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4281. Interventions to improve antihypertensive drug adherence: a quantitative review of trials

-report, an electronic medication event monitoring system (MEMS), and pharmacy records of prescription refills. The adherence rate was defined as the proportion of prescribed doses taken. The most frequently used definition was that of Sackett et al. (see Other Publications of Related Interest), which defined adherence as greater than 80% pill consumption. Adherence was typically measured at the end of the study (e.g. the last study month), but in several cases adherence was reported for the entire (...) (or quasi-randomised) controlled trials published in peer-reviewed literature were considered. The study designs included were randomised controlled trials (RCTs), quasi-randomised trials in which assignment was by an arbitrary method or by minimisation, and crossover designs. Studies in which fewer than 10 participants were randomised were excluded. The length of follow-up ranged from 2 to 29 months. Specific interventions included in the review The interventions included the use of electronic vial

2000 DARE.

4282. Antimicrobial treatment in acute maxillary sinusitis: a meta-analysis

were subsequently resolved by the two authors reviewing the paper together. Only data within the publications were considered and authors were not contacted for additional information. The following information was extracted from the publications: type and properties of the antibiotic, outcome details, study setting (primary care/secondary care), prescription of local decongestants (no/yes), treatment dose (prescribed daily dose/antibiotic divided by daily dose (DDD) as defined by the WHO) (1 (...) significant OR, studies with similar background characteristics were clustered in order to increase the power of the analyses. The following background characteristics were considered as potential confounders: setting, prescription of local decongestants, treatment, dose, duration of treatment, basis for the diagnosis, geographical area and year of publication. Clinical significance was defined using an arbitrary cut off point of p>1.50 or p<0.67. Clustering of the studies was considered to be justified

1997 DARE.

4283. Strategies for diagnosing and treating suspected acute bacterial sinusitis: a cost-effectiveness analysis

assumptions: there was no recurrence of resolved symptoms; the risk of developing side effects from the antibiotics remained constant; side effects lasted 2 days and required a change in prescription, but no further reactions occurred and the cure rate was unaltered; antibiotic treatment of patients who did not have ABS did not alter their symptoms; only untreated patients with ABS experienced severe disease complications (brain abscess, meningitis, facial or orbital cellulitis). Outcomes assessed (...) . Weekend days were valued at the same rate to reflect non-work productivity losses and other, unspecified, indirect costs. Productivity losses were calculated from data on the usual weekly earnings for wage and salary earners, obtained electronically from the Bureau of Labor Statistics. The number of days of work lost for each severity of sinusitis was derived using the model. A median value of $115 per day was used. Only productivity losses of patients, not their caregivers, were included. Discounting

2001 NHS Economic Evaluation Database.

4284. Breast imaging - a guide for practice

. A summary of key points is provided at the end of each chapter. INTRODUCTION AND BACKGROUND TO THE GUIDE Aim and scope The overall aim of Breast imaging: a guide for practice is to optimise the early and accurate diagnosis of breast abnormalities. A secondary aim is to maximise both the woman’s and the clinician’s satisfaction with the breast imaging experience. This guide is not intended to be prescriptive or to serve as a training manual, but rather to offer a guide to practice. While acknowledging (...) of Breast imaging: a guide for practice is to optimise the early and accurate diagnosis of breast abnormalities. A secondary aim is to maximise both the woman’s and the clinician’s satisfaction with the breast imaging experience. This guide is not intended to be prescriptive or to serve as a training manual, but rather to offer a guide to practice. While acknowledging that access to imaging services may be limited in some regions, the recommendations for practice are applicable to both rural/remote

2001 Cancer Australia

4285. Clinical practice guidelines for the management of advanced breast cancer

to provide information to assist decision-making and are based on the evidence available at time of publication. They are not meant to be prescriptive.1 Clinical practice guidelines for the management of advanced breast cancer I N T R O D U C T I O N In 1996, the NHMRC National Breast Cancer Centre established a multidisciplinary working group to develop clinical practice guidelines for the management of advanced breast cancer. The working group comprised representatives from breast surgery, radiology (...) 3 and 8– 11 contain information which is also applicable to locally advanced breast cancer and local recurrence. The process employed to develop the guidelines is described in Appendix B, including the purpose and scope of the guidelines and its intended audience. These guidelines are not rigid procedural paths. They are inclusive, not prescriptive. They aim to provide information on which decisions can be made rather than dictating what those decisions should be. The guidelines use a four-point

