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61. Standardizing Dose Prescriptions: An ASTRO White Paper

. Summary and future directions In this white paper, a recommendation is made for the keyelementsofaradiationtherapyprescriptionalongwith a standardized manner for how these elements are to be presented. It is our hope that the suggested formalism for the key elements of the prescription be used in all areas where this same information is displayed: in weekly management notes, completion/summary notes, patient care plans, and hospital electronic medical records systems.Inthismanner (...) Standardizing Dose Prescriptions: An ASTRO White Paper Special Article Standardizing dose prescriptions: An ASTRO white paper Suzanne B. Evans MD, MPH a, ? , Benedick A. Fraass PhD b , Paula Berner CMD, FAAMD c , Kevin S. Collins PhD, RT(R)(T), CMD d , Teamour Nurushev PhD e , Michael J. O’Neill MD f , Jing Zeng MD g , Lawrence B. Marks MD h a Department of Radiation Oncology, Yale University, New Haven, Connecticut b Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles

2016 American Society for Radiation Oncology

62. A survey of perceptions and attitudes about direct-to-consumer advertising of prescription drugs among college students in South Korea. (PubMed)

by the Korean government, and prescription drugs should not be advertised through the Internet. It is recommended that the Korean government cautiously examine whether DTCA of prescription drugs should be permitted, after considering the current marketing strategies of pharmaceutical companies on the Internet and the effects of online electronic-DTCA on Korean consumers. (...) A survey of perceptions and attitudes about direct-to-consumer advertising of prescription drugs among college students in South Korea. Direct-to-consumer advertising (DTCA) of prescription drugs can be both beneficial and harmful to healthcare consumers. Therefore, DTCA for prescription drugs is a topic that should be considered crucially, at this point, when the interests of patients as well as pharmaceutical companies in DTCA of prescription drugs are growing in South Korea. The goals

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2018 PLoS ONE

63. Perceptions among Alberta Healthcare Professionals of Prescription Drug Misuse

Perceptions among Alberta Healthcare Professionals of Prescription Drug Misuse www.ccsa.ca • www.cclt.ca Perceptions among Alberta Healthcare Professionals of Prescription Drug Misuse Final Report April 2015 Amy J. Porath-Waller, Ph.D. Senior Research and Policy Analyst, Canadian Centre on Substance Abuse Jonathan E. Brown, Ph.D. Applied Solutions and Consulting Aarin P. Frigon, M.A., CHRP Applied Solutions and Consulting Perceptions among Alberta Healthcare Professionals of Prescription Drug (...) Misuse Final Report This document was published by the Canadian Centre on Substance Abuse (CCSA). Suggested citation: Porath-Waller, A., Brown, J., & Frigon, A. (2015). Perceptions among Alberta healthcare professionals of prescription drug misuse. Ottawa, ON: Canadian Centre on Substance Abuse. © Canadian Centre on Substance Abuse, 2015. CCSA, 500–75 Albert Street Ottawa, ON K1P 5E7 Tel.: 613-235-4048 Email: info@ccsa.ca Production of this document has been made possible through a financial

2015 Canadian Centre on Substance Abuse

64. Prescription Monitoring Programs in Canada: Best Practice and Program Review

for the Electronic Recording and Reporting of Controlled Drugs (Nicholas, 2013). These programs are quite varied in their administration and scope, but all are designed to exert controls on the prescription of products with pharmacological properties that can lead to misuse and addiction. The purposes of PMPs have been articulated in many ways, but the common themes are: • To enhance patient care and assist in the safe use of controlled prescription drugs by monitoring outpatient prescription dispensing (...) focused on the use of multiple copy prescription pads. These programs require that prescribers use special paper prescription pads to produce a valid prescription. This requirement is still in place in several jurisdictions, with or without electronic submissions. Each paper prescription has two or three copies, where in addition to the pharmacy copy, another copy might stay with the prescriber or be submitted to the PMP for tracking purposes. In addition to tracking prescription information

