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Electronic Prescription

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101. Reducing the default dispense quantity for new opioid analgesic prescriptions: study protocol for a cluster randomised controlled trial. (PubMed)

dispense quantity for new opioid analgesic prescriptions in the electronic health record (EHR) is a promising intervention to reduce prescribing.This study is a prospective cluster randomised controlled trial with two parallel arms. Primary care sites (n=32) and emergency departments (n=4) will be randomised in matched pairs to either a modification of the EHR so that new opioid analgesic prescriptions default to a dispense quantity of 10 tablets (intervention) or to no EHR change (control (...) Reducing the default dispense quantity for new opioid analgesic prescriptions: study protocol for a cluster randomised controlled trial. As opioid analgesic consumption has grown, so have opioid use disorder and opioid-related overdoses. Reducing the quantity of opioid analgesics prescribed for acute non-cancer pain can potentially reduce risks to the individual receiving the prescription and to others who might unintentionally or intentionally consume any leftover tablets. Reducing the default

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2018 BMJ open

102. Re: 'Determinants of in-hospital antibiotic prescription behaviour' by Lambregts et al. (PubMed)

Re: 'Determinants of in-hospital antibiotic prescription behaviour' by Lambregts et al. 30594653 2019 02 04 1469-0691 2018 Dec 28 Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases Clin. Microbiol. Infect. Cognitive biases in the decision-making process of antibiotic prescribing. S1198-743X(18)30798-5 10.1016/j.cmi.2018.12.010 Peiffer-Smadja N N Hopital Bichat Claude Bernard, Infectious Diseases Department (...) , Paris, France; INSERM, Infection Antimicrobials Modelling Evolution, Paris, France. Electronic address: nathan.psmadja@gmail.com. Lescure F X FX Hopital Bichat Claude Bernard, Infectious Diseases Department, Paris, France; INSERM, Infection Antimicrobials Modelling Evolution, Paris, France. Maatoug R R Hopital Universitaire Pitie Salpetriere, Department of Psychiatry, Paris, France. Rohaut B B Institut du Cerveau et de la Moelle epiniere, PICNIC Lab, Paris, France; Columbia University Department

2018 Clinical Microbiology and Infection

103. Trends in statin prescription prevalence, initiation, and dosing: Hong Kong, 2004-2015. (PubMed)

included if they received a lipid test at a single center (n = 58,672). Using the territory-wide electronic health record, prescribed daily statin dose, nondaily dose frequency, and statin dose intensity were determined for statin prescriptions from 2004 to 2015. Statin prescription prevalence and initiation rates were estimated using the appropriate at-risk population in the hospital catchment area as the denominator. Prescribed daily doses were stratified by primary or secondary cardiovascular (...) Trends in statin prescription prevalence, initiation, and dosing: Hong Kong, 2004-2015. Clinical practice guidelines recommend specific statin doses for the primary and secondary prevention of cardiovascular disease. Little is known about how statin utilization and dosing have evolved over time in Hong Kong. The aim of this study was to describe trends in statin prevalence, initiation, and dosing from 2004 to 2015.Patients receiving public health services, who were prescribed a statin, were

2018 Atherosclerosis

104. Effect of Electronic Health Record-Based Medication Support and Nurse-Led Medication Therapy Management on Hypertension and Medication Self-management: A Randomized Clinical Trial

Effect of Electronic Health Record-Based Medication Support and Nurse-Led Medication Therapy Management on Hypertension and Medication Self-management: A Randomized Clinical Trial Complex medication regimens pose self-management challenges, particularly among populations with low levels of health literacy.To test medication management tools delivered through a commercial electronic health record (EHR) with and without a nurse-led education intervention.This 3-group cluster randomized clinical (...) trial was performed in community health centers in Chicago, Illinois. Participants included 794 patients with hypertension who self-reported using 3 or more medications concurrently (for any purpose). Data were collected from April 30, 2012, through February 29, 2016, and analyzed by intention to treat.Clinics were randomly assigned to to groups: electronic health record-based medication management tools (medication review sheets at visit check-in, lay medication information sheets printed after

2018 EvidenceUpdates

105. NHMRC CEO Statement: Electronic cigarettes (e-cigarettes)

NHMRC CEO Statement: Electronic cigarettes (e-cigarettes) CEO Statement: Electronic cigarettes | NHMRC NHMRC Tagline NHMRC Tagline Publication date Publication date Content type Filtered by: All Publications News Page Search Quick links Toggle navigation Main navigation Funding One researcher has the potential to improve millions of lives. We provide funding for research through our grant system, with a transparent peer-review process to determine how funding is allocated. May 07 2018 May 07 (...) researchers and help them protect intellectual property. Jun 14 2018 Jul 25 2018 About us At NHMRC we are excited by the huge potential benefits of the research we fund and by the opportunities we have to ensure Australians have access to evidence-based, authoritative health advice. We create pathways to a healthier future through our research funding, our health guidelines and the ethical standards we set and uphold. Jul 25 2018 Jul 25 2018 CEO Statement: Electronic cigarettes CEO Statement: Electronic

