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Electronic Prescription

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181. Assessment of Topical Corticosteroid Prescribing, Counseling, and Communication Among Dermatologists and Pharmacists. (Abstract)

-question survey recalling experiences with TC prescribing from the past year along with self-reported demographic information.Dermatologists' and pharmacists' self-reported counseling of patients regarding TC application, duration of use, and adverse effects; frequency of communication of changes to TC prescriptions and instructions; and demographic data were tabulated and compared.Of the 117 dermatologists, 52 (44.4%) completed and returned the survey; of the 2954 pharmacists, 111 (3.8%) returned (...) Assessment of Topical Corticosteroid Prescribing, Counseling, and Communication Among Dermatologists and Pharmacists. Topical corticosteroids (TCs) are common treatments for many dermatologic conditions. Anecdotal experience and literature suggest that dermatologists and pharmacists differ in their beliefs about TCs and approach to TC counseling, creating the opportunity for patient confusion.To examine interprofessional practice gaps between dermatologists and pharmacists with regard to how

2019 JAMA dermatology (Chicago, Ill.)

182. Predictors and variability of antibiotic prescribing amongst family physicians. (Abstract)

physicians in Ontario, Canada using a repository of electronic medical records. Using multilevel logistic regression models fitted with random intercepts for physicians, we evaluated the association of patient-, physician- and clinic-level characteristics with antibiotic prescribing rates.We included 3 956 921 physician-patient encounters, 322 129 unique patients and 313 physicians from 41 family medicine clinics. Physicians prescribed a median of 54 (interdecile range 28-95) antibiotics per 1000 (...) Predictors and variability of antibiotic prescribing amongst family physicians. Rising rates of antimicrobial resistance are driven by overuse of antibiotics. Characterizing physician antibiotic prescribing variability can inform interventions to optimize antibiotic use.To describe predictors of overall antibiotic prescribing as well as the inter-physician variability in antibiotic prescribing amongst family physicians.We conducted a 5 year cohort study of antibiotic prescribing rates by family

2019 Journal of Antimicrobial Chemotherapy

183. Antibiotic prescribing for common infections in UK general practice: variability and drivers. Full Text available with Trip Pro

Antibiotic prescribing for common infections in UK general practice: variability and drivers. To examine variations across general practices and factors associated with antibiotic prescribing for common infections in UK primary care to identify potential targets for improvement and optimization of prescribing.Oral antibiotic prescribing for common infections was analysed using anonymized UK primary care electronic health records between 2000 and 2015 using the Clinical Practice Research (...) in their propensity to prescribe antibiotics and this variance increased over time. Change points in prescribing did not reflect updates to national guidelines. Prescribing levels within practices were not consistent for different infectious conditions. A history of antibiotic use significantly increased the risk of receiving a subsequent antibiotic (by 22%-48% for patients with three or more antibiotic prescriptions in the past 12 months), as did higher BMI, history of smoking and flu vaccinations. Other drivers

2019 Journal of Antimicrobial Chemotherapy

184. Improving the Safety of Teratogen Prescribing Practices in a Pediatric Rheumatology Clinic. (Abstract)

clinic.Eligible participants included female patients age 10 and older prescribed teratogenic medications in a single-center tertiary care pediatric rheumatology clinic. Seven plan-do-study-act cycles were completed to test the following interventions: visible project reminders, physician and nurse education, progress updates, previsit planning, and development of an electronic health record education template. Chart reviews were performed, and control charts were created for each aim to analyze improvement (...) Improving the Safety of Teratogen Prescribing Practices in a Pediatric Rheumatology Clinic. Although teratogenic medications are commonly used to treat rheumatic disease, no standard model currently exists for educating adolescent patients about teratogenic risk or performing routine pregnancy screening. We performed a quality improvement project to increase education and pregnancy screening in girls and women of childbearing age prescribed teratogenic medications in our pediatric rheumatology

