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Electronic Prescription

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4461. Electronic Communications and Home Blood Pressure Monitoring

already available at GHC including portions of their electronic medical record (including their blood pressures and the graphic display of these), messaging, and prescription refill services, and laboratory results. Group-2 (Blood Pressure Monitoring) will additionally receive home blood pressure monitors, instruction on their use, and a proficiency training session on Web-based communication and encouraged to use this to communicate their blood pressures with their physician, refill medications (...) Electronic Communications and Home Blood Pressure Monitoring Electronic Communications and Home Blood Pressure Monitoring - 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. Electronic Communications and Home

2005 Clinical Trials

4462. Improving diagnostic testing and reducing overuse of antibiotics for children with pharyngitis: a useful role for the electronic medical record. (PubMed)

Improving diagnostic testing and reducing overuse of antibiotics for children with pharyngitis: a useful role for the electronic medical record. Because of rising resistance to antibiotics, appropriate use of antibiotics is an important measure of quality of care. The purpose of this study was to use an electronic medical record (EMR) to assess use of diagnostic testing and of antibiotics for pharyngitis in a pediatric outpatient setting and to target areas for improvement.Using data retrieved (...) from the EMR, we analyzed visits from March 1, 2001 to February 28, 2002 for children 3 to 18 years old diagnosed with pharyngitis. We determined the proportion of episodes with a diagnostic test for group A streptococci, the proportion for which a prescription for an antibiotic was dispensed and factors that predicted prescribing and testing.Of 391 episodes of pharyngitis, a test was ordered for 303 (78%). Antibiotics were prescribed for 90 (23%); for 76 of 90 (84%) a test was ordered. Clinicians

2003 Pediatric Infectious Dsease Journal

4463. Predicting the risk of gastrointestinal bleeding due to nonsteroidal antiinflammatory drugs: NSAID electronic assessment of risk. (PubMed)

Predicting the risk of gastrointestinal bleeding due to nonsteroidal antiinflammatory drugs: NSAID electronic assessment of risk. To validate that, using patient demographics and other risk factors readily obtained from computerized databases, one can predict a priori the risk for developing a nonsteroidal antiinflammatory drug (NSAID) associated gastrointestinal (GI) bleed prior to exposing patients to therapy.We conducted a retrospective cohort analysis using computer-stored information from (...) a large group-model health maintenance organization. All patients who received one or more prescriptions for a single NSAID over a 9 month period were eligible. Historical and risk factor data was obtained for age, sex, prior GI bleeds, use of GI medications, prednisone use, and use of disease modifying antirheumatic drugs (DMARD). We tested a model (eSCORE) that is based on a previous risk stratification method. The primary outcome was a hospital admission for a GI bleed (GI event).A total of 303,211

2003 Journal of Rheumatology

4464. Matching the dosimetry characteristics of a dual-field Stanford technique to a customized single-field Stanford technique for total skin electron therapy. (PubMed)

Matching the dosimetry characteristics of a dual-field Stanford technique to a customized single-field Stanford technique for total skin electron therapy. To compare the dosimetry characteristics of a customized single-field and a matching dual-field electron beam for total skin electron therapy (TSET) within the framework of the Stanford technique. To examine and quantify its impact on patient dosimetry.Two characteristically different electron beams were used for TSET employing the Stanford (...) technique: a single-field beam created from a pencil beam of electrons passing through 7 meters of air and a dual-field beam created from two heavily scattered electron beams directed at oblique angles to patients. The dosimetry characteristics of the two beams were measured by using ionization chambers, radiographic films, and thermal luminescent detectors. The impact of beam characteristic on patient dosimetry was quantified on both anthromorphic phantoms and on patients. Treatment protocols aimed

2004 Biology and Physics

4465. Electronic prescribing needed in hospitals to monitor use of antibiotics (PubMed)

Electronic prescribing needed in hospitals to monitor use of antibiotics 17413155 2007 04 23 2012 03 06 1756-1833 334 7596 2007 Apr 07 BMJ (Clinical research ed.) BMJ Electronic prescribing needed in hospitals to monitor use of antibiotics. 712 Hitchen Lisa L eng News England BMJ 8900488 0959-8138 0 Anti-Bacterial Agents AIM IM Anti-Bacterial Agents supply & distribution Drug Prescriptions Drug Therapy, Computer-Assisted Hospitals statistics & numerical data Humans 2007 4 7 9 0 2007 4 24 9 0