2015 National Health and Medical Research Council

106. Increased Cardiac Sympathetic Activity and Oxidative Stress in Habitual Electronic Cigarette Users: Implications for Cardiovascular Risk (PubMed)

Increased Cardiac Sympathetic Activity and Oxidative Stress in Habitual Electronic Cigarette Users: Implications for Cardiovascular Risk Electronic cigarettes (e-cigarettes) have gained unprecedented popularity, but virtually nothing is known about their cardiovascular risks.To test the hypothesis that an imbalance of cardiac autonomic tone and increased systemic oxidative stress and inflammation are detectable in otherwise healthy humans who habitually use e-cigarettes.Cross-sectional case (...) -control study of habitual e-cigarette users and nonuser control individuals from 2015 to 2016 at the University of California, Los Angeles. Otherwise healthy habitual e-cigarette users between the ages of 21 and 45 years meeting study criteria, including no current tobacco cigarette smoking and no known health problems or prescription medications, were eligible for enrollment. Healthy volunteers meeting these inclusion criteria who were not e-cigarette users were eligible to be enrolled as control

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2017 JAMA cardiology

107. Applying STOPP Guidelines in Primary Care Through Electronic Medical Record Decision Support: Randomized Control Trial Highlighting the Importance of Data Quality (PubMed)

Applying STOPP Guidelines in Primary Care Through Electronic Medical Record Decision Support: Randomized Control Trial Highlighting the Importance of Data Quality Potentially Inappropriate Prescriptions (PIPs) are a common cause of morbidity, particularly in the elderly.We sought to understand how the Screening Tool of Older People's Prescriptions (STOPP) prescribing criteria, implemented in a routinely used primary care Electronic Medical Record (EMR), could impact PIP rates in community (non

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2017 JMIR medical informatics

108. Electronic Health Records (EHRs)

Electronic Health Records (EHRs) Evidence Summary: Electronic Health Records (EHRs) To the Chief Information Officer of the Champlain LHIN Prepared by the CIHR-funded Knowledge to Action research group: Sara Khangura, Jeremy Grimshaw, David Moher This report covers a broad collection of recent literature and evidence around the electronic health record (EHR). Evidence summarized from systematic reviews is highlighted in blue boxes, like this one. Systematic review evidence is generally favoured (...) . Key challenges identified by health practitioners who have implemented EHRs b. Proposed Solutions 10. EHRs: More Research? Background • In 1991, the Institute of Medicine released a landmark report recommending that electronic health records (EHRs) be implemented in health systems within 10 years 1 ; • Almost 20 years later, only a small proportion of health providers have implemented EHRs. 2 3 • A meta-analysis of diffusion rates of EHRs in the U.S. shows that uptake has slowed in recent years

2014 OHRI Knowledge to Action

109. A Pragmatic Randomized Control Trial Comparing Models of Care in the Management of Prescription Opioid Misuse

A Pragmatic Randomized Control Trial Comparing Models of Care in the Management of Prescription Opioid Misuse A Pragmatic Randomized Control Trial Comparing Models of Care in the Management of Prescription Opioid Misuse - 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. A Pragmatic Randomized Control Trial Comparing Models of Care in the Management of Prescription Opioid Misuse (OPTIMA) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov

2017 Clinical Trials

110. Evaluating the Impact of Prescription Fill Rates on Risk Stratification Model Performance. (PubMed)

Evaluating the Impact of Prescription Fill Rates on Risk Stratification Model Performance. Risk adjustment models are traditionally derived from administrative claims. Prescription fill rates-extracted by comparing electronic health record prescriptions and pharmacy claims fills-represent a novel measure of medication adherence and may improve the performance of risk adjustment models.We evaluated the impact of prescription fill rates on claims-based risk adjustment models in predicting both (...) concurrent and prospective costs and utilization.We conducted a retrospective cohort study of 43,097 primary care patients from HealthPartners network between 2011 and 2012. Diagnosis and/or pharmacy claims of 2011 were used to build 3 base models using the Johns Hopkins ACG system, in addition to demographics. Model performances were compared before and after adding 3 types of prescription fill rates: primary 0-7 days, primary 0-30 days, and overall. Overall fill rates utilized all ordered prescriptions