2019 Pediatrics

185. Long-term assessment of NSAID prescriptions and potential nephrotoxicity risk in adult kidney transplant recipients. Full Text available with Trip Pro

retrospectively followed in the VA system from 2001-10 that assessed for risk of AKI with NSAID prescriptions. NSAID prescriptions, patient characteristics and eGFRs were abstracted from the VA comprehensive electronic health record. NSAID exposure was assessed by duration, dosage and type. AKI events were defined by ≥50% decrease in eGFR. Risk was estimated using longitudinal multivariable generalized logistic regression model.5,100 patients were included with a total of 29,980 years of follow up; 671 NSAID (...) Long-term assessment of NSAID prescriptions and potential nephrotoxicity risk in adult kidney transplant recipients. NSAID use is recommended to be avoided in kidney transplantation (KTX), with a paucity of studies assessing their safety within this population. This study aims to use a large cohort of Veterans Affairs (VA) KTX recipients to assess the risk of acute kidney injury (AKI) with NSAID use.This is a ten-year longitudinal cohort study of adult kidney transplant recipients

2019 Transplantation

186. Changes in prescribing for bipolar disorder between 2009 and 2016: national-level data linkage study in Scotland. Full Text available with Trip Pro

patterns in bipolar disorder in Scotland between 2009 and 2016.By linking prescribing data to the electronic Scottish Morbidity Records, we identified a cohort of 23 135 patients with bipolar disorder who were prescribed psychotropic medication between 2009 and 2016. We examined trends in proportions of patients prescribed each of six drug categories. Random effects logistic models examined change in prescribing over years of interest.The most common form of treatment was antidepressant monotherapy (...) Changes in prescribing for bipolar disorder between 2009 and 2016: national-level data linkage study in Scotland. People with bipolar disorder typically require long-term pharmacological treatment to prevent episodes of depression or mania. However, evidence-based guidelines are often not followed by prescribers and, in some countries, prescribing of lithium is in decline. Polypharmacy is also common in bipolar disorder.AimsTo employ a data linkage approach to describe and evaluate prescribing

2019 British Journal of Psychiatry

187. Adherence to antibiotic guidelines and reported penicillin allergy: pooled cohort data on prescribing and allergy documentation from two English National Health Service (NHS) trusts. Full Text available with Trip Pro

Adherence to antibiotic guidelines and reported penicillin allergy: pooled cohort data on prescribing and allergy documentation from two English National Health Service (NHS) trusts. To investigate documentation of antimicrobial allergy and to determine prescribing adherence to local antibiotic guidelines for inpatients with and without reported penicillin allergy treated for infection in a National Health Service (NHS) context.Data were collected at two English hospital NHS trusts over two (...) time-periods: June 2016 and February 2017.Cohort study. Trust 1 data were sourced from prospective point prevalence surveys. Trust 2 data were extracted retrospectively from an electronic report.Inpatients treated for urinary tract infection (UTI), community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP) and skin and soft tissue infection (SSTI). Data on allergy were collected, and antibiotic selection assessed for adherence to trust guidelines with differences between groups presented

2019 BMJ open

188. NHMRC CEO Statement: Electronic cigarettes (e-cigarettes)

NHMRC CEO Statement: Electronic cigarettes (e-cigarettes) CEO Statement: Electronic cigarettes | NHMRC NHMRC Tagline NHMRC Tagline Publication date Publication date Content type Filtered by: All Publications News Page Search Quick links Toggle navigation Main navigation Funding One researcher has the potential to improve millions of lives. We provide funding for research through our grant system, with a transparent peer-review process to determine how funding is allocated. May 07 2018 May 07 (...) researchers and help them protect intellectual property. Jun 14 2018 Jul 25 2018 About us At NHMRC we are excited by the huge potential benefits of the research we fund and by the opportunities we have to ensure Australians have access to evidence-based, authoritative health advice. We create pathways to a healthier future through our research funding, our health guidelines and the ethical standards we set and uphold. Jul 25 2018 Jul 25 2018 CEO Statement: Electronic cigarettes CEO Statement: Electronic