2000 Cancer Australia

4286. Clinical practice guidelines for the management of early breast cancer

of breast cancer should consult the relevant texts. These guidelines are neither rigid procedural paths, nor prescriptive. They aim to provide information on which decisions can be made, rather than dictate what decisions should be. 2 Clinical practice recommendations are boxed as ‘Guidelines’ throughout the text and are summarised at the beginning under ‘Summary of Guidelines’. These are all evidence-based and the level of evidence is clearly denoted. There are also boxed ‘Key points’ to draw

2001 Cancer Australia

4287. Effectiveness reviews in health promotion

health promotion interventions … 40 Chapter 5 Searching for studies to include in effectiveness reviews 5.1 Why is systematic searching important? ….. 40 5.2 Searching electronic databases ….. 42 5.3 Methods 5.3.1 Developing a search strategy for each database … 46 5.3.2 Testing the search strategies for their sensitivity and specificity 48 5.3.3 Identifying the best combination of databases to use …. 49 5.4 Results 5.4.1 Search strategies … 49 5.4.2 Sensitivity and specificity of the search (...) >magazine= type journals should raise awareness and signpost full reports. ? Summaries of reviews, however short, should include the Abottom line@ and its implications for planning of services and gaps in knowledge. ? Full reports (paper or electronic versions) should be available to purchasers and providers. These reports should include: C a clear description of the review methods, why these methods have been chosen and the implications they have for the evidence used to draw conclusions about

1999 EPPI Centre

4288. Promoting Continence Using Prompted Voiding

, including in electronic form, for educational or non-commercial purposes, without requiring the consent or permission of the Registered Nurses’ Association of Ontario, provided that an appropriate credit or citation appears in the copied work as follows: Registered Nurses’ Association of Ontario (2005). Promoting Continence Using Prompted Voiding. (Revised). Toronto, Canada: Registered Nurses’ Association of Ontario. Promoting Continence Using Prompted Voiding 67 How to Use this Document This nursing

2002 Registered Nurses' Association of Ontario

4289. Risk Assessment and Prevention of Pressure Ulcers

copying appears, the balance of this document may be produced, reproduced and published, in any form, including in electronic form, for educational or non-commercial purposes, without requiring the consent or permission of the Registered Nurses’ Association of Ontario, provided that an appropriate credit or citation appears in the copied work as follows: Registered Nurses’ Association of Ontario (2005). Risk assessment and prevention of pressure ulcers. (Revised). Toronto, Canada: Registered Nurses

2002 Registered Nurses' Association of Ontario

4290. Suicide prevention strategies: a systematic review. (PubMed)

via electronic searches of MEDLINE, the Cochrane Library, and PsychINFO databases using multiple search terms related to suicide prevention. Studies, published between 1966 and June 2005, included those that evaluated preventative interventions in major domains; education and awareness for the general public and for professionals; screening tools for at-risk individuals; treatment of psychiatric disorders; restricting access to lethal means; and responsible media reporting of suicide.Data were (...) extracted on primary outcomes of interest: suicidal behavior (completion, attempt, ideation), intermediary or secondary outcomes (treatment seeking, identification of at-risk individuals, antidepressant prescription/use rates, referrals), or both. Experts from 15 countries reviewed all studies. Included articles were those that reported on completed and attempted suicide and suicidal ideation; or, where applicable, intermediate outcomes, including help-seeking behavior, identification of at-risk

2005 JAMA

4291. Medication use leading to emergency department visits for adverse drug events in older adults. (PubMed)

-sectional survey of outpatient medical visits.National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance System, 2004-2005; National Ambulatory Medical Care Survey, 2004; and National Hospital Ambulatory Medical Care Survey, 2004.Persons 65 years of age or older seeking emergency department and outpatient care.Estimated number of and risks for emergency department visits for adverse drug events involving Beers criteria medications and other medications.Among U.S. patients (...) prescription frequency, the risk for emergency department visits for adverse events due to these 3 medications was 35 times (CI, 9.6 to 61) greater than that for medications considered to be always potentially inappropriate.Adverse events were identified only in emergency departments.Compared with other medications, Beers criteria medications caused low numbers of and few risks for emergency department visits for adverse events. Performance measures and interventions targeting warfarin, insulin