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2007 BMJ : British Medical Journal

4466. Electronic prescribing could save at least $29bn (PubMed)

Electronic prescribing could save at least $29bn 15142905 2004 05 24 2012 03 06 1756-1833 328 7449 2004 May 15 BMJ (Clinical research ed.) BMJ Electronic prescribing could save at least 29bn dollars. 1155 Tanne Janice Hopkins JH eng News England BMJ 8900488 0959-8138 AIM IM Cost Savings Drug Prescriptions economics Drug Utilization economics Internet United States 2004 5 15 5 0 2004 5 25 5 0 2004 5 15 5 0 ppublish 15142905 10.1136/bmj.328.7449.1155 328/7449/1155 PMC411085

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2004 BMJ : British Medical Journal

4467. Computer aided prescribing: Electronic prescribing is helpful in children too (PubMed)

Computer aided prescribing: Electronic prescribing is helpful in children too 15217889 2004 07 19 2018 11 13 1756-1833 328 7455 2004 Jun 26 BMJ (Clinical research ed.) BMJ Computer aided prescribing: electronic prescribing is helpful in children too. 1566 Wong Kenneth K Tam Paul P eng Comment Letter England BMJ 8900488 0959-8138 AIM IM BMJ. 2004 May 15;328(7449):1172-3 15142923 Child Drug Prescriptions standards Drug Therapy, Computer-Assisted standards Humans Medication Errors prevention

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2004 BMJ : British Medical Journal

4468. Evaluation of Standardized Tasks for Primary Care Physicians Using the MOXXI Electronic Prescribing and Integrated Drug Management System (PubMed)

Evaluation of Standardized Tasks for Primary Care Physicians Using the MOXXI Electronic Prescribing and Integrated Drug Management System The Medical Office for the Twenty First Century (MOXXI) is a research project testing the potential benefits of an electronic prescription and drug management system for primary care physicians. This system includes a dynamic electronic pad for prescription entry with fields for treatment indications; a drug profiler with a graphic representation of the list (...) of prescription medications purchased in the last year; a refill compliance calculator; dates of emergency room visits and hospital admissions; cost of drugs dispensed; and an alert system that detects interactions among drugs, treatment duplications, and contraindications with certain allergies or specific diseases. One concern expressed by physicians that could influence uptake and acceptability is the increased time that may be required to use the system. User abilities are a factor in this process

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2003 AMIA Annual Symposium Proceedings

4469. Physicians and electronic health records: a statewide survey. (PubMed)

of 1345 physicians responded to the survey (71.4% response rate), and 387 (28.8%) reported that their practice had adopted EHRs. More than 80% of physicians with EHRs reported having the ability to view laboratory reports (84.8%) and document visits electronically (84.0%), but considerably fewer reported being able to order laboratory tests electronically (46.8%) or transmit prescriptions to a pharmacy electronically (44.7%). Fewer than half of the physicians who had systems with clinical decision (...) support, transmittal of electronic prescriptions, and radiology order entry actually used these functions most or all of the time. Compared with physicians who had not adopted EHRs, EHR users reported more positive views of the effects of computers on health care; there were no significant differences in these attitudes between high and low users of EHRs. Overall, about 1 in 4 physicians reported dissatisfaction with medical practice; there was no difference in this measure by EHR adoption

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2007 Archives of Internal Medicine

4470. Medication error in the care of HIV/AIDS patients: electronic surveillance, confirmation, and adverse events. (PubMed)

% for antiretroviral monotherapy. Incidence of confirmed errors was 9.80 errors per 1000 new prescriptions dispensed for incorrect dosing, 9.51 errors per 1000 for contraindicated medications, and <1.00 for all other categories. Adverse events associated with confirmed errors were observed only in the contraindicated medications error category. The likelihood of a contraindicated medications error was significantly increased among patients >or=50 years of age and decreased among black patients.Use of electronic (...) Medication error in the care of HIV/AIDS patients: electronic surveillance, confirmation, and adverse events. Medication error occurring during the care of HIV-infected patients may lead to treatment failure, drug toxicity, or even death.The objective of this study was to ascertain and confirm 5 categories of medication error in the care of HIV-infected patients.This study was a retrospective study to describe the occurrence of preventable medication error and to determine if adverse events