2015 Canadian Centre on Substance Abuse

65. Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial. (PubMed)

electronically, supported by a local practice champion nominated for the trial.Primary outcome was the rate of antibiotic prescriptions for respiratory tract infections from electronic health records. Serious bacterial complications were evaluated for safety. Analysis was by Poisson regression with general practice as a random effect, adjusting for covariates. Prespecified subgroup analyses by age group were reported.The trial included 41 AMS practices (323 155 patient years) and 38 usual care practices (259 (...) Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial. To evaluate the effectiveness and safety at population scale of electronically delivered prescribing feedback and decision support interventions at reducing antibiotic prescribing for self limiting respiratory tract infections.Open label, two arm, cluster randomised controlled trial.UK general practices

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2019 BMJ Controlled trial quality: predicted high

66. Zolpidem in comatose patients: Prescriptions on clinical practice and time for a new randomized clinical trial. (PubMed)

Zolpidem in comatose patients: Prescriptions on clinical practice and time for a new randomized clinical trial. 30682515 2019 01 25 1878-8769 2019 Jan 22 World neurosurgery World Neurosurg Zolpidem in comatose patients: Prescriptions on clinical practice and time for a new randomized clinical trial. S1878-8750(19)30146-9 10.1016/j.wneu.2019.01.049 Welling Leonardo C LC Neurological Surgery Department. State University of Ponta Grossa. Brazil. Welling Mariana S MS Neurology Department. State (...) University of Ponta Grossa. Brazil. Figueiredo Eberval G EG Neurological Surgery Department. University of Sao Paulo. Brazil. Electronic address: ebgadelha@yahoo.com. eng Journal Article 2019 01 22 United States World Neurosurg 101528275 1878-8750 2019 1 26 6 0 2019 1 27 6 0 2019 1 27 6 0 aheadofprint 30682515 S1878-8750(19)30146-9 10.1016/j.wneu.2019.01.049

2019 World neurosurgery Controlled trial quality: uncertain

67. Practice Variation in Anticoagulation Prescription and Outcomes after Device-Detected Atrial Fibrillation: Insights from the Veterans Health Administration. (PubMed)

variation in OAC prescription. We used multivariable Cox proportional hazards regressions to determine the association of OAC prescription with stroke by device-detected AF burden.Among 10 212 patients with cardiac implantable electronic devices, 4570 (45%), 3969 (39%), 3263 (32%), and 2469 (24%) had device-detected AF >6 minutes, >1 hour, >6 hours, and >24 hours, respectively. For device-detected AF >1 hour, 1712 patients met inclusion criteria (72±10 years; 1.5% female; CHA2DS2-VASc score 4.0±1.4; HAS (...) Practice Variation in Anticoagulation Prescription and Outcomes after Device-Detected Atrial Fibrillation: Insights from the Veterans Health Administration. Device-detected atrial fibrillation (AF) is associated with increased risk of stroke; however, there are no clearly defined thresholds of AF burden at which to initiate oral anticoagulation (OAC). We sought to describe OAC prescription practice variation in response to new device-detected AF and the association with outcomes.We performed

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2019 Circulation

68. Long-term assessment of NSAID prescriptions and potential nephrotoxicity risk in adult kidney transplant recipients. (PubMed)

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

69. Identifying Factors That Predict the Prescription of Non-vitamin K Antagonist Oral Anticoagulants in Older Individuals With Atrial Fibrillation. (PubMed)

Identifying Factors That Predict the Prescription of Non-vitamin K Antagonist Oral Anticoagulants in Older Individuals With Atrial Fibrillation. Factors that influence decision of non-vitamin K antagonist oral anticoagulants (NOACs) use among older atrial fibrillation (AF) patients in long-term care (LTC) facilities have not been well studied. The aim of this study was to assess whether increased frailty influenced physicians to prescribe NOACs over warfarin.We retrospectively reviewed (...) the electronic medical record (EMR) and pharmacy data of 25 LTC facilities in Ontario, Canada, in May 2015. The diagnosis of AF was ascertained from EMR and confirmed by complete chart review of a random sample of the cohort. A score of ≥2 on the Changes in Health, End-stage disease, Signs, and Symptoms (CHESS) scale was used as a surrogate marker of frailty.Multivariable logistic regression model was used to assess whether a higher frailty score is associated with the use of NOACs in comparison to warfarin

