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Medical Directive

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1. Medication Administration via Direct Intravenous Push versus Minibags: Comparative Clinical Effectiveness and Guidelines

Medication Administration via Direct Intravenous Push versus Minibags: Comparative Clinical Effectiveness and Guidelines Medication Administration via Direct Intravenous Push versus Minibags: Comparative Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Medication Administration via Direct Intravenous Push versus Minibags: Comparative Clinical Effectiveness and Guidelines Medication Administration via Direct Intravenous Push versus Minibags: Comparative Clinical (...) Effectiveness and Guidelines Published on: January 6, 2017 Project Number: RB1049-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the comparative clinical effectiveness of medication delivery via direct intravenous push versus minibags? What are the evidence-based guidelines regarding medication delivery via direct intravenous push or minibags? Key Message One non-randomized study was identified regarding medication delivery via

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

2. Can Patient Group Directions (PGDs) be used to supply or administer a medication which is part of a clinical trial, study or pilot?

Can Patient Group Directions (PGDs) be used to supply or administer a medication which is part of a clinical trial, study or pilot? Can Patient Group Directions (PGDs) be used to supply or administer a medication which is part of a clinical trial, study or pilot? – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice Menu · · 26th June 2019 There is nothing in legislation that prevents the use of PGDs in clinical trials, studies or pilots if the medicine has (...) a product licence and all other legal and good practice requirements relating to PGDs are met. Often medicines administered or supplied under a PGD as part of a clinical trial, study or pilot are not actually part of the investigation which is more commonly focused on the service design, delivery or patient group. Examples include use of a vaccine in a population outside the national immunisation schedule or the supply of PreP as a programme pilot. The UK licensing status of the medications involved

2019 Specialist Pharmacy Services

3. Protocol-directed sedation versus non-protocol-directed sedation in mechanically ventilated intensive care adults and children. Full Text available with Trip Pro

ratio (RR) for mortality across studies, with 95% confidence intervals (CIs).We included four studies with a total of 3323 participants (864 adults and 2459 paediatrics) in this update. Three studies were single-centre, patient-level RCTs and one study was a multicentre cluster-RCT. The settings were in metropolitan centres and included general, mixed medical-surgical, medical only and a range of paediatric units. All four included studies compared the use of protocol-directed sedation, specifically (...) Protocol-directed sedation versus non-protocol-directed sedation in mechanically ventilated intensive care adults and children. The sedation needs of critically ill patients have been recognized as a core component of critical care that is vital to assist recovery and ensure humane treatment. Evidence suggests that sedation requirements are not always optimally managed. Suboptimal sedation, both under- and over-sedation, have been linked to short-term (e.g. length of stay) and long-term (e.g

2018 Cochrane

4. Cases in Precision Medicine: When Patients Present With Direct-to-Consumer Genetic Test Results. (Abstract)

Cases in Precision Medicine: When Patients Present With Direct-to-Consumer Genetic Test Results. A couple is planning to start a family, and they decide to order a 23andMe test after reading about the company's carrier screening test and the new BRCA1/BRCA2 test. They bring the results to their internist for advice on how to proceed. Given the rise in public interest in human genetics and precision medicine, direct-to-consumer genetic testing is becoming increasingly popular, and clinicians

2019 Annals of Internal Medicine

5. Videotelephony-assisted medical direction to improve emergency medical service. (Abstract)

Videotelephony-assisted medical direction to improve emergency medical service. In South Korea, on-line medical direction using voice calls has been implemented to improve the quality of the emergency medical system. However, in the same, short time span, video will be able to convey more information than by voice. The purpose of this study is to find out if videotelephony-assisted medical direction (VAMD) can change the intervention of the emergency medical technician compared to using (...) conventional voice calls.We conducted a prospective study of 312 patients with online medical direction from November 2017 to November 2018. We assisted patients with direct medical direction using conventional voice calls from October to November 2017, and then VAMD was implemented from October to November 2018.From the total number of conventional voice calls, 131 were used for this study, and of the total number of VAMD interventions, 181 were included. There were differences between conventional voice

2019 American Journal of Emergency Medicine

6. Patient-Centered Medical Home Implementation in Indian Health Service Direct Service Facilities Full Text available with Trip Pro

Patient-Centered Medical Home Implementation in Indian Health Service Direct Service Facilities In an effort to provide care that is more accessible, team-based, coordinