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Electronic Prescription

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101. Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients (PubMed)

Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients This study estimated the extent and predictors of primary nonadherence (i.e., prescriptions made by physicians but not initiated by patients) to methotrexate and to biologics or tofacitinib in rheumatoid arthritis (RA) patients who were newly prescribed these medications.Using administrative claims linked with electronic health records (EHRs) from multiple healthcare provider organizations (...) in the USA, RA patients who received a new prescription for methotrexate or biologics/tofacitinib were identified from EHRs. Claims data were used to ascertain filling or administration status. A logistic regression model for predicting primary nonadherence was developed and tested in training and test samples. Predictors were selected based on clinical judgment and LASSO logistic regression.A total of 36.8% of patients newly prescribed methotrexate failed to initiate methotrexate within 2 months; 40.6

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2018 Arthritis research & therapy

102. The Prescription of Mobile Apps by Primary Care Teams: A Pilot Project in Catalonia (PubMed)

The Prescription of Mobile Apps by Primary Care Teams: A Pilot Project in Catalonia In Catalonia, the Fundació TIC Salut Social's mHealth Office created the AppSalut Site to showcase to mobile apps in the field of health and social services. Its primary objective was to encourage the public to look after their health. The catalogue allows primary health care doctors to prescribe certified, connected apps, which guarantees a safe and reliable environment for their use. The generated data can (...) be consulted by health care professionals and included in the patient's clinical history. This document presents the intervention and the major findings following a five-month pilot project conducted in the Barcelona area.The objective of the pilot study was to test, in a real, controlled environment, the implementation of AppSalut. Specifically, we tested whether (1) the procedures corresponding to the prescription, transmission, and evaluation of the data functions correctly, (2) users interact

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2018 JMIR mHealth and uHealth

103. Use of a Behavioral Economic Intervention to Reduce Antibiotic Prescription for Upper Respiratory Infections

flags such as COPD, HIV) will be identified using electronic health record clinical billable data and low-value antibiotic prescriptions rates per visit will be monitored at both sites. Differences in prescriptions rates will be determined using an interrupted time-series analysis comparing utilization between sites using a repeated measures logistic regression model. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 2500 (...) Use of a Behavioral Economic Intervention to Reduce Antibiotic Prescription for Upper Respiratory Infections Use of a Behavioral Economic Intervention to Reduce Antibiotic Prescription for Upper Respiratory Infections - 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

2018 Clinical Trials

104. Social Media on Prescription for Colorectal Cancer Patients

Social Media on Prescription for Colorectal Cancer Patients Social Media on Prescription for Colorectal Cancer Patients - 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. Social Media on Prescription (...) Not Applicable Detailed Description: This is a prospective randomized parallel group design. Consecutive patients will be recruited from participating hospitals and randomized to either "prescribed participation" or just receiving information about the platform but with no prescription. All patients are also receiving standard care. After treatment all patients will receive information about the platform and the aim with the platform. A short demonstration of the platform will also be provided. The platform

2018 Clinical Trials

105. Predicting the need for a reduced drug dose, at first prescription (PubMed)

Predicting the need for a reduced drug dose, at first prescription Prescribing the right drug with the right dose is a central tenet of precision medicine. We examined the use of patients' prior Electronic Health Records to predict a reduction in drug dosage. We focus on drugs that interact with the P450 enzyme family, because their dosage is known to be sensitive and variable. We extracted diagnostic codes, conditions reported in clinical notes, and laboratory orders from Stanford's clinical

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2018 Scientific reports

106. Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review (PubMed)

Patient Safety and Pro Re Nata Prescription and Administration: A Systematic Review PRN is the acronym for 'pro re nata,' written against prescriptions whose administration should be based on patients' needs, rather than at set times. The aim of this systematic review was to explore safety issues and adverse events arising from PRN prescription and administration. Electronic databases including Scopus, PubMed [including Medline], Embase, Cinahl, Web of Science and ProQuest were systematically (...) searched to retrieve articles published from 2005 to 2017.we included all randomized controlled trials (RCTs) and studies with comparison groups, comparing PRN prescription and administration with scheduled administration, where safety issues and adverse events were reported. The authors independently assessed titles, abstracts and full-texts of retrieved studies based on inclusion criteria and risk of bias. Results were summarised narratively. The search identified 7699 articles. Title, abstract

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2018 Pharmacy: Journal of Pharmacy Education and Practice

