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Electronic Prescription

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4161. Measuring Adherence to Topical Therapy in Children With Atopic Dermatitis and the Impact of a Return Visit

: To evaluate adherence to topical therapy using adherence data collected by the MEMS cap (Medication Electronic Monitoring System) in pediatric patients with atopic dermatitis (AD) and the impact of a return visit. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 30 participants Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Measuring Adherence to Topical Therapy (...) of prescription topical therapy for atopic dermatitis (e.g., corticosteroids or retinoids) within the past 2 weeks. Use of any investigational therapy within the past 4 weeks. Pregnant females, females who are breast feeding, or females of childbearing potential who are not practicing an acceptable method of birth control (abstinence, birth control pill/patch, barrier with spermicidal jelly, IUD, etc.), as determined by the investigator. Acceptable contraception must be used during the entire study

2008 Clinical Trials

4162. Integrating Targeted MedlinePlus Health Prescriptions Into Clinic Practice Workflow

Integrating Targeted MedlinePlus Health Prescriptions Into Clinic Practice Workflow Integrating Targeted MedlinePlus Health Prescriptions Into Clinic Practice Workflow - 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. Integrating Targeted MedlinePlus Health Prescriptions Into Clinic Practice Workflow 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. Read our for details. ClinicalTrials.gov Identifier: NCT00634608 Recruitment Status : Completed First Posted : March 13, 2008 Last Update Posted : September 30, 2016 Sponsor: University of Missouri-Columbia

2008 Clinical Trials

4163. Functional Magnetic Resonance Imaging (fMRI) Investigation of Nicotine Withdrawal Symptoms

by a doctor (as confirmed by orbital X-Ray). Inner ear implants. Tattoos with metal containing inks or piercings that can not be removed except those, which, in the opinion of the Investigator, will not interfere with the study procedures or compromise safety. History of claustrophobia or subject feels unable to lie still on their back for a period of 90 min in the MR scanner. Presence of a cardiac pacemaker or other electronic device or ferromagnetic metal foreign bodies in vulnerable positions (...) as assessed by a standard pre-MRI questionnaire supported by plain X-Rays where appropriate. Prior/Concomitant Medication Use of any central nervous system (CNS) active, prescription medication within 14 days of first treatment visit. Use of any over the counter (OTC) medication within 14 days of each treatment visit except those, which, in the opinion of the Investigator, will not interfere with the study procedures or compromise safety. Paracetamol (up to 2 g) may be taken up to 24 hrs prior to each

2008 Clinical Trials

4164. Measuring Adherence in Subjects With Acne Vulgaris in a Clinic Population Subtitle: Topical Benzoyl Peroxide for Acne

14, 2008 Results First Posted : March 17, 2017 Last Update Posted : August 28, 2018 Sponsor: Wake Forest University Information provided by (Responsible Party): Wake Forest University Health Sciences ( Wake Forest University ) Study Details Study Description Go to Brief Summary: The purpose of this research study is to see how often benzoyl peroxide is applied for acne. Use of medication was monitored electronically. Condition or disease Intervention/treatment Phase Acne Vulgaris Drug: Benzoyl (...) or sensitivity to topical benzoyl peroxide gel in the subject. Inability to complete all study-related visits. Introduction of any other prescription medication, topical or systemic, for acne vulgaris while participating in the study. Subjects should not be using topical retinoids or benzoyl peroxide products, including Proactive® or topical prescription medications for the treatment of acne vulgaris for at least 2 weeks prior to beginning the study. Oral medications for the treatment of acne should not have

2008 Clinical Trials

4165. Electronic Medical Record (EMR) Utilization for Public Health Surveillance (PubMed)

Electronic Medical Record (EMR) Utilization for Public Health Surveillance Public health surveillance systems need to be refined. We intend to use a generic approach for early identification of patients with severe influenza-like illness (ILI) by calculating a score that estimates a patients disease-severity. Accordingly, we built the Intelligent Severity Score Estimation Model (ISSEM), structured so that the inference process would reflect experts decision-making logic. Each patients disease (...) -severity score is calculated from numbers of respiratory ICD9 encounters, and laboratory, radiologic, and prescription-therapeutic orders in the EMR. Other ISSEM components include chronic disease evidence, probability of immunodeficiency, and the providers general practice-behavior patterns.Sensitivity was determined from 200 randomly selected patients with upper- and lower-respiratory tract ILI; specificity, from 300 randomly selected patients with URI only. For different age groups, ISSEM