2015 National Health and Medical Research Council

189. Electronic Health Record-based Interventions for Reducing Inappropriate Imaging in the Clinical Setting

Electronic Health Record-based Interventions for Reducing Inappropriate Imaging in the Clinical Setting Electronic Health Record-based Interventions for Reducing Inappropriate Imaging in the Clinical Setting: A Systematic Review of the Evidence January 2015 Prepared for: Department of Veterans Affairs Veterans Health Administration Quality Enhancement Research Initiative Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence-based Synthesis Program (ESP (...) , coordinates dissemination activities, and develops collaborations with VA leadership to identify new ESP topics of importance to Veterans and the VA healthcare system. Comments on this evidence report are welcome and can be sent to Nicole Floyd, ESP Coordinating Center Program Manager, at Nicole.Floyd@va.gov. Recommended citation: Goldzweig C L, Orshansky G, Paige N M, Ewing B A, Miake-Lye I M, Beroes J M, Shekelle P G. Electronic Health Record-Based Interventions for Reducing Inappropriate Imaging

2015 Veterans Affairs Evidence-based Synthesis Program Reports

190. Should Neuraminidase Inhibitors Be Prescribed To Patients With Influenza?

Should Neuraminidase Inhibitors Be Prescribed To Patients With Influenza? Systematic Review Snapshot TAKE-HOME MESSAGE Patientswhoreceivedneuraminidaseinhibitorsforacutein?uenzawithin48hours of symptom onset began to have symptom resolution approximately 1 day sooner compared with those who received placebo. Should Neuraminidase Inhibitors Be Prescribed for Patients With In?uenza? EBEM Commentators Deepa M. Patel, MD Stephen R. Pitts, MD, MPH Department of Emergency Medicine Emory University (...) ) *Oseltamivir 138.7 hours (5.8 days) vs placebo 160 hours (6.7 days). Table 2. Effect of oseltamivir on hospitalization events compared with placebo. Odds Ratio 95% Con?dence Interval Number of Studies (No. of Patients) Hospitalization events 0.95 0.57–1.61 7 (4,696) METHODS DATA SOURCES A list of clinical trials was compiled with the following: previous reviews, electronic databases (CENTRAL, MEDLINE, EMBASE, DatabaseofAbstractsofReviewsof Effects, NHS Economic Evaluation Database), Food and Drug

2013 Annals of Emergency Medicine Systematic Review Snapshots

191. Electron streams in air during magnetic-resonance image-guided radiation therapy. Full Text available with Trip Pro

phantom, was irradiated with field sizes of 6.3 cm × 6.3 cm (FS6.3) and 12.6 cm × 12.6 cm (FS12.6) at gantry angles of 0°, 30°, and 330°, and phantom-angles of 10°, 20°, and 30°. For each beam delivery, the isocenter was located at the center of mass of the phantom and 3 Gy was delivered to the isocenter (prescription dose = 3 Gy). The doses given by the air-electron-streams were measured using the EBT3 films on the panels placed orthogonal to the direction of the magnetic field at distances of 10 (...) Electron streams in air during magnetic-resonance image-guided radiation therapy. To investigate the undesired irradiations outside of the treatment field by electron streams in air (air-electron-stream) during magnetic-resonance image-guided radiation therapy (MR-IGRT). A custom-made support phantom adjusting angles between the beam central axis (CAX) and the phantom surface (termed phantom-angles), were used. Using the ViewRay system, a rectangular parallelepiped phantom placed on the support

2019 PLoS ONE

192. Effect of Electronic Health Record-Based Medication Support and Nurse-Led Medication Therapy Management on Hypertension and Medication Self-management: A Randomized Clinical Trial Full Text available with Trip Pro