2017 Medical Care

111. Impact of Implementing National Guidelines on Antibiotic Prescriptions for Acute Respiratory Tract Infections in Pediatric Emergency Departments: An Interrupted Time Series Analysis. (PubMed)

guidelines on antibiotic prescriptions for acute respiratory tract infection (ARTI) in PEDs.We conducted a multicentric, quasiexperimental, interrupted time series analysis of prospectively collected electronic data from 7 French PEDs. We included all pediatric patients who visited a participating PED during the study period from November 2009 to October 2014 and were diagnosed with an ARTI. The intervention consisted of local protocol implementation, education sessions, and feedback. The main outcome (...) Impact of Implementing National Guidelines on Antibiotic Prescriptions for Acute Respiratory Tract Infections in Pediatric Emergency Departments: An Interrupted Time Series Analysis. Many antibiotics are prescribed inappropriately in pediatric emergency departments (PEDs), but little data are available in these settings about effective interventions based on guidelines that follow the antimicrobial stewardship principle. Our aim was to assess the impact of implementing the 2011 national

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2017 Clinical Infectious Diseases

112. Explicit definitions of potentially inappropriate prescriptions of antibiotics in older patients: a compilation derived from a systematic review. (PubMed)

Explicit definitions of potentially inappropriate prescriptions of antibiotics in older patients: a compilation derived from a systematic review. Potentially inappropriate prescriptions (PIPs) of antibiotics (antibiotic-PIPs) are generally detected by applying implicit definitions based on expert opinion. Explicit definitions are less frequently used, even though this approach would enable the automated detection of antibiotic-PIPs in electronic health records. Here, explicit definitions (...) of antibiotic-PIPs used in studies of older adults were systematically reviewed. The MEDLINE®, Scopus® and Web of ScienceTM core collection databases were searched with a combination of three terms and their synonyms: 'potentially inappropriate prescription' AND 'antibiotic treatment' AND 'older patients'. Following standardised selection of publications, explicit definitions of antibiotic-PIPs were extracted and were classified into infectious diseases domains and subdomains. A total of 600 search queries

2017 International journal of antimicrobial agents

113. Ecological Assessment of Clinicians' Antipsychotic Prescription Habits in Psychiatric Inpatients: A Novel Web- and Mobile Phone-Based Prototype for a Dynamic Clinical Decision Support System. (PubMed)

Ecological Assessment of Clinicians' Antipsychotic Prescription Habits in Psychiatric Inpatients: A Novel Web- and Mobile Phone-Based Prototype for a Dynamic Clinical Decision Support System. Electronic prescribing devices with clinical decision support systems (CDSSs) hold the potential to significantly improve pharmacological treatment management.The aim of our study was to develop a novel Web- and mobile phone-based application to provide a dynamic CDSS by monitoring and analyzing (...) practitioners' antipsychotic prescription habits and simultaneously linking these data to inpatients' symptom changes.We recruited 353 psychiatric inpatients whose symptom levels and prescribed medications were inputted into the MEmind application. We standardized all medications in the MEmind database using the Anatomical Therapeutic Chemical (ATC) classification system and the defined daily dose (DDD). For each patient, MEmind calculated an average for the daily dose prescribed for antipsychotics (using

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2017 Journal of medical Internet research

114. Changes in Provider Prescribing Patterns After Implementation of an Emergency Department Prescription Opioid Policy. (PubMed)

used the electronic medical record to analyze the number and type of opioid discharge prescriptions during the study period from 2006-2014, before and after the prescribing guidelines were instituted in the ED.The number of patients discharged with a prescription for opioids decreased 39.6% (25.7% to 15.6%; absolute decrease 10.2%; 95% confidence interval [CI] 9.6-10.7; p < 0.001) after the intervention. The improvements were sustained 2.5 years after the intervention. Decreases were seen in all (...) Changes in Provider Prescribing Patterns After Implementation of an Emergency Department Prescription Opioid Policy. Prescription opioid-associated abuse and overdose is a significant cause of morbidity and mortality in the United States. Opioid prescriptions generated from emergency departments (EDs) nationwide have increased dramatically over the past 20 years, and opioid-related overdose deaths have become an epidemic, according to the Centers for Disease Control and Prevention.Our aim

2017 Journal of Emergency Medicine

115. Characteristics Associated with Drug Prescription and Compliance Among Young Children with Autism Spectrum Disorder. (PubMed)

and compliance among young children with ASD.We studied patterns of drug utilization in a population-based sample of 211 young children with ASD in Southern Israel. Data regarding drug prescription and compliance (percentage of purchased drugs out of total prescriptions) were acquired from the electronic records of these patients. Compliance rates (CRs) were calculated as percentage of purchased drugs of the total number of prescriptions.A total of 122 prescriptions were made for 75 children in our sample (...) Characteristics Associated with Drug Prescription and Compliance Among Young Children with Autism Spectrum Disorder. Psychotropic drugs are prescribed to people with autism spectrum disorder (ASD) usually as a means to alleviate comorbidities associated with the disorder. However, despite the uncertainty regarding the efficacy of these treatments for ASD, their prevalence is continuously increasing. The goal of this study was to understand the characteristics associated with drug prescription