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2008 AMIA Annual Symposium Proceedings

4166. Uptake of electronic prescribing in community-based practices. (PubMed)

-prescriptions written from April 2004 to March 2005. We tabulated the number of clinicians using the e-prescribing system and the number of prescriptions written. We also obtained claims data from the 2 insurance companies and calculated the proportion of each clinician's prescriptions that were written electronically. We developed multivariable models to estimate the impact of different clinician characteristics on the proportional rate of e-prescribing.During the first 12 months of the e-prescribing (...) program, 1,217 prescribers began using the e-prescribing system. In the final month of the study, over 55,000 e-prescriptions were written for patients covered by the 2 included insurance plans. The proportion of total reimbursed claims per clinician written electronically increased slowly during the study period and was still below 30% by the end of the study period. This number increased to 42% when we restricted the sample to medications normally used for acute indications. Multivariable models

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2008 Journal of General Internal Medicine

4167. Variation in electronic prescribing implementation among twelve ambulatory practices. (PubMed)

Variation in electronic prescribing implementation among twelve ambulatory practices. Electronic prescribing has been advocated as an important tool for improving the safety and quality of medication use in ambulatory settings. However, widespread adoption of e-prescribing in ambulatory settings has yet to be realized. The determinants of successful implementation and use in these settings are not well understood.To describe the practice characteristics associated with implementation and use (...) of e-prescribing in ambulatory settings.Multi-method qualitative case study of ambulatory practices before and after e-prescribing implementation.Sixteen physicians and 31 staff members working in 12 practices scheduled for implementation of an e-prescribing program and purposively sampled to ensure a mix of practice size and physician specialty.Field researchers used observational and interview techniques to collect data on prescription-related clinical workflow, information technology experience

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2008 Journal of General Internal Medicine

4168. Overdose rate of drugs requiring renal dose adjustment: data analysis of 4 years prescriptions at a tertiary teaching hospital. (PubMed)

was useful to analyze the vast amount of electronic hospital data. Drug overdose is quite common among inpatients with renal insufficiency. Only a few drugs are responsible for most of drug overdoses. The physicians' clinical experience, workload of prescriptions, and patients' renal function are correlated with drug overdose. (...) Overdose rate of drugs requiring renal dose adjustment: data analysis of 4 years prescriptions at a tertiary teaching hospital. To determine the overdose rate of drugs that require renal dose adjustment and factors related with overdose.Total of 23,635,210 records of prescriptions and laboratory data of inpatients at a tertiary teaching hospital for the period from January 2002 to December 2005.A clinical data mart was constructed. A knowledge base containing dose adjusting information about 56

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2008 Journal of General Internal Medicine

4169. Instantaneous preference was a stronger instrumental variable than 3- and 6-month prescribing preference for NSAIDs. (PubMed)

between different IV measures with exposure.In an ambulatory electronic medical record database of university-based physicians, we compared correlations with exposure among three measures of prescriber preference: instantaneous preference, and the proportion of that prescriber's prescriptions in the past 3 and 6 months that were for an NSAID.We identified 37,934 initial NSAID/COX-2 prescriptions. The correlation with exposure was 0.283 (95% confidence interval 0.274-0.292) for instantaneous preference (...) Instantaneous preference was a stronger instrumental variable than 3- and 6-month prescribing preference for NSAIDs. Prescriber preference has been used as an instrumental variable (IV) in a prior study of nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) vs. selective cyclooxygenase-2 (COX-2) inhibitors, with preference expressed as the drug constituting the immediately preceding prescription by the same prescriber (instantaneous preference). We sought to compare the correlations

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2008 Journal of Clinical Epidemiology

4170. Cross-sectional versus sequential quality indicators of risk factor management in patients with type 2 diabetes. (PubMed)

consisted of 1912 patients who received diabetes care from one of 40 general practitioners in The Netherlands. Clinical outcomes, prescriptions, and demographic data were collected from electronic medical records. Quality was assessed for glycemic, blood pressure, and lipid control using indicators focusing on clinical outcomes, and treatment in relation to outcomes. Indicator results were compared with a reference method based on national guidelines for general practice.According to the reference