2007 Annals of Internal Medicine

4292. Risk of serious NSAID-related gastrointestinal events during long-term exposure: a systematic review

of articles A high-sensitivity search for randomised trials was conducted by searching the Third Quarter 2002 issue of the Cochrane Controlled Trials Register from its start date. The criteria for study selection were: study sample included patients exposed to prescription non-selective NSAIDs for a duration greater than 6 months; “serious GI event” incidence or risk was reported, by duration of NSAID exposure; events occurred during current use of medication; and the study was published in full (...) of patients with bleeds. Furthermore, information on numbers at risk over time was not available for that study. Data extraction and analysis Data for validity assessment criteria and patient characteristics were extracted from the articles (variables available on request). Outcomes data for serious GI event incidence at specific times were extracted where available, or otherwise were taken from an electronic citation, email correspondence (Dr M Mamdani, Scientist, Institute for Clinical Evaluative

2006 EvidenceUpdates

4293. Responding to the rofecoxib withdrawal crisis: a new model for notifying patients at risk and their health care providers. (PubMed)

Responding to the rofecoxib withdrawal crisis: a new model for notifying patients at risk and their health care providers. We decided to inform our patients of the withdrawal of rofecoxib, one of the largest drug withdrawals in United States history, and instruct them to contact their providers for guidance.To identify and inform patients and providers affected by the rofecoxib withdrawal.Descriptive observational study.Tertiary care center with an electronic medical record (EMR (...) ) system.Patients with an active rofecoxib prescription within the EMR.Existing information technology and traditional communication resources were used to automate the identifying and notifying of patients and providers and to deactivate rofecoxib prescriptions in the EMR.Characteristics of patients receiving rofecoxib at our institution, details of their prescription and provider, number of EMR alerts, and medication discontinuations.The 11,699 patients with a rofecoxib prescription in our practice were sent

2005 Annals of Internal Medicine

4294. A three-part intervention to change the use of hormone replacement therapy in response to new evidence. (PubMed)

years who had a prescription filled at the VA-TVHS for combination HRT between 1 January 2002 and 1 July 2002.Discontinuation of HRT.A 3-part intervention consisted of 1) notifying patients who were using combination HRT of the results of the Women's Health Initiative study (patient education component), 2) sending all providers an e-mail with the Women's Health Initiative study results (provider education component), and 3) placing an electronic alert in each eligible patient's chart (provider care (...) A three-part intervention to change the use of hormone replacement therapy in response to new evidence. Slow adaptation of new information by providers may result in suboptimal care.To evaluate changes in prescriptions for combination hormone replacement therapy (HRT) after a multicomponent intervention to deliver new information to patients and providers.Quasi-experimental study with multiple baselines.Veterans Affairs Tennessee Valley Healthcare System (VA-TVHS).Female veterans age 50 to 79

2004 Annals of Internal Medicine

4295. Oral chemotherapy safety practices at US cancer centres: questionnaire survey. (PubMed)

electronic systems for most oral chemotherapy prescribing. For six commonly used oral chemotherapies, on average 10 centres required a diagnosis on the prescription, 11 required the protocol number, four required the cycle number, nine required double checking by a second clinician, 14 required a calculation of body surface area, and 14 required a calculation of dose per square metre of body surface area. Only a third of centres requested patients' written informed consent when oral chemotherapy (...) Oral chemotherapy safety practices at US cancer centres: questionnaire survey. To characterise current safety practices for the use of oral chemotherapy.Written questionnaire survey of pharmacy directors of cancer centres.Comprehensive cancer centres in the United States.Respondents from 42 (78%) of 54 eligible centres completed the survey, after consulting with 89 colleagues. Clinicians at 29 centres used handwritten prescriptions, two used preprinted paper prescriptions, and six used

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2007 BMJ

4296. Clopidogrel versus acetylsalicylic acid for the secondary prevention of vascular diseases

and 325 mg daily [6,23,24]. For patients with IHD, the Medicinal Commission of German Physicians (Arzneimittelkommission der Deutschen Ärzteschaft) primarily recommends 100 mg daily [25]. This recommendation is reflected in the German prescription numbers: in the vast majority of cases, antiplatelet ASA therapy is prescribed in a dosage of 100 mg daily [26]. Presumably there is no difference in benefit between daily doses of 75 mg and 325 mg ASA [20]. With regard to severe bleeding complications

