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Electronic Prescription

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61. 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

62. 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

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. 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

65. Towards creating the perfect electronic prescription. (PubMed)

Towards creating the perfect electronic prescription. Significant strides have been made in electronic (e)-prescribing standards and software applications that have further fueled the adoption and use of e-prescribing. However, for e-prescribing to realize its full potential for improving the safety, effectiveness, and efficiency of prescription drug delivery, important work remains to be carried out. This perspective describes the ultimate goal of all e-prescribing stakeholders including (...) prescribers and dispensing pharmacists: a clear, complete, and unambiguous e-prescription order that can be seamlessly received, processed, and fulfilled at the dispensing pharmacy without the need for additional clarification from the prescriber. We discuss the challenges to creating the perfect e-prescription by focusing on selected data segments and data fields that are available in the new e-prescription transaction as defined in the NCPDP SCRIPT Standard and suggest steps that could be taken to move

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2014 Journal of the American Medical Informatics Association

66. Evaluation of electronic prescription implementation in polymedicated users of Catalonia, Spain: a population-based longitudinal study. (PubMed)

Evaluation of electronic prescription implementation in polymedicated users of Catalonia, Spain: a population-based longitudinal study. To assess whether electronic prescribing is a comprehensive health management tool that may contribute to rational drug use, particularly in polymedicated patients receiving 16 or more medications in the public healthcare system in the Barcelona Health Region (BHR).16 months of retrospective study followed by 12 months of prospective monitoring.Primary (...) healthcare in BHR, Catalonia, Spain.All insured patients, especially those who are polymedicated in six basic health areas (BHA). Polymedicated patients were those with a consumption of ≥16 drugs/month.Monitoring demographic and consumption variables obtained from the records of prescriptions dispensed in pharmacies and charged to the public health system, as well as the resulting drug use indicators. Territorial variables related to implementation of electronic prescribing were also described and were

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2014 BMJ open

67. Assessment of legibility and completeness of handwritten and electronic prescriptions (PubMed)

Assessment of legibility and completeness of handwritten and electronic prescriptions To assess the legibility and completeness of handwritten prescriptions and compare with electronic prescription system for medication errors.Prospective study.King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia.Handwritten prescriptions were received from clinical units of Medicine Outpatient Department (MOPD), Primary Care Clinic (PCC) and Surgery Outpatient Department (SOPD) whereas electronic (...) prescriptions were collected from the pediatric ward. The handwritten prescription was assessed for completeness by the checklist designed according to the hospital prescription and evaluated for legibility by two pharmacists. The comparison between handwritten and electronic prescription errors was evaluated based on the validated checklist adopted from previous studies.Legibility and completeness of prescriptions.398 prescriptions (199 handwritten and 199 e-prescriptions) were assessed. About 71 (35.7

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2014 Saudi Pharmaceutical Journal : SPJ

68. 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

69. 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

70. Identification of patients with hemoglobin SS/Sβ0 thalassemia disease and pain crises within electronic health records (PubMed)

Identification of patients with hemoglobin SS/Sβ0 thalassemia disease and pain crises within electronic health records Electronic health records (EHRs) are a source of big data that provide opportunities for conducting population-based studies and creating learning health systems, especially for rare conditions such as sickle cell disease (SCD). The objective of our study is to validate algorithms for accurate identification of patients with hemoglobin (Hb) SS/Sβ0 thalassemia and acute care (...) encounters for pain among SCD patients within EHR warehouse. We used data for children receiving care at Children's Hospital of Wisconsin from 2013 to 2016 to test the accuracy of the 2 algorithms. The algorithm for genotype identification used composite information (blood test results, transcranial Doppler) along with diagnoses codes. Acute pain encounters were identified using diagnoses codes and further refined by using prescription of IV pain medications. Sensitivities and specificities were

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2018 Blood advances

71. Improving the Affordability of Prescription Medications for People with Chronic Respiratory Disease. An Official American Thoracic Society Policy Statement. (PubMed)

Improving the Affordability of Prescription Medications for People with Chronic Respiratory Disease. An Official American Thoracic Society Policy Statement. Mounting evidence indicates that out-of-pocket costs for prescription medications, particularly among low- and middle-income patients with chronic diseases, are imposing financial burden, reducing medication adherence, and worsening health outcomes. This problem is exacerbated by a paucity of generic alternatives for prevalent lung diseases (...) , such as asthma and chronic obstructive pulmonary disease, as well as high-cost medicines for rare diseases, such as cystic fibrosis. Affordability and access challenges are especially salient in the United States, as citizens of many other countries pay lower prices for and have greater access to prescription medications.The American Thoracic Society convened a multidisciplinary committee comprising experts in health policy pharmacoeconomics, behavioral sciences, and clinical care, along with individuals

