice.Medication errors and correction interventions were collected by reviewing the incident reports obtained from the outpatient pharmacy in a specialized hospital (...) in Egypt. A data collection form was used to classify the errors. The Main outcome measures are prescribing and prescription errors, dispensing errors, error free prescriptions, pharmacy call-backs and phone calls for five months before and five months after the electronic system implementation.3512 incident reports were reviewed for errors in the hand-written and electronic phases. The use of electronic system led to a minor significant 2% reduction in prescribing errors, significant 1.2% decrease

2019 International journal of medical informatics

6. Electronic medication complete communication strategy for opioid prescriptions in the emergency department: Rationale and design for a three-arm provider randomized trial. (PubMed)

Electronic medication complete communication strategy for opioid prescriptions in the emergency department: Rationale and design for a three-arm provider randomized trial. Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing.To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC2) Opioid Strategy (...) (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care.The ED EMC2 Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions. This strategy

2018 Contemporary clinical trials

7. Pharmacy Customers' Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland. (PubMed)

Pharmacy Customers' Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland. One of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers.The aim (...) of this study was to investigate Finnish pharmacy customers' (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions.Questionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community

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2018 Journal of medical Internet research

8. Communication failure: analysis of prescribers' use of an internal free-text field on electronic prescriptions. (PubMed)

Communication failure: analysis of prescribers' use of an internal free-text field on electronic prescriptions. Electronic prescribing promises to improve the safety and clarity of prescriptions. However, it also can introduce miscommunication between prescribers and pharmacists. There are situations where information that is meant to be sent to pharmacists is not sent to them, which has the potential for dangerous errors.To examine how frequently prescribers or administrative personnel put (...) information intended for pharmacists in a field not sent to pharmacists, classify the type of information included, and assess the potential harm associated with these missed messages.Medication record data from our legacy electronic health record were requested for ambulatory care patients seen at an academic medical center from January 1, 2000, to May 31, 2015 (20 123 881 records). From this database, 6 060 272 medication orders met our inclusion criteria. We analyzed a random sample of 10 000

2018 Journal of the American Medical Informatics Association

9. The use of electronic alerts in primary care computer systems to identify the excessive prescription of short-acting beta2-agonists for people with asthma: a systematic review (PubMed)

The use of electronic alerts in primary care computer systems to identify the excessive prescription of short-acting beta2-agonists for people with asthma: a systematic review Computers are increasingly used to improve prescribing decisions in the management of long-term conditions however the effects on asthma prescribing remain unclear. We aimed to synthesise the evidence for the use of computerised alerts that identify excessive prescribing of short-acting beta2-agonists (SABAs) to improve (...) asthma management for people with asthma. MEDLINE, CINAHL, Embase, Cochrane and Scopus databases (1990-2016) were searched for randomised controlled trials using electronic alerts to identify excessive prescribing of SABAs for people with asthma in primary care. Inclusion eligibility, quality appraisal (Cochrane risk of bias tool) and data extraction were performed by two independent reviewers. Findings were synthesised narratively. A total of 2035 articles were screened and four trials were eligible

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2018 NPJ primary care respiratory medicine

10. Learning Doctors’ Medicine Prescription Pattern for Chronic Disease Treatment by Mining Electronic Health Records: A Multi-Task Learning Approach (PubMed)

Learning Doctors’ Medicine Prescription Pattern for Chronic Disease Treatment by Mining Electronic Health Records: A Multi-Task Learning Approach Increasing learning ability from massive medical data and building learning methods robust to data quality issues are key factors toward building data-driven clinical decision support systems for medicine prescription decision support. Here, we attempted accordingly to address the factors using a multi-task neural network approach, benefiting from (...) multi-task learning's advantage in modeling commonalities to increase learning performance and neural network's robustness to imprecise data. By mining electronic health record data, we learned medicine prescription patterns of multiple correlated antidiabetic agents in blood glucose control and antihypertensive drugs in blood pressure control scenarios. We achieved AUC increases of 0.02 to 0.06 in single drug prescription and an accuracy increase of 0.05 in prescription pattern prediction compared

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2018 AMIA Annual Symposium Proceedings

11. Errors in Electronic Health Record–Based Data Query of Statin Prescriptions in Patients With Coronary Artery Disease in a Large, Academic, Multispecialty Clinic Practice (PubMed)