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2008 Medical Care

4171. Effect of electronic prescribing with formulary decision support on medication use and cost. (PubMed)

Effect of electronic prescribing with formulary decision support on medication use and cost. Electronic prescribing (e-prescribing) with formulary decision support (FDS) prompts prescribers to prescribe lower-cost medications and may help contain health care costs. In April 2004, 2 large Massachusetts insurers began providing an e-prescribing system with FDS to community-based practices.Using 18 months (October 1, 2003, to March 31, 2005) of administrative data, we conducted a pre-post study (...) with concurrent controls. We first compared the change in the proportion of prescriptions for 3 formulary tiers before and after e-prescribing began, then developed multivariate longitudinal models to estimate the specific effect of e-prescribing when controlling for baseline differences between intervention and control prescribers. Potential savings were estimated using average medication costs by formulary tier.More than 1.5 million patients filled 17.4 million prescriptions during the study period

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2008 Archives of Internal Medicine

4172. Electronic health record components and the quality of care. (PubMed)

the association between presence of EHR components and: (1) blood pressure control; and (2) receipt of appropriate therapy for chronic conditions. We examined similar associations for complete EHRs which we defined as one that includes physician and nursing notes, electronic reminder system, computerized prescription order entry, test results, and computerized test order entry. We constructed multivariate models to examine the association between EHR components and each outcome controlling for patient (...) Electronic health record components and the quality of care. Electronic health records (EHRs) have been promoted as an important tool to improve quality of care. We examined the association between EHR components, a complete EHR, and the quality of care.Using data from the 2005 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, we conducted a cross-sectional analysis of all visits with an established primary care provider and examined

2008 Medical Care

4173. Patient decision to initiate therapy for osteoporosis: the influence of knowledge and beliefs. (PubMed)

Health Organization criteria for osteoporosis. Patients were excluded if they received osteoporotic medications in the prior 6 months.Patients were sent a questionnaire that included items assessing satisfaction with physician-patient communication, trust in the physician, osteoporosis knowledge and beliefs, beliefs about prescription medications, and perceptions of barriers to medication use. Administrative electronic health records were used to identify prescription drug use and health care (...) utilization.Two hundred and thirty-six women returned surveys and research authorization forms out of 465 contacted for participation. One hundred and thirty-five (57.2%) filled a prescription for an osteoporotic drug in the first 3 months after the DXA exam. The largest differences between initiators and non-initiators were in beliefs in the benefits of medications, and distrust of medications, with initiators believing more strongly in the benefits and effectiveness of medications (p < .001), and non

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2008 Journal of General Internal Medicine

4174. Costs of interstitial cystitis in a managed care population. (PubMed)

Costs of interstitial cystitis in a managed care population. To assess the direct medical costs, medication, and procedure use associated with interstitial cystitis (IC) in women in the Kaiser Permanente Northwest (KPNW) managed care population.The KPNW electronic medical record was used to identify women diagnosed with IC (n = 239). Each of these patients was matched with three controls according to age and duration in the health plan. Health plan cost accounting data were used to determine (...) the inpatient, outpatient, and pharmacy costs for 1998 to 2003. An analysis of the prescription medication use and cystoscopic and urodynamic procedures commonly associated with IC was also performed. To evaluate for co-morbidities, an automated risk-adjustment model linked to 28 chronic medical conditions was applied to the administrative data sets from both groups.The mean duration from the date of IC diagnosis to the end of the study period was 36.6 months (range 1.4 to 60). The mean yearly costs were

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2008 Urology

4175. Unintentional child poisonings treated in United States hospital emergency departments: national estimates of incident cases, population-based poisoning rates, and product involvement. (PubMed)

National Electronic Injury Surveillance System, involving a national probability sample of US hospital emergency departments, were used as a basis for developing national estimates of product-related poisonings involving children<5 years of age treated in US hospital emergency departments in 2004.There were an estimated 86194 child poisoning incidents treated in US hospital emergency departments in 2004, amounting to 429.4 poisonings per 100000 children. Approximately 70% of the poisonings involved (...) children 1 or 2 years of age, slightly more than one half involved boys, and 13.3% resulted in hospital admission. Approximately 59.5% of the poisonings involved oral prescription drugs, oral nonprescription drugs, or supplements. Other major product categories resulting in poisonings included cleaning products (13.2%), drugs and ointment preparations intended for external use (4.9%), and personal care products (4.7%). Approximately 54.7% of the poisonings involved products already subject to child