2018 American Journal of Respiratory and Critical Care Medicine

72. Effects of Psychosocial Interventions for Behavioral and Psychological Symptoms in Dementia on the Prescription of Psychotropic Drugs: A Systematic Review and Meta-Analyses. (PubMed)

to reduce psychotropic drug use.To assess the effect of multidisciplinary psychosocial interventions in nursing homes on the psychotropic drug prescription rate.Literature obtained from searches in 9 electronic databases was systematically reviewed. In addition, the pooled effects of specific psychosocial interventions in homogenous subgroups were analyzed (meta-analysis).Eleven randomized controlled studies that investigated multiple psychotropic drugs interventions (psychotropic drugs in 3 (...) Effects of Psychosocial Interventions for Behavioral and Psychological Symptoms in Dementia on the Prescription of Psychotropic Drugs: A Systematic Review and Meta-Analyses. Dementia is often accompanied by neuropsychiatric symptoms. Psychotropic drugs for the treatment of neuropsychiatric symptoms are frequently used to manage these problems, but they are of limited effectiveness and can have serious side effects. Psychosocial interventions are advocated as first line treatment and may help

2018 Journal of the American Medical Directors Association

73. Systemic fluoroquinolone prescriptions for hospitalized children in Belgium, results of a multicenter retrospective drug utilization study. (PubMed)

electronic medical files, the study included all children who received a systemic FQ prescription in two Belgian university children's hospitals between 2010 and 2013. Two authors reviewed prescribed daily doses. Univariate and multivariate logistic regression models were used to analyze risk factors for inadequately dosing. Results262 FQ prescriptions for individual patients were included for analysis. 16.8% of these prescriptions were for labeled indications, and 35.1% were guided by bacteriological (...) Systemic fluoroquinolone prescriptions for hospitalized children in Belgium, results of a multicenter retrospective drug utilization study. Fluoroquinolones (FQ) are increasingly prescribed for children, despite being labeled for only a limited number of labeled pediatric indications. In this multicenter retrospective drug utilization study, we analyzed indications for systemic FQ prescriptions in hospitalized children and the appropriateness of the prescribed dose.Using data obtained from

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2018 BMC Infectious Diseases

74. Assessment of Emergency Department Antibiotic Discharge Prescription Dosing Errors for Pediatric Patients in a Community Hospital Health System. (PubMed)

for an oral antibiotic were included in error analysis if they had a weight updated in the electronic medical record during the encounter. We used a predefined threshold of +10% variance from the recommended dose to quantify error. Prescriber, environmental, and antibiotic specific data were also collected to identify variables associated with high incidence of error.Among the 1934 prescriptions included in our error analysis, we detected 776 (40%) dosing errors. Of the prescriptions reviewed, 288 (15 (...) Assessment of Emergency Department Antibiotic Discharge Prescription Dosing Errors for Pediatric Patients in a Community Hospital Health System. We quantify and describe emergency department antibiotic discharge prescription dosing errors for pediatric patients in a community hospital health system.This was a retrospective chart review evaluating emergency department discharge prescriptions written between July 1, 2014, and June 30, 2015. Pediatric patients who received a prescription

2018 Pediatric Emergency Care

75. Treatment outcomes in patients with opioid use disorder initiated by prescription: a systematic review protocol. (PubMed)

from young males using heroin to a greater number of older people and women using prescription opioids. The primary objective of this review is to examine the literature on the association between the first exposure to opioids through prescription versus illicit use and OST treatment outcomes.An electronic search will be conducted on the EMBASE, MEDLINE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Two independent reviewers will conduct the initial (...) Treatment outcomes in patients with opioid use disorder initiated by prescription: a systematic review protocol. In North America, opioid use has become a public health crisis with policy makers declaring it a state of emergency. Opioid substitution therapy (OST) is a harm-reduction method used in treating opioid use disorder. While OST has shown to be successful in improving treatment outcomes, there is still a great degree of variability among patients. This cohort of patients has shifted