2019 Journal of the American Medical Directors Association

70. Examining the effect of prescription sequence on developing adverse drug reactions: The case of renal failure in diabetic patients. (PubMed)

emergent sequential pattern mining techniques to electronic health records.Using longitudinal medication and diagnosis records from more than 377,000 diabetic patients, in this study, we assessed the possible effect of prescription sequences in developing acute renal failure as a prevalent ADR among this group of patients. Relying on emergent sequential pattern mining, two statistical case-control approaches were designed and employed for this purpose.The results taken from the two employed approaches (...) Examining the effect of prescription sequence on developing adverse drug reactions: The case of renal failure in diabetic patients. While the effect of medications in development of Adverse Drug Reactions (ADRs) have been widely studied in the past, the literature lacks sufficient coverage in investigating whether the sequence in which [ADR-prone] drugs are prescribed (and administered) can increase the chances of ADR development. The present study investigates this potential effect by applying

2019 International journal of medical informatics

71. Intervention to reduce benzodiazepine prescriptions in primary care, study protocol of a hybrid type 1 cluster randomised controlled trial: the BENZORED study. (PubMed)

prescription and BZD deprescribing, monthly feedback about their BZD prescribing practices and access to a support web page. Outcome measures for each GP are the defined daily dosage per 1000 inhabitants per day and the proportion of long-term BZD users at 12 months. Data will be collected from the electronic prescription database of the public health system, and will be subjected to intention-to-treat analysis. Implementation will be evaluated by mixed methods following the five domains (...) Intervention to reduce benzodiazepine prescriptions in primary care, study protocol of a hybrid type 1 cluster randomised controlled trial: the BENZORED study. Benzodiazepines (BZDs) are mainly used to treat anxiety and sleep disorders, and are often prescribed for long durations, even though prescription guidelines recommend short-term use due to the risk of dependence, cognitive impairment, and falls and fractures. Education of general practitioners (GPs) regarding the prescription of BZDs

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2019 BMJ open Controlled trial quality: uncertain

72. Continued Statin Prescriptions After Adverse Reactions and Patient Outcomes: A Cohort Study. (PubMed)

Continued Statin Prescriptions After Adverse Reactions and Patient Outcomes: A Cohort Study. Many patients discontinue statin treatment, often after having a possible adverse reaction. The risks and benefits of continued statin therapy after an adverse reaction are not known.To examine the relationship between continuation of statin therapy (any prescription within 12 months after an adverse reaction) and clinical outcomes.Retrospective cohort study.Primary care practices affiliated with 2 (...) academic medical centers.Patients with a presumed adverse reaction to a statin between 2000 and 2011.Information on adverse reactions to statins was obtained from structured electronic medical record data or natural-language processing of narrative provider notes. The primary composite outcome was time to a cardiovascular event (myocardial infarction or stroke) or death.Most (81%) of the adverse reactions to statins were identified from the text of electronic provider notes. Among 28 266 study patients

2017 Annals of Internal Medicine

73. Preoperative Exposure to Benzodiazepines or Sedative/hypnotics Increases the Risk of Greater Filled Opioid Prescriptions After Surgery. (PubMed)

of opioids, benzodiazepines, and sedative/hypnotics filled 6 months before and after the procedure. Patients were grouped into exposed or naïve cohorts depending on whether a prescription was filled 6 months before surgery. Smoking history (current or previous smoking was considered positive) and a history of mood and pain disorders (as noted in the medical history), were collected from the outpatient and the operating room electronic medical record.After controlling for age, gender, and other (...) Preoperative Exposure to Benzodiazepines or Sedative/hypnotics Increases the Risk of Greater Filled Opioid Prescriptions After Surgery. The effect of the preoperative exposure to controlled substances such as benzodiazepines and sedative/hypnotics on prolonged opioid consumption after hand surgery is not known.(1) Is preoperative exposure to benzodiazepines and sedative/hypnotics associated with greater numbers of filled postoperative opioid prescriptions after hand surgery? (2) Is a positive