Effect of Electronic Health Record-Based Medication Support and Nurse-Led Medication Therapy Management on Hypertension and Medication Self-management: A Randomized Clinical Trial Complex medication regimens pose self-management challenges, particularly among populations with low levels of health literacy.To test medication management tools delivered through a commercial electronic health record (EHR) with and without a nurse-led education intervention.This 3-group cluster randomized clinical (...) trial was performed in community health centers in Chicago, Illinois. Participants included 794 patients with hypertension who self-reported using 3 or more medications concurrently (for any purpose). Data were collected from April 30, 2012, through February 29, 2016, and analyzed by intention to treat.Clinics were randomly assigned to to groups: electronic health record-based medication management tools (medication review sheets at visit check-in, lay medication information sheets printed after

2018 EvidenceUpdates

193. Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications. Full Text available with Trip Pro

Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications. The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further (...) propose CDSS.A web application (www.MEmind.net) was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014. The web-application reported average daily dose prescribed for antipsychotics, prescribed daily dose (PDD), and the PDD to defined daily dose (DDD) ratio.The MEmind web-application reported that antipsychotics

2016 PLoS ONE

194. Pharmacist-to-prescriber intervention to close therapeutic gaps for statin use in patients with diabetes: A randomized controlled trial. (Abstract)

a statin medication.This new measure has been implemented within the Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) dashboard.In this randomized controlled study, eligible patients identified in EQuIPP are those who received medications from a large chain community pharmacy in North Carolina, are 40-75 years, had ≥2 prescription fills of a diabetes medication, and were not receiving statin therapy.The control group received no intervention. Primary care prescribers (...) of patients in the intervention group were contacted by phone and fax to obtain a prescription for an appropriate statin.The primary outcome was the proportion of patients in each group who were dispensed a statin, calculated using Fisher exact test. Sub-analyses were performed to control for patient age, sex, and insurance type.The number of statins prescribed was statistically significant between intervention group (n = 221) versus control group (n = 199) with 46 statins versus 17 statins, respectively

2018 Journal of the American Pharmacists Association : JAPhA Controlled trial quality: uncertain

195. Improving the Affordability of Prescription Medications for People with Chronic Respiratory Disease. An Official American Thoracic Society Policy Statement. Full Text available with Trip Pro

Improving the Affordability of Prescription Medications for People with Chronic Respiratory Disease. An Official American Thoracic Society Policy Statement. Mounting evidence indicates that out-of-pocket costs for prescription medications, particularly among low- and middle-income patients with chronic diseases, are imposing financial burden, reducing medication adherence, and worsening health outcomes. This problem is exacerbated by a paucity of generic alternatives for prevalent lung diseases (...) , such as asthma and chronic obstructive pulmonary disease, as well as high-cost medicines for rare diseases, such as cystic fibrosis. Affordability and access challenges are especially salient in the United States, as citizens of many other countries pay lower prices for and have greater access to prescription medications.The American Thoracic Society convened a multidisciplinary committee comprising experts in health policy pharmacoeconomics, behavioral sciences, and clinical care, along with individuals

2018 American Journal of Respiratory and Critical Care Medicine

196. Re: 'Determinants of in-hospital antibiotic prescription behaviour' by Lambregts et al. (Abstract)

Re: 'Determinants of in-hospital antibiotic prescription behaviour' by Lambregts et al. 30594653 2019 02 04 1469-0691 2018 Dec 28 Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases Clin. Microbiol. Infect. Cognitive biases in the decision-making process of antibiotic prescribing. S1198-743X(18)30798-5 10.1016/j.cmi.2018.12.010 Peiffer-Smadja N N Hopital Bichat Claude Bernard, Infectious Diseases Department (...) , Paris, France; INSERM, Infection Antimicrobials Modelling Evolution, Paris, France. Electronic address: nathan.psmadja@gmail.com. Lescure F X FX Hopital Bichat Claude Bernard, Infectious Diseases Department, Paris, France; INSERM, Infection Antimicrobials Modelling Evolution, Paris, France. Maatoug R R Hopital Universitaire Pitie Salpetriere, Department of Psychiatry, Paris, France. Rohaut B B Institut du Cerveau et de la Moelle epiniere, PICNIC Lab, Paris, France; Columbia University Department