Errors in Electronic Health Record–Based Data Query of Statin Prescriptions in Patients With Coronary Artery Disease in a Large, Academic, Multispecialty Clinic Practice With the recent implementation of the Medicare Quality Payment Program, providers face increasing accountability for delivering high-quality care. Such pay-for-performance programs aim to leverage systematic data captured by electronic health record (EHR) systems to measure performance; however, the fidelity of EHR query (...) for assessing performance has not been validated compared with manual chart review. We sought to determine whether our institution's methodology of EHR query could accurately identify cases in which providers failed to prescribe statins for eligible patients with coronary artery disease.A total of 9459 patients with coronary artery disease were seen at least twice at the Emory Clinic between July 2014 and June 2015, of whom 1338 (14.1%, 95% confidence interval 13.5-14.9%) had no statin prescription

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2018 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

12. Validity of electronic hospital discharge prescription records as a source of medication data for pharmacoepidemiological research (PubMed)

Validity of electronic hospital discharge prescription records as a source of medication data for pharmacoepidemiological research The advent of hospital electronic medical records (EMRs) with electronic prescribing provides considerable opportunity for pharmacoepidemiological research. However, validity of EMR prescribing data for research purposes is not well established. Validity concerns the percentage of cases in which medications and characteristics (name, type, formulation, dose (...) ) are true when verified with an independent data source. This study evaluated the validity of EMR discharge prescription data within the Eastern Health hospital network in Melbourne, Australia.A random sample of patients were selected who had a diagnosis of atrial fibrillation (AF) and were prescribed at least five medications. Prescription records from 2012 to 2015 were compared with pharmacy dispensing and hospital medical records (reference standards). Medication name, dose, directions and route

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2018 Therapeutic advances in drug safety

13. Adverse events of smoking cessation treatments (nicotine replacement therapy and non-nicotine prescription medication) and electronic cigarettes in the Food and Drug Administration Adverse Event Reporting System, 2004−2016 (PubMed)

Adverse events of smoking cessation treatments (nicotine replacement therapy and non-nicotine prescription medication) and electronic cigarettes in the Food and Drug Administration Adverse Event Reporting System, 2004−2016 Several smoking cessation treatments (nicotine replacement therapy and non-nicotine prescription medication) and electronic cigarettes are widely used. We evaluated the adverse events related to smoking cessation treatments and electronic cigarettes in the US Food and Drug (...) Administration Adverse Event Reporting System database.We analyzed reports of adverse events associated with smoking cessation treatment and electronic cigarettes terms dated between January 2004 and December 2016. We used the reporting odds ratio with 95% confidence intervals to detect a signal for each adverse event.In total, 8,867,135 reports in the Food and Drug Administration Adverse Event Reporting System database were analyzed. The numbers of adverse events for nicotine replacement therapy

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2018 SAGE open medicine

14. Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly: A Population-Based Cohort Study in an Electronic Prescription Database (PubMed)

Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly: A Population-Based Cohort Study in an Electronic Prescription Database Gabapentin and pregabalin are widely prescribed to elderly people, but data on their pharmacokinetics, safety, and efficacy in this population are scarce. Neurological adverse effects are common. Atrial fibrillation (AF) associated with their use has been described in several case reports and case series, but the incidence is unknown.The aim

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2018 Drug Safety

15. SUPPORT‐AF: Piloting a Multi‐Faceted, Electronic Medical Record‐Based Intervention to Improve Prescription of Anticoagulation (PubMed)

SUPPORT‐AF: Piloting a Multi‐Faceted, Electronic Medical Record‐Based Intervention to Improve Prescription of Anticoagulation Background Only 50% of eligible atrial fibrillation ( AF ) patients receive anticoagulation ( AC ). Feasibility and effectiveness of electronic medical record (EMR)-based interventions to profile and raise provider AC percentage is poorly understood. The SUPPORT-AF (Supporting Use of AC Through Provider Profiling of Oral AC Therapy for AF) study aims to improve (...) rates of adherence to AC guidelines by developing and delivering supportive tools based on the EMR to providers treating patients with AF. Methods and Results We emailed cardiologists and community-based primary care providers affiliated with our institution reports of their AC percentage relative to peers. We also sent an electronic medical record-based message to these providers the day before an appointment with an atrial fibrillation patient who was eligible but not receiving AC . The electronic