2005 Medical Care

4471. The impact of prescribing safety alerts for elderly persons in an electronic medical record: an interrupted time series evaluation. (PubMed)

The impact of prescribing safety alerts for elderly persons in an electronic medical record: an interrupted time series evaluation. Considerable effort and attention have focused on medication safety in elderly persons; one approach that has been understudied in the outpatient environment is the use of computerized provider order entry with clinical decision support. The objective of this study was to examine the effects of computerized provider order entry with clinical decision support (...) in elderly persons. The main outcome measure was dispensing per 10,000 members per month.Following the implementation of the drug-specific alerts, a large and persistent reduction (5.1 prescriptions per 10,000, P=.004), a 22% relative decrease from the month before alert implementation, in the exposure of elderly patients to nonpreferred medications was observed. We found no evidence of a decrease in use of nonpreferred agents for nonelderly patients. The reduction seen in use of nonpreferred agents

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2006 Archives of Internal Medicine

4472. Effects of an automated electronic reminder in changing the antiplatelet drug-prescribing behavior among Italian general practitioners in diabetic patients: an intervention trial. (PubMed)

Effects of an automated electronic reminder in changing the antiplatelet drug-prescribing behavior among Italian general practitioners in diabetic patients: an intervention trial. To evaluate whether an electronic reminder integrated into a routine computer system increases the use of antiplatelet drugs for diabetic patients among Italian general practitioners (GPs).A randomized controlled trial was carried out among 300 GPs and their patients selected from the Health Search Database. Among (...) these, 150 GPs (intervention group) received instructions to activate an electronic reminder plus a letter summarizing the beneficial effects of antiplatelet drugs in diabetic patients with at least one additional cardiovascular risk factor ("high risk"), whereas the other 150 GPs (control group) received only the letter. The electronic reminder, integrated into a standard software system for the management of the daily clinical practice, was displayed when every participating GP opened the medical

2003 Diabetes Care Controlled trial quality: uncertain

4473. A cluster randomized trial evaluating electronic prescribing in an ambulatory care setting. (PubMed)

to reduce prescription error. The trial was designed to overcome the limitations associated with traditional study design.This study was designed as a 65-week, cluster randomized, parallel study.The trial was conducted within ambulatory outpatient clinics in an academic tertiary care centre in Ontario, Canada. The electronic prescribing software for the study is a Canadian electronic prescribing software package which provides physician prescription entry with decision support at the point of care (...) . Using a handheld computer (PDA) the physician selects medications using an error minimising menu-based pick list from a comprehensive drug database, create specific prescription instructions and then transmit the prescription directly and electronically to a participating pharmacy via facsimile or to the physician's printer using local area wireless technology. The unit of allocation and randomization is by 'week', i.e. the system is "on" or "off" according to the randomization scheme and the unit

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2007 Trials Controlled trial quality: uncertain

4474. Evaluating Patient Information Prescriptions

general information in response to patient information needs; 3) Documentation of the questions and the information service provided in response to these in the patient's Electronic Patient Record for review by providers as needed; and, 4) Triage of patient's/parents clinical questions to providers. Other Name: Information prescriptions or IRx Outcome Measures Go to Primary Outcome Measures : Patient Satisfaction [ Time Frame: 4 years ] Secondary Outcome Measures : provider perceptions and behavior (...) Evaluating Patient Information Prescriptions Evaluating Patient Information Prescriptions - 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. Evaluating Patient Information Prescriptions The safety

2006 Clinical Trials

4475. Rates of retrieval of self-injectable epinephrine prescriptions: a descriptive report. (PubMed)

was a retrospective review of electronic medical records of patients prescribed SIE at a large military medical center in a 1-year period. Rates of prescription retrieval were determined, and patient demographic information was collected. Additional information recorded included the number of devices prescribed per prescription, the International Classification of Diseases, Ninth Revision, code associated with each prescription, and the ambulatory care setting associated with the patient encounter resulting (...) Rates of retrieval of self-injectable epinephrine prescriptions: a descriptive report. Some studies have demonstrated poor patient compliance with carrying and administering self-injectable epinephrine (SIE). No study has attempted to define the number or characteristics of patients who are prescribed SIE and subsequently do not retrieve the prescription.To determine fill rates of SIE prescriptions and to provide a descriptive report of patients who do not fill those prescriptions.This