2018 Clinical Microbiology and Infection

197. Application of Economics & Social Psychology to Improve Opioid Prescribing Safety (AESOPS): R21 Pilot Phase

and an abundance of evidence of harm. The objective of the R21 pilot phase of the Application of Economics & Social psychology to improve Opioid Prescribing Safety (AESOPS) is to develop and test novel behavioral nudges to encourage adherence to pain and CDC guidelines for opioid prescribing for persons with noncancer pain. Interventions will leverage the electronic health record (EHR): Accountable Justification alerts triggered by discordant prescriptions that populate the note with provider's rationale (...) Psychology to Improve Opioid Prescribing Safety (AESOPS): R21 Pilot Phase Estimated Study Start Date : February 2019 Estimated Primary Completion Date : June 2019 Estimated Study Completion Date : August 2019 Arms and Interventions Go to Arm Intervention/treatment Experimental: Clinical Decision Support/Audit & Feedback Clinical decision support nudges (Accountable Justification and Active Choice (SmartSet)) within the electronic health record and Audit and Feedback on performance. Participating

2018 Clinical Trials

198. User-centered design and usability testing of RxMAGIC: a prescription management and general inventory control system for free clinic dispensaries. Full Text available with Trip Pro

was a requirement for deployment. We utilized health data standards to communicate with the existing order entry system; an outgoing electronic prescribing framework was leveraged to send prescription data to RxMAGIC. The results of the usability study were positive, with all tested features receiving a mean score of four or five (i.e. somewhat easy or easy, respectively) on a five-point Likert scale assessing ease of completion, thus demonstrating the system's simplicity and high learnability. RxMAGIC (...) User-centered design and usability testing of RxMAGIC: a prescription management and general inventory control system for free clinic dispensaries. To address challenges related to medication management in underserved settings, we developed a system for Prescription Management And General Inventory Control, or RxMAGIC, in collaboration with the Birmingham Free Clinic in Pittsburgh, Pennsylvania. RxMAGIC is an interoperable, web-based medication management system designed to standardize

2018 BMC health services research

199. Variability in Antibiotic Prescribing for Upper Respiratory Illnesses by Provider Specialty. (Abstract)

Variability in Antibiotic Prescribing for Upper Respiratory Illnesses by Provider Specialty. To evaluate variation in antibiotic prescribing between pediatric and nonpediatric providers for common upper respiratory illnesses.Patient encounters for children aged <18 years from a regional health care system were identified. Electronic medical records from 2011 to 2016 were extracted for diagnoses of upper respiratory infection, pharyngitis, acute otitis media, and sinusitis. Encounters (...) with competing medical diagnoses, recent hospitalization, and antibiotic prescriptions within 30 days were excluded. Adherence to antibiotic guidelines was assessed by provider training (pediatric, nonpediatric physicians, and advance practice providers). Additional factors assessed were calendar year, and patient's age, sex, insurance status, and number of sick visits in the prior year.Across 6 years, 141 361 visits were examined: 43 914 for upper respiratory infection, 43 701 for pharyngitis, 43 925

2018 Journal of Pediatrics

200. Too much of a bad thing: Discharge opioid prescriptions in pediatric appendectomy patients. (Abstract)

found in the electronic medical record (EMR) or through a statewide prescription monitoring database. All dosing data were converted to oral morphine equivalents (OMEs). Analysis of variance and logistic regression were used.During the study, 590 patients underwent appendectomy, of which 371 (62.9%) were diagnosed as having simple acute appendicitis. The majority of patients were prescribed an opioid analgesic (62.5%). Demographics were similar between those who received opioids and those who did (...) not. The OME prescribed per day (range 0.2 to 3.4 mg/kg/day) was highly variable as was duration of prescription (1 to 30 days). Odds of emergency department visit were 3.3 times higher (95% CI 1.3-8.2) in those who received opioids.Postdischarge prescription practices for pediatric appendectomy are highly variable. Two-thirds of patients who received narcotics had a higher rate of complications. Greater scrutiny is required to optimize opioid stewardship.Retrospective comparative study.Level III.Copyright

2018 Journal of Pediatric Surgery

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