2008 Pediatrics

4176. Race-ethnic Differences in Factors Associated with Inhaled Steroid Adherence Among Adult Asthmatics. (PubMed)

health maintenance organization in southeast Michigan. Individuals were sent a survey that included questions about internal factors (e.g., patient beliefs, knowledge, and motivation) and external factors (e.g., socioeconomic status, barriers to care, social support, and stressors) potentially related to ICS adherence. Adherence was calculated using electronic prescription and fill data. Stepwise regression was used to identify factors associated with adherence before and after stratifying by race (...) Race-ethnic Differences in Factors Associated with Inhaled Steroid Adherence Among Adult Asthmatics. Adherence to inhaled corticosteroid (ICS) medication is known to be low overall, but tends to be lower among African-American patients when compared with white patients.To understand the factors that contribute to ICS adherence among African-American and white adults with asthma.Eligible individuals had a prior diagnosis of asthma, one or more ICS prescriptions, and were members of a large

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2008 American Journal of Respiratory and Critical Care Medicine

4177. Pilot Study of an Interactive Voice Response System to Improve Medication Refill Compliance. (PubMed)

for prescription refill and daily medication reminders. We tested two novel features: personalized, medication-specific reminder messages and communication via voice recognition.Patients enrolled in a study of electronic prescribing and medication management in Quebec, Canada who were taking chronic disease-related drugs were eligible to participate. Consenting patients had their demographic, telephone, and medication information transferred to an IVR system, which telephoned patients to remind them to take (...) mediations and/or refill their prescriptions. Facilitators and barriers of the IVR system use and acceptability of the IVR system were assessed through a structured survey and open-ended questions administered by telephone interview.Of the 528 eligible patients who were contacted, 237 refused and 291 consented; 99 participants had started the pilot study when it was terminated because of physician and participant complaints. Thirty-eight participants completed the follow-up interview. The majority found

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2008 Medical Informatics and Decision Making

4178. Comparison of conventional inserts and an add-on electron MLC for chest wall irradiation of left-sided breast cancer. (PubMed)

distributions related to electron fields were compared with 10 left-sided breast cancer patients after radical mastectomy. The prescription dose was 50 Gy at a build-up maximum. The same dose was prescribed for the ipsilateral axillary, parasternal and supraclavicular lymph nodes that were treated with photons and calculated with a pencil beam algorithm. The insert beams were shaped with 1.5 cm thick Wood's metal electron inserts in an electron applicator of a Varian 2100 C/D linac. Doses for the eMLC (...) Comparison of conventional inserts and an add-on electron MLC for chest wall irradiation of left-sided breast cancer. Collimation of irregularly shaped clinical electron beams is currently based on electron inserts made of low melting point alloys. The present investigation compares a conventional electron applicator with insert and add-on eMLC-based dose distributions in the postoperative chest wall irradiation of left-sided breast cancer.Voxel Monte Carlo++ (VMC++) calculated dose

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2008 Acta Oncologica

4179. Medication safety messages for patients via the web portal: the MedCheck intervention. (PubMed)

at three primary care practices affiliated with a teaching hospital. MedCheck, a medication safety application, sent patients a secure electronic message 10 days after they received a new or changed prescription. MedCheck asked if the patient had filled the prescription or experienced medication-related problems, and then forwarded the patient's response to their primary care physician.We selected a stratified random sample of 267 subjects from 1821 patients who received and opened a MedCheck message (...) Medication safety messages for patients via the web portal: the MedCheck intervention. Communication failures account for many adverse drug events (ADEs) in adult primary care. Improving patient-physician communication may improve medication safety. Accordingly, the goal of this study was to learn whether electronic medication safety messages directed to patients can improve communication about medications and identify ADEs.We studied adult patients enrolled in a patient Internet portal

2008 International journal of medical informatics Controlled trial quality: uncertain

4180. Electronic communications and home blood pressure monitoring (e-BP) study: design, delivery, and evaluation framework. (PubMed)

provider, access to a shared medical record, prescription refill and other services); or (c) this plus pharmacist care management (collaborative care management between the patient, the pharmacist, and the patient's physician via a secure patient website and the electronic medical record).We will determine whether a new model of patient-centered care that leverages Web communications, self-monitoring, and collaborative care management improves hypertension control. If this model proves successful (...) Electronic communications and home blood pressure monitoring (e-BP) study: design, delivery, and evaluation framework. Randomized controlled trials have provided unequivocal evidence that treatment of hypertension decreases mortality and major disability from cardiovascular disease; however, blood pressure remains inadequately treated in most affected individuals. This large gap continues despite the facts that more than 90% of adults with hypertension have health insurance, and hypertension

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2008 Contemporary clinical trials Controlled trial quality: uncertain

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