2019 Clinical Orthopaedics and Related Research

74. Prescription patterns of lipid lowering agents among older patients in general practice: an analysis from a national database in the Netherlands. (PubMed)

of 244,328 adults ≥70 years from electronic health records of 415 Dutch general practices from 2011-15 were used. Number of LLD prescriptions in patients with (n = 55,309) and without (n = 189,019) cardiovascular disease (CVD) was evaluated according to age, frailty and comorbidities.about 69% of adults ≥70 years with CVD and 36% without CVD were prescribed a LLD. LLD prescriptions decreased with age; with CVD: 78% aged 70-74 years and 29% aged ≥90 years were prescribed a LLD, without CVD: 37% aged 70-74 (...) Prescription patterns of lipid lowering agents among older patients in general practice: an analysis from a national database in the Netherlands. Dutch cardiovascular risk management guidelines state almost every older adult (≥70 years) is eligible for a lipid lowering drug (LLD). However, life expectancy, frailty or comorbidities may influence this treatment decision.investigate how many older adults, according to age, frailty (Drubbel-frailty index) and comorbidities were prescribed LLDs.data

2019 Age and ageing

75. The utility of a statewide prescription drug-monitoring database vs the Current Opioid Misuse Measure for identifying drug-aberrant behaviors in emergency department patients already on opioids. (PubMed)

The utility of a statewide prescription drug-monitoring database vs the Current Opioid Misuse Measure for identifying drug-aberrant behaviors in emergency department patients already on opioids. The most recent guidelines on prescribing opioids from the United States Centers for Disease Control recommend that clinicians not prescribe opioids as first-line therapy for chronic non-cancer pain. If an opioid prescription is considered for a patient already on opioids, prescribers are encouraged (...) to check the statewide prescription drug monitoring database (PDMP). Some additional guidelines recommend screening tools such as the Current Opioid Misuse Measure (COMM) which may also help identify drug-aberrant behaviors.To compare the PDMP and the Current Opioid Misuse Measure (COMM), a commonly-recommended screening tool for patients on opioids, in detecting drug-aberrant behaviors in patients already taking opioids at the time of ED presentation.Patients on opioids were enrolled prospectively

2019 American Journal of Emergency Medicine

76. Development of Machine Learning Algorithms for Prediction of Sustained Postoperative Opioid Prescriptions After Total Hip Arthroplasty. (PubMed)

Development of Machine Learning Algorithms for Prediction of Sustained Postoperative Opioid Prescriptions After Total Hip Arthroplasty. Postoperative recovery after total hip arthroplasty (THA) can lead to the development of prolonged opioid use but there are few tools for predicting this adverse outcome. The purpose of this study is to develop machine learning algorithms for preoperative prediction of prolonged opioid prescriptions after THA.A retrospective review of electronic health records (...) was conducted at 2 academic medical centers and 3 community hospitals to identify adult patients who underwent THA for osteoarthritis between January 1, 2000 and August 1, 2018. Prolonged postoperative opioid prescriptions were defined as continuous opioid prescriptions after surgery to at least 90 days after surgery. Five machine learning algorithms were developed to predict this outcome and were assessed by discrimination, calibration, and decision curve analysis.Overall, 5507 patients underwent THA