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2018 Systematic reviews

76. A Prescription for Note Bloat: An Effective Progress Note Template. (PubMed)

A Prescription for Note Bloat: An Effective Progress Note Template. United States hospitals have widely adopted electronic health records (EHRs). Despite the potential for EHRs to increase efficiency, there is concern that documentation quality has suffered.To examine the impact of an educational session bundled with a progress note template on note quality, length, and timeliness.A multicenter, nonrandomized prospective trial.Four academic hospitals across the United States.Intern physicians

2018 Journal of Hospital Medicine

77. Physician Time Burden Associated with Querying Prescription Drug Monitoring Programs. (PubMed)

Physician Time Burden Associated with Querying Prescription Drug Monitoring Programs. Prescription drug monitoring programs (PDMPs) enable prescribers to review patient prescription histories, and their use is mandatory in many states. We estimated the cost of physicians retrieving PDMP patient reports compared with a model where a delegate (i.e., administrative staff) retrieves reports.We performed a cost analysis with a one-year time horizon, from the perspective of physicians' employers. We (...) obtained specialty-specific estimates of controlled substance prescribing frequency from the National Ambulatory Medical Care Survey, 2012-2014. We defined three PDMP usage cases based on the frequency of queries: comprehensive (before every Schedule II-IV controlled substance prescription), selective (before new Schedule II-IV prescriptions and every six months for continuing medications), and minimal (before new Schedule II or III prescriptions and annually for continuing medications).The delegate

2018 Pain Medicine

78. Impact of acute otitis media clinical practice guidelines on antibiotic and analgesic prescriptions: a systematic review. (PubMed)

and after guideline introduction. All studies had an observational design, using longitudinal data of children aged under 15 years (n=200-4.6 million) from either routine care, insurance databases or electronic surveys. Risk of bias of all studies was judged serious to critical.Of the five studies reporting on antibiotic prescription rates, three showed a decline of 5%-12% up to 3 years after guideline introduction and two found no or negligible effect. In one US study, the initial 9% decline decreased (...) Impact of acute otitis media clinical practice guidelines on antibiotic and analgesic prescriptions: a systematic review. Clinical practice guidelines focusing on judicious use of antibiotics for childhood acute otitis media (AOM) have been introduced in many countries around the world.To systematically review the effects of these guidelines on the prescription of antibiotics and analgesics for children with AOM.Systematic searches of PubMed, Embase and Cochrane Library from inception to 6 June

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2018 Archives of Disease in Childhood

79. Prescription of high-risk medications among patients with chronic kidney disease: a cross-sectional study from the Washington, Wyoming, Alaska, Montana and Idaho region Practice and Research Network. (PubMed)

Prescription of high-risk medications among patients with chronic kidney disease: a cross-sectional study from the Washington, Wyoming, Alaska, Montana and Idaho region Practice and Research Network. Patients with chronic kidney disease (CKD) are at high risk for adverse drug events related to medication dosing errors and prescriptions for relatively contraindicated medications, such as non-steroidal anti-inflammatory drugs (NSAIDs).To examine the scope of and variation in prescribing (...) relatively contraindicated medications and medications above the recommended dose levels among patients with stage III/IV CKD in primary care practice.This is a cross-sectional descriptive study that used structured electronic health record data. The study participants were patients aged 18 years and older from three primary care clinics in a practice-based research network. Number/proportion of adult patients with stage III/IV CKD; proportion of these patients with at least one NSAID or other relatively

2018 Family Practice

80. Physicians' Perspectives Regarding Prescription Drug Monitoring Program Use Within the Department of Veterans Affairs: a Multi-State Qualitative Study. (PubMed)

Physicians' Perspectives Regarding Prescription Drug Monitoring Program Use Within the Department of Veterans Affairs: a Multi-State Qualitative Study. The Department of Veterans Affairs (VA) has implemented robust strategies to monitor prescription opioid dispensing, but these strategies have not accounted for opioids prescribed by non-VA providers. State-based prescription drug monitoring programs (PDMPs) are a potential tool to identify VA patients' receipt of opioids from non-VA prescribers (...) use, physicians endorsed (1) linking PDMPs with the VA electronic health record, (2) using templated notes to document PDMP use, and (3) delegating routine PDMP queries to ancillary staff.Despite the time and administrative burdens associated with their use, VA physicians in our study broadly supported PDMPs. The application of our findings to ongoing PDMP implementation efforts may strengthen PDMP use both within and outside VA and improve the safe prescribing of opioids.

2018 Journal of General Internal Medicine

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