2006 Institute for Quality and Efficiency in Healthcare (IQWiG)

4297. What is the evidence for an interaction between erythromycin and: fluconazole, itrazonazole, ketoconazole, diltiazem, verapamil?

electronic Library for Medicines (5) adds: “An accompanying editorial discusses the practical implications of drug-induced QT-interval prolongation. It states "in the absence of other predisposing factors, the absolute risk of drug-induced torsades de pointes is probably extremely low when a single QT-interval–prolonging drug is prescribed in therapeutic doses, as evidenced by the millions of courses of erythromycin that have been taken safely during the past 30 years. However, for patients with other (...) , Interactions between erythromycin and verapamil. 2. Goldschmidt, N. et al. “Compound cardiac toxicity of oral erythromycin and verapamil”. Annals of pharmacotherapy, Nov 01, 35 (11), pgs 1396 – 1399. ( ) 3. Molden, E. et al. “Co-prescription of cytochrome P450 2D6/3A4 inhibitor-substrate pairs in clinical practice. A retrospective analysis of data from Norwegian primary pharmacies.” European journal of clinical pharmacology, April 05, 61 (2), pgs 119 – 125. ( ) 4. Ray, W. A. et al. “Oral erythromycin

2006 TRIP Answers

4298. In patients with recurrent tonsillitis, is there any evidence that the use of long term low dose prophylactic penicillin leads to a reduced requirement for tonsillectomy when compared with treatment o

is a self-limiting condition. Symptoms resolve within 3 days in 40% of people and within 1 week in 85% of people, irrespective of whether or not the sore throat is due to a streptococcal infection… Prescription of an antibiotic increases re-attendance rates for further episodes of sore throat. There is also the risk of adverse effects, and there is concern that indiscriminate prescribing increases bacterial resistance in the community.” (4). Although the guidance does go on to say that antibiotic (...) Database of Systematic Reviews 1999, Issue 3. Art. No.: CD001802. DOI: 10.1002/14651858.CD001802 3. Paradise, J. et al. “Tonsillectomy and Adenotonsillectomy for Recurrent Throat Infection in Moderately Affected Children” PEDIATRICS. July 2002; 110 (1): 7-15. 4. Prodigy Guidance. “Sore Throat.” 2004. Accessed Electronically: September 30, 2006. Answered 2 October 2006 Follow us: © 2019 Trip Database Ltd. company number 04316414. Trip is proud to be made in the UK.

2006 TRIP Answers

4299. Do you have any studies examining the effect of poor handwriting on patients?

= 0.010) and they wrote significantly quicker (p = 0.005). However a small minority of the doctors was responsible for the majority of illegible words written by that group.” A 1996 BMJ paper [3] found: “This study fails to support the conventional wisdom that doctors' handwriting is worse than others'.” However, it does include a discussion of possible ramifications of poor handwriting. A 2001 paper in the Pharmaceutical Journal reported on a survey of prescription errors in general practice [4 (...) ]. The authors found "140 errors were found on 140 of the 1,373 handwrittten items presented during the study period (10.2 per cent) compared with 2,676 errors on 2,527 of the 36,448 computer-generated items (7.34 per cent) (chi-squared 21.5, df=1, P The National Patient Safety Agency has a section on their website dealing with medication errors [5] which reports on handwriting: “Often issues of legibility and handwriting are examined in terms of prescribing errors; many studies show evidence that electronic

2006 TRIP Answers

4300. Is your prescription of distance running shoes evidence-based? (PubMed)

Is your prescription of distance running shoes evidence-based? To determine whether the current practice of prescribing distance running shoes featuring elevated cushioned heels and pronation control systems tailored to the individual's foot type is evidence-based.MEDLINE (1950-May 2007), CINAHL (1982-May 2007), EMBASE (1980-May 2007), PsychInfo (1806-May 2007), Cochrane Database of Systematic Reviews (2(nd) Quarter 2007), Cochrane Central Register of Controlled trials (2(nd) Quarter 2007 (...) ), SPORTSDiscus (1985-May 2007) and AMED (1985-May 2007).English language articles were identified via keyword and medical subject headings (MeSH) searches of the above electronic databases. With these searches and the subsequent review process, controlled trials or systematic reviews were sought in which the study population included adult recreational or competitive distance runners, the exposure was distance running, the intervention evaluated was a running shoe with an elevated cushioned heel

2009 British Journal of Sports Medicine

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