2019 Journal of Arthroplasty

77. Correlates of Nonmedical Prescription Opioid Use Among U.S. Adolescents. (PubMed)

opioid use. Nonmedical prescription opioid use was 1.5 times more likely among electronic vapor users (AOR=1.58, 95% CI=1.34, 1.86), 2 times more likely among cigarette (AOR=2.49, 95% CI=2.16, 2.88) and marijuana users (AOR=2.45, 95% CI=2.05, 2.93), and almost 3 times as likely among alcohol users (AOR=2.98, 95% CI=2.18, 4.07).Study findings suggest a need for more interventions for nonmedical prescription opioid use among adolescents in the U.S. Information on nonmedical prescription opioid use (...) Correlates of Nonmedical Prescription Opioid Use Among U.S. Adolescents. The purpose of this study is to assess risk factors, including other substance use, for nonmedical prescription opioid use among U.S. adolescents.A secondary data analysis of the 2017 Youth Risk Behavior Survey was conducted (n=10,175) in 2018. The outcome was nonmedical prescription opioid use. Predictor variables included other substance use, mood, sleep, academic performance, and demographic characteristics. Survey

2019 American journal of preventive medicine

78. Reducing drug prescription errors and adverse drug events by application of a probabilistic, machine-learning based clinical decision support system in an inpatient setting. (PubMed)

usefulness of medication error alerts generated by a novel system using outlier detection screening algorithms, used on top of a legacy standard system, in a real-life inpatient setting.We integrated a novel outlier system into an existing electronic medical record system, in a single medical ward in a tertiary medical center. The system monitored all drug prescriptions written during 16 months. The department's staff assessed all alerts for accuracy, clinical validity, and usefulness. We recorded all (...) Reducing drug prescription errors and adverse drug events by application of a probabilistic, machine-learning based clinical decision support system in an inpatient setting. Drug prescription errors are made, worldwide, on a daily basis, resulting in a high burden of morbidity and mortality. Existing rule-based systems for prevention of such errors are unsuccessful and associated with substantial burden of false alerts.In this prospective study, we evaluated the accuracy, validity, and clinical

2019 Journal of the American Medical Informatics Association

79. Has a Prescription-limiting Law in Rhode Island Helped to Reduce Opioid Use After Total Joint Arthroplasty? (PubMed)

Has a Prescription-limiting Law in Rhode Island Helped to Reduce Opioid Use After Total Joint Arthroplasty? In the United States, since 2016, at least 28 of 50 state legislatures have passed laws regarding mandatory prescribing limits for opioid medications. One of the earliest state laws (which was passed in Rhode Island in 2016) restricted the maximum morphine milligram equivalents provided in the first postoperative prescription for patients defined as opioid-naïve to 30 morphine milligram (...) equivalents per day, 150 total morphine milligram equivalents, or 20 total doses. While such regulations are increasingly common in the United States, their effects on opioid use after total joint arthroplasty are unclear.(1) Are legislative limitations to opioid prescriptions in Rhode Island associated with decreased opioid use in the immediate (first outpatient prescription postoperatively), 30-day, and 90-day periods after THA and TKA? (2) Is this law associated with similar changes in postoperative

2019 Clinical Orthopaedics and Related Research

80. Demand for health services and drug prescriptions among overweight or obese preschool children. (PubMed)

Demand for health services and drug prescriptions among overweight or obese preschool children. To evaluate the association between excess weight and the demand of health services in preschool children compared with healthy weight.The data come from the Longitudinal Study of Childhood Obesity cohort (1884 4-year-old children, residing in the Madrid region, Spain) who provided information through telephone questionnaire, physical examination and electronic medical records. We defined overweight (...) , general and abdominal obesity based on body mass index, waist circumference and waist-to-height ratio. Using mixed models of multivariable negative binomial regression we calculated the incidence rate ratio (IRR) regarding primary care (PC) doctor visits, drug prescriptions and hospital admissions by weight status at the end of the 2-year follow-up.Childhood general obesity was associated with a higher demand for PC services related to psychological problems (IRR=1.53; 95% CI 1.02 to 2.28

2019 Archives of Disease in Childhood

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