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2018 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

16. Development of an algorithm to link electronic health record prescriptions with pharmacy dispense claims. (PubMed)

Development of an algorithm to link electronic health record prescriptions with pharmacy dispense claims. Medication adherence is an important aspect of chronic disease management. Electronic health record (EHR) data are often not linked to dispensing data, limiting clinicians' understanding of which of their patients fill their medications, and how to tailor care appropriately. We aimed to develop an algorithm to link EHR prescribing to claims-based dispensing data and use the results (...) inform clinical care, we computed adjusted odds ratios of dispense by patient-, encounter-, and clinic-level characteristics.Seventy-six percent of cardio-protective medication prescriptions and 74% of diabetes medications were linked to a dispensing record. Age, income, ethnicity, insurance, assigned primary care provider, comorbidity, time on EHR, and clinic size were significantly associated with odds of dispensing.EHR prescriptions and pharmacy dispense data can be linked at the record level

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2018 Journal of the American Medical Informatics Association

17. Analysis of medication therapy discontinuation orders in new electronic prescriptions and opportunities for implementing CancelRx. (PubMed)

Analysis of medication therapy discontinuation orders in new electronic prescriptions and opportunities for implementing CancelRx. To illustrate the need for wider implementation of the CancelRx message by quantifying and characterizing the inappropriate usage of new electronic prescription (NewRx) messages for communicating discontinuation instructions to pharmacies.A retrospective analysis on a nationally representative random sample of 1 400 000 NewRx messages transmitted over 7 days (...) to identify e-prescriptions containing medication discontinuation instructions in NewRx text fields. A vocabulary of search terms signifying cancellation instructions was formulated and then iteratively refined. True-positives were subsequently identified programmatically and through manual reviews. Two independent reviewers identified incidences in which these instructions were associated with high-alert or look-alike-sound-like (LASA) medications.We identified 9735 (0.7% of the total) NewRx messages

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2018 Journal of the American Medical Informatics Association

18. Using electronic health records to characterize prescription patterns: focus on antidepressants in nonpsychiatric outpatient settings (PubMed)

Using electronic health records to characterize prescription patterns: focus on antidepressants in nonpsychiatric outpatient settings To characterize nonpsychiatric prescription patterns of antidepressants according to drug labels and evidence assessments (on-label, evidence-based, and off-label) using structured outpatient electronic health record (EHR) data.A retrospective analysis was conducted using deidentified EHR data from an outpatient practice at a New York City-based academic medical (...) center. Structured "medication-diagnosis" pairs for antidepressants from 35 325 patients between January 2010 and December 2015 were compared to the latest drug product labels and evidence assessments.Of 140 929 antidepressant prescriptions prescribed by primary care providers (PCPs) and nonpsychiatry specialists, 69% were characterized as "on-label/evidence-based uses." Depression diagnoses were associated with 67 233 (48%) prescriptions in this study, while pain diagnoses were slightly less common

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2018 Jamia Open

19. A Study of the Effectiveness of Electronic Interventions on the Standardized Prescription Benzodiazepines

A Study of the Effectiveness of Electronic Interventions on the Standardized Prescription Benzodiazepines A Study of the Effectiveness of Electronic Interventions on the Standardized Prescription Benzodiazepines - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100 (...) ). Please remove one or more studies before adding more. A Study of the Effectiveness of Electronic Interventions on the Standardized Prescription Benzodiazepines The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03724669

2018 Clinical Trials

20. Prescriber response to computerized drug alerts for electronic prescriptions among hospitalized patients. (PubMed)

Prescriber response to computerized drug alerts for electronic prescriptions among hospitalized patients. Clinical decision support systems (CDSS) reduce prescription errors, but their effectiveness is reduced by high alert rates, "alert fatigue", and indiscriminate rejection.To compare acceptance rates of alerts generated by the SafeRx® prescription CDSS among different alert types and departments in a tertiary care hospital, identify factors associated with alert acceptance, and determine (...) whether alert overrides were justified.In a retrospective study, we compared acceptance rates of all prescription alerts generated in 2013 in 18 departments of Israel's largest tertiary care center. In a prospective study in 2 internal medicine departments, we collected data on factors potentially associated with alert override, and an expert panel evaluated the justification for each overridden alert. We used multivariate analyses to examine the association between patient and physician-related

2017 International journal of medical informatics

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