2006 Asthma & Immunology

4476. Antibiotic prescription and cost patterns in a general intensive care unit (PubMed)

Antibiotic prescription and cost patterns in a general intensive care unit Antibiotic prescription habits, cost pattern, and the prospective intervention in an Intensive Care Unit were analyzed.Data on antibiotic utilization and costs were collected prospectively from individual electronic charts from August 2003 to January 2004, and retrospectively from August to December 2002.A total of 180 and 107 patients were surveyed in 2002 and 2003. In 2002, Piperacillin-Tazobactam (13.8%) and Imipenem (...) on promoting infectious control with rational antibiotic prescription aimed at minimizing the future emergence of bacterial resistance and futile expenses.

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2007 Pharmacy Practice

4477. Drug-Age Alerting for Outpatient Geriatric Prescriptions: A Joint Study using Interoperable Drug Standards (PubMed)

Drug-Age Alerting for Outpatient Geriatric Prescriptions: A Joint Study using Interoperable Drug Standards For more than a decade, the Beers criteria have identified specific medications that should generally be avoided in the geriatric population. Studies that have shown high prevalence rates of these potentially inappropriate medications have used disparate methodologies to identify these medications and hence are difficult to replicate and generalize. In an effort to improve prescribing (...) behavior, we are building a drug-age alerting system utilizing standard drug coding systems for use in our Electronic Health Record (EHR) systems.

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2005 AMIA Annual Symposium Proceedings

4478. Using Outpatient Prescription Claims to Evaluate Medication Adherence In An Acute Myocardial Infarction Population (PubMed)

Using Outpatient Prescription Claims to Evaluate Medication Adherence In An Acute Myocardial Infarction Population We have previously shown that using computerized alerts and academic detailing results in significant improvement in physician adherence to secondary prevention guidelines for acute myocardial infarction. However, information about patient medication adherence after hospital discharge was not previously available. Using electronic outpatient prescription claims data, medication

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2005 AMIA Annual Symposium Proceedings

4479. Adherence to black box warnings for prescription medications in outpatients. (PubMed)

Adherence to black box warnings for prescription medications in outpatients. Few data are available regarding the prevalence of potentially dangerous drug-drug, drug-laboratory, and drug-disease interactions among outpatients. Our objectives were to determine how frequently clinicians prescribe drugs in violation of black box warnings for these issues and to determine how frequently such prescribing results in harm.In an observational study of 51 outpatient practices using an electronic health (...) record, we measured the frequency with which patients received prescriptions in violation of black box warnings for drug-drug, drug-laboratory, and/or drug-disease interactions. We performed medical record reviews in a sample of patients to detect adverse drug events. Multivariate analysis was conducted to assess the relationship of prescribing in violation of black box warnings to patient and clinician characteristics, adjusting for potential confounders and clustering.Of 324 548 outpatients who

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2006 Archives of Internal Medicine

4480. Randomized controlled trial of an informatics-based intervention to increase statin prescription for secondary prevention of coronary disease. (PubMed)

Randomized controlled trial of an informatics-based intervention to increase statin prescription for secondary prevention of coronary disease. Suboptimal treatment of hyperlipidemia in patients with coronary artery disease (CAD) is well documented. We report the impact of a computer-assisted physician-directed intervention to improve secondary prevention of hyperlipidemia.Two hundred thirty-five patients under the care of 14 primary care physicians in an academically affiliated practice (...) with an electronic health record were enrolled in this proof-of-concept physician-blinded randomized, controlled trial. Each patient with CAD or risk equivalent above National Cholesterol Education Program-recommended low-density lipoprotein (LDL) treatment goal for greater than 6 months was randomized, stratified by physician and baseline LDL. Physicians received a single e-mail per intervention patient. E-mails were visit independent, provided decision support, and facilitated "one-click" order writing.The

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2006 Journal of General Internal Medicine Controlled trial quality: uncertain

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