107. Building interpretable models for polypharmacy prediction in older chronic patients based on drug prescription records (PubMed)

from drug prescription records for newly diagnosed chronic patients. We evaluate the models' performance with a strong focus on interpretability of the results.A centrally collected nationwide dataset of prescription records was used to perform electronic phenotyping of patients for the following two chronic conditions: type 2 diabetes mellitus (T2D) and cardiovascular disease (CVD). In addition, a hospital discharge dataset was linked to the prescription records. A regularized regression model (...) Building interpretable models for polypharmacy prediction in older chronic patients based on drug prescription records Multimorbidity presents an increasingly common problem in older population, and is tightly related to polypharmacy, i.e., concurrent use of multiple medications by one individual. Detecting polypharmacy from drug prescription records is not only related to multimorbidity, but can also point at incorrect use of medicines. In this work, we build models for predicting polypharmacy

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2018 PeerJ

108. Prescription fill rates for acute and chronic medications in claims-EMR linked data. (PubMed)

Prescription fill rates for acute and chronic medications in claims-EMR linked data. Nonadherence to prescribed medications poses a significant public health problem. Prescription data in electronic medical records (EMRs) linked with pharmacy claims data provides an opportunity to examine the prescription fill rates and factors associated with it.Using a claims-EMR linked data, patients who had a prescription for either an antibiotic, antihypertensive, or antidiabetic in EMR were identified (...) (index prescription). Prescription fill was defined as a pharmacy claim found within the 90 days following the EMR prescription. For each medication group, patient characteristics and fill rates were examined using descriptive statistics. Multivariate logistic regression was used to evaluate the association between fill rates and factors such as age, race, brand vs generic, and prior treatment during 365 days before the index date.Among 77,996 patients with index antibiotic prescription, 78,462

2018 Medicine

109. Association of the Use of a Mandatory Prescription Drug Monitoring Program With Prescribing Practices for Patients Undergoing Elective Surgery. (PubMed)

Association of the Use of a Mandatory Prescription Drug Monitoring Program With Prescribing Practices for Patients Undergoing Elective Surgery. Most states have adopted the routine use of a prescription drug monitoring program (PDMP) to curb overprescribing of opioids. The American College of Surgeons promotes the use of these programs as a "guiding principle to curb the opioid epidemic." However, there is a paucity of data on the effects of the use of these programs for surgical patient (...) populations.To determine the association of the mandatory use of a PDMP with the opioid prescribing practices for patients undergoing general surgery.A prospective observational cohort study was conducted at an academic hospital in New Hampshire among 1057 patients undergoing representative elective general surgical procedures from July 1, 2016, to June 30, 2017.New state legislation mandated the use of a PDMP and opioid risk-assessment tool for all patients receiving an outpatient opioid prescription in New

2018 JAMA surgery

110. Patient and physician predictors of hyperlipidemia screening and statin prescription. (PubMed)

Health System.Data on patients, screening orders, and prescriptions were obtained from the electronic health record. Multivariate logistic regression models were fit to binary outcomes of lipid screening and statin prescription.Among 97,189 eligible patients, 79.9% had an order for hyperlipidemia screening. In adjusted models, significant patient predictors of greater odds of having screening ordered included a history of diabetes (odds ratio [OR], 1.19; 95% CI, 1.10-1.29; P <.001) or hypertension (...) Patient and physician predictors of hyperlipidemia screening and statin prescription. Appropriate lipid management has been demonstrated to reduce cardiovascular events, but rates of hyperlipidemia screening and statin therapy are suboptimal. We aimed to evaluate patient and physician predictors of guideline-concordant hyperlipidemia screening and statin prescription.Retrospective study of patients with primary care provider (PCP) visits from 2014 to 2016 at the University of Pennsylvania

2018 American Journal Of Managed Care

111. Time to Filling of New Prescriptions for Chronic Disease Medications Among a Cohort of Elderly Patients in the USA. (PubMed)

until filling in a cohort of elderly patients.Retrospective cohort study of new prescription episodes.Data comes from a linked database of electronic health records and claims for patients aged ≥ 65 years enrolled in Medicare Parts A, B, and D during 2007-2014. We identified patients receiving a new prescription for a chronic disease medication with continuous Medicare enrollment for 180 days prior to the index prescription order and no fills or orders for the medication during this period.Time (...) Time to Filling of New Prescriptions for Chronic Disease Medications Among a Cohort of Elderly Patients in the USA. Data on primary nonadherence remains sparse, due to a lack of data resources that combine information on medication prescribing and dispensing. In addition, previous work on primary nonadherence has used follow-up periods ranging from 30 days up to 18 months, making results difficult to compare.To evaluate the prevalence and predictors of primary nonadherence by measuring time

