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Electronic Prescription

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61. 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

62. 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

63. 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

64. 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

65. A new OPIATE (Optimizing Positive Ibuprofen and Acetaminophen Treatment Expectations) model: A brief comment on "Concurrent and lagged associations of prescription opioid use with pain and negative affect in the daily lives of chronic pain patients" (Carp (PubMed)

A new OPIATE (Optimizing Positive Ibuprofen and Acetaminophen Treatment Expectations) model: A brief comment on "Concurrent and lagged associations of prescription opioid use with pain and negative affect in the daily lives of chronic pain patients" (Carp This commentary expands upon the clinical implications arising from the Carpenter et al. (2019) negative reinforcement model of opioid use. A new model called OPIATE-which stands for Optimizing Positive Ibuprofen and Acetaminophen Treatment (...) and acetaminophen. These strategies are (a) altering defaults in electronic medical record systems; (b) highlighting appropriate descriptive social norms to patients; (c) improving the quality of interactions during discharges between patients and their physicians, nurses, and pharmacists; and (d) priming patients to have positive expectations regarding ibuprofen and acetaminophen involving careful selection of language to describe these medications.Instead of creating alternative pharmaceuticals, efforts

2019 Journal of Consulting and Clinical Psychology

66. 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

67. 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

68. Low-Value Proton Pump Inhibitor Prescriptions Among Older Adults at a Large Academic Health System. (PubMed)

currently prescribed any PPI using the electronic health record (EHR) medication list (current defined as September 1, 2018). A geriatrician, a gastroenterologist, a QI expert, and two primary care physicians (PCPs) created multidisciplinary PPI appropriateness criteria based on evidenced-based guidelines. Supervised by a gastroenterologist and PCP, two internal medicine residents conducted manual chart reviews in a random sample of 399 patients prescribed PPIs. We considered prescriptions potentially (...) Low-Value Proton Pump Inhibitor Prescriptions Among Older Adults at a Large Academic Health System. Older adults are particularly vulnerable to complications from proton pump inhibitor (PPI) drugs. We sought to characterize the prevalence of potentially low-value PPI prescriptions among older adults to inform a quality improvement (QI) intervention.We created a cohort of patients, aged 65 years or older, receiving primary care at a large academic health system in 2018. We identified patients

2019 Journal of the American Geriatrics Society

69. 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

70. Evaluating the implementation of RxNorm in ambulatory electronic prescriptions. (PubMed)

Evaluating the implementation of RxNorm in ambulatory electronic prescriptions. RxNorm is a standardized drug nomenclature maintained by the National Library of Medicine that has been recommended as an alternative to the National Drug Code (NDC) terminology for use in electronic prescribing. The objective of this study was to evaluate the implementation of RxNorm in ambulatory care electronic prescriptions (e-prescriptions).We analyzed a random sample of 49 997 e-prescriptions that were (...) received by 7391 locations of a national retail pharmacy chain during a single day in April 2014. The e-prescriptions in the sample were generated by 37 801 ambulatory care prescribers using 519 different e-prescribing software applications.We found that 97.9% of e-prescriptions in the study sample could be accurately represented by an RxNorm identifier. However, RxNorm identifiers were actually used as drug identifiers in only 16 433 (33.0%) e-prescriptions. Another 431 (2.5%) e-prescriptions

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2015 Journal of the American Medical Informatics Association

71. Electronic Prescription Data to Improve Primary Care Prescribing

Electronic Prescription Data to Improve Primary Care Prescribing Electronic Prescription Data to Improve Primary Care Prescribing - 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 Prescription Data (...) Research Official Title: Electronic Prescription Data to Improve Primary Care Prescribing Study Start Date : July 2015 Actual Primary Completion Date : January 2017 Actual Study Completion Date : July 1, 2017 Arms and Interventions Go to Arm Intervention/treatment Experimental: Bronchodilators Prescription Data Feedback to GP Practices - practices will be fed back data for people with presumed asthma who have either been dispensed more than 12 short-acting beta-agonist bronchodilators in the last 12

2015 Clinical Trials

72. The effects of introducing an electronic prescription system with no copayments (PubMed)

The effects of introducing an electronic prescription system with no copayments To examine the impact of introducing an electronic prescription system with no copayments on the number of prescriptions, the size of prescriptions, and the number of visits and phone calls to primary physicians.Fixed regression models using monthly data on per capita prescriptions claims and consultations between 2009 and 2013 at the municipality level, before and after the introduction of the electronic (...) prescription system.The electronic prescription system with no copayment increased the number of prescriptions by between 6.0 and 8.1 %. It decreased the average size of each prescription, but it did not decrease the number of consultations.The reduced direct and indirect costs of obtaining prescriptions after the introduction of the electronic prescription system changed the financial incentives facing the patients and physicians. This led to significant changes in the level and size of prescriptions

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2015 Health economics review