2017 Journal of Child and Adolescent Psychopharmacology

116. What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study. (PubMed)

in documenting the indication on prescriptions remains a challenge for vendors of electronic medication management systems. (...) What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study. Documenting the indication on prescriptions and dispensed medicines labels is not standard practice in Australia. However, previous studies that have focused on the content and design of dispensed medicines labels, have suggested including the indication as a safety measure. The aim of this study was to investigate the perspectives

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2017 BMC health services research

117. Case Not Closed: Prescription Errors 12 Years after Computerized Physician Order Entry Implementation. (PubMed)

to the systems. We analyzed 2500 electronic prescriptions (1250 prescriptions from 2015 and 1250 prescriptions from 2016). Prescription errors were identified by a pediatric intensive care physician and classified as potential adverse drug events, medication prescription errors, or rule violations. Their prevalence was compared with the rate in 2007, reported in a previous study from the same unit. A randomly selected 10% of the prescriptions were also analyzed by the pediatric intensive care unit pharmacist (...) Case Not Closed: Prescription Errors 12 Years after Computerized Physician Order Entry Implementation. To assess the prolonged impact of computerized physician order entry (CPOE) on medication prescription errors in pediatric intensive care patients.This observational study was conducted at a pediatric intensive care unit in which a CPOE (Metavision, iMDsoft, Israel) with a limited clinical decision support system was implemented between 2004 and 2007. Since then, no changes were made

2017 Journal of Pediatrics

118. Ondansetron Prescription for Home Use in a Pediatric Emergency Department. (PubMed)

Ondansetron Prescription for Home Use in a Pediatric Emergency Department. Ondansetron has been shown to decrease admission rates and the need for intravenous fluids among pediatric emergency department (ED) patients with acute gastroenteritis, but there is limited evidence regarding its use after ED discharge. This study describes prescribing patterns for ondansetron and assesses the effects of ondansetron home prescription on rate of return.Data were gathered from the electronic health record (...) patients with acute gastroenteritis were identified during the study period. Of these, 76% received ondansetron in the ED, and 71% were discharged with prescriptions for ondansetron. Seven-day ED return rates were similar between groups (6% with prescription, 5% without, P = 0.66). A total of 2287 patients received home prescriptions for ondansetron. Fifty-four percent of these patients' discharge diagnoses were classed as gastrointestinal complaints, 14% other infectious conditions, 9% respiratory

2017 Pediatric Emergency Care

119. Psychotropic Drug Prescription in Adolescents: A Retrospective Study in a Swiss Psychiatric University Hospital. (PubMed)

Psychotropic Drug Prescription in Adolescents: A Retrospective Study in a Swiss Psychiatric University Hospital. This retrospective study aims to evaluate off-label prescriptions and administrations of psychotropic medications in adolescents in a university psychiatric hospital in Switzerland.Data were collected during the entire stays from the electronic database for 76 inpatients in 2008 and 76 inpatients in 2014. Data collected included gender, age, psychiatric diagnosis, duration (...) of hospitalization, and psychotropic drug prescriptions and administrations.A total of 224 psychotropic drugs (mean 2.9 drugs/patient) were prescribed in 2008 and 268 (mean 3.5 drugs/patient) in 2014. Due to the prescriptions of some drugs as required, only 76% of the prescriptions were actually administered in 2008 (mean 2.3 drugs/patient) and 55% in 2014 (mean 1.9 drugs/patient). Antipsychotics were the most frequently prescribed drugs in 2008 (74% of patients) and 2014 (86% of patients). Anxiolytics were also

2017 Journal of Child and Adolescent Psychopharmacology

120. How a one-time bridging prescription became an every time refill

prescribed by primary care doctors), over 10 years ago, before we even started using our current electronic health record. Bridging a gap The documentation of that original prescription showed that the patient had been receiving this medicine from another provider, and had recently terminated his relationship with that subspecialist, and requested a single bridging prescription of this medicine until he could establish care with a new appropriate prescriber of this medicine. This was a well-documented (...) How a one-time bridging prescription became an every time refill How a one-time bridging prescription became an every time refill How a one-time bridging prescription became an every time refill | | June 11, 2017 285 Shares At what point, we have to ask ourselves, does a medical error that we do over and over again cease to be an error, and simply become business as usual? At one of the patient safety conferences this week, where we reviewed sentinel events that occurred in the hospital

2017 KevinMD blog

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