2018 Journal of General Internal Medicine

112. Optimal Implementation of Prescription Drug Monitoring Programs in the Emergency Department (PubMed)

Optimal Implementation of Prescription Drug Monitoring Programs in the Emergency Department The opioid epidemic is the most significant modern-day, public health crisis. Physicians and lawmakers have developed methods and practices to curb opioid use. This article describes one method, prescription drug monitoring programs (PDMP), through the lens of how to optimize use for emergency departments (ED). EDs have rapidly become a central location to combat opioid abuse and drug diversion. PDMPs (...) can provide emergency physicians with comprehensive prescribing information to improve clinical decisions around opioids. However, PDMPs vary tremendously in their accessibility and usability in the ED, which limits their effectiveness at the point of care. Problems are complicated by varying state-to-state requirements for data availability and accessibility. Several potential solutions to improving the utility of PDMPs in EDs include integrating PDMPs with electronic health records, implementing

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2018 Western Journal of Emergency Medicine

113. By Default: The Effect of Prepopulated Prescription Quantities on Opioid Prescribing in the Emergency Department (PubMed)

By Default: The Effect of Prepopulated Prescription Quantities on Opioid Prescribing in the Emergency Department Opioid prescribing patterns have come under increasing scrutiny with the recent rise in opioid prescriptions, opioid misuse and abuse, and opioid-related adverse events. To date, there have been limited studies on the effect of default tablet quantities as part of emergency department (ED) electronic order entry. Our goal was to evaluate opioid prescribing patterns before and after (...) the removal of a default quantity of 20 tablets from ED electronic order entry.We performed a retrospective observational study at a single academic, urban ED with 58,000 annual visits. We identified all adult patients (18 years or older) seen in the ED and discharged home with prescriptions for tablet forms of hydrocodone and oxycodone (including mixed formulations with acetaminophen). We compared the quantity of tablets prescribed per opioid prescription 12 months before and 10 months after

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2018 Western Journal of Emergency Medicine

114. Antibiotic prescription for the prevention and treatment of postoperative complications after routine dental implant placement. A cross-sectional study performed in Spain (PubMed)

Antibiotic prescription for the prevention and treatment of postoperative complications after routine dental implant placement. A cross-sectional study performed in Spain As there are no established guidelines for antibiotic prescription after dental implant placement a study was made to determine the current prescribing habits of several groups of practitioners regarding antibiotics to prevent and/or treat postoperative complications - early failures and infections - in relation to routine (...) dental implant placement.An electronic survey was sent to postgraduate students and professionals with experience in routine dental implant placement who practice in Spain. The questions asked were related to whether antibiotics were routinely prescribed either pre- or postoperatively to prevent and/or treat postoperative complications during routine dental implant placement, and, if so, what antibiotics, dosage, frequency, and duration were used. Descriptive and bivariate analyses of the data were

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2018 Journal of clinical and experimental dentistry

115. Too much of a bad thing: Discharge opioid prescriptions in pediatric appendectomy patients. (PubMed)

found in the electronic medical record (EMR) or through a statewide prescription monitoring database. All dosing data were converted to oral morphine equivalents (OMEs). Analysis of variance and logistic regression were used.During the study, 590 patients underwent appendectomy, of which 371 (62.9%) were diagnosed as having simple acute appendicitis. The majority of patients were prescribed an opioid analgesic (62.5%). Demographics were similar between those who received opioids and those who did (...) Too much of a bad thing: Discharge opioid prescriptions in pediatric appendectomy patients. Opioid misuse is a public health crisis in the United States. This study aimed to evaluate the discharge opioid prescription practices for pediatric simple appendectomy patients.A retrospective review of pediatric appendectomy patients at a tertiary children's hospital was conducted from October 2016 to January 2018. Only patients with simple appendicitis were included. Written opioid prescriptions were

2018 Journal of Pediatric Surgery

116. User-centered design and usability testing of RxMAGIC: a prescription management and general inventory control system for free clinic dispensaries. (PubMed)

was a requirement for deployment. We utilized health data standards to communicate with the existing order entry system; an outgoing electronic prescribing framework was leveraged to send prescription data to RxMAGIC. The results of the usability study were positive, with all tested features receiving a mean score of four or five (i.e. somewhat easy or easy, respectively) on a five-point Likert scale assessing ease of completion, thus demonstrating the system's simplicity and high learnability. RxMAGIC (...) User-centered design and usability testing of RxMAGIC: a prescription management and general inventory control system for free clinic dispensaries. To address challenges related to medication management in underserved settings, we developed a system for Prescription Management And General Inventory Control, or RxMAGIC, in collaboration with the Birmingham Free Clinic in Pittsburgh, Pennsylvania. RxMAGIC is an interoperable, web-based medication management system designed to standardize

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2018 BMC health services research

117. 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

118. 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

119. 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

120. 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

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