73. Prescription Errors Before and After Introduction of Electronic Medication Alert System in a Pediatric Emergency Department. (PubMed)

Prescription Errors Before and After Introduction of Electronic Medication Alert System in a Pediatric Emergency Department. Prescription errors occur frequently in pediatric emergency departments (PEDs).The effect of computerized physician order entry (CPOE) with electronic medication alert system (EMAS) on these is unknown. The objective was to compare prescription errors rates before and after introduction of CPOE with EMAS in a PED. The hypothesis was that CPOE with EMAS would significantly (...) reduce the rate and severity of prescription errors in the PED.A prospective comparison of a sample of outpatient, medication prescriptions 5 months before and after CPOE with EMAS implementation (7,268 before and 7,292 after) was performed. Error types and rates, alert types and significance, and physician response were noted. Medication errors were deemed significant if there was a potential to cause life-threatening injury, failure of therapy, or an adverse drug effect.There was a significant

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2015 Academic Emergency Medicine

74. Merging Electronic Health Record Data and Genomics for Cardiovascular Research

available in the EHR) and in the posttest state (a high-risk genetic test result is already in the EHR). In the future, interoperability of EHRs could allow genetic test results to be available at all relevant points of care, including dispensing pharmacies and outpatient clinics ( ). Figure. Current and future approaches to filling prescriptions. Genetic test results obtained from electronic health records (EHRs) could guide diagnosis and suggest drug dosages. Preemptive testing has the advantage (...) Merging Electronic Health Record Data and Genomics for Cardiovascular Research Merging Electronic Health Record Data and Genomics for Cardiovascular Research | Circulation: Cardiovascular Genetics Search Hello Guest! Login to your account Email Password Keep me logged in Search February 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article Merging Electronic Health Record Data

2016 American Heart Association

75. The Challenges of Electronic Health Records and Diabetes Electronic Prescribing: Implications for Safety Net Care for Diverse Populations (PubMed)

for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1) the adoption of RxNorm; (2) standardized naming and picklist options for high alert medications such as insulin; (3) the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4) enhanced bidirectional (...) The Challenges of Electronic Health Records and Diabetes Electronic Prescribing: Implications for Safety Net Care for Diverse Populations Widespread electronic health record (EHR) implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care

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2017 Journal of diabetes research

76. 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

77. 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

78. Meeting user needs in national healthcare systems: lessons from early adopter community pharmacists using the electronic prescriptions service. (PubMed)

Meeting user needs in national healthcare systems: lessons from early adopter community pharmacists using the electronic prescriptions service. The Electronic Prescription Service release Two (EPS2) is a new national healthcare information and communication technology in England that aims to deliver effective prescription writing, dispensing and reimbursement service to benefit patients. The aim of the study was to explore initial user experiences of Community Pharmacists (CPs) using EPS2.We (...) conducted nonparticipant observations and interviews in eight EPS2 early adopter community pharmacies classified as 'first-of-type' in midlands and northern regions in England. We interviewed eight pharmacists and two dispensers in addition to 56 hours recorded nonparticipant observations as field notes. Line-by-line coding and thematic analysis was conducted on the interview transcripts and field notes.CPs faced two types of challenge. The first was to do with missing electronic prescriptions

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2014 Medical Informatics and Decision Making

79. Evaluation of a mobile electronic assistant to aid in fluindione prescription: The INRPlus cluster randomized trial. (PubMed)

Evaluation of a mobile electronic assistant to aid in fluindione prescription: The INRPlus cluster randomized trial. Regular monitoring of the international normalized ratio (INR) is crucial for dose adjustment of vitamin K antagonists (VKA) to maximize time in therapeutic range (TTR). We compared the use of a mobile electronic assistant INRPlus which proposes patient-specific fluindione doses, to standard fluindione management in a cluster randomized controlled study.Twenty clusters of six (...) % of non-compliant patients and 67.1% of reference patients.In this trial, the use of the INRPlus electronic assistant resulted in a non-significant improvement in TTR that may be due to a higher than expected TTR in the control group.Copyright © 2014 Elsevier Ltd. All rights reserved.

2014 Thrombosis research

80. Electronic Algorithms Based on Host Biomarkers Point of Care Tests to Decide on Admission and Antibiotic Prescription in Tanzanian Febrile Children

Electronic Algorithms Based on Host Biomarkers Point of Care Tests to Decide on Admission and Antibiotic Prescription in Tanzanian Febrile Children Electronic Algorithms Based on Host Biomarkers to Manage Febrile Children - 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 (...) and Antibiotic Prescription in Tanzanian Febrile Children Study Start Date : December 2014 Actual Primary Completion Date : February 2016 Actual Study Completion Date : February 2016 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Experimental: e-POCT Febrile children managed using the e-POCT tool. The e-POCT tool is an electronic algorithm that integrates key clinical elements with the results of malaria and host biomarkers

2014 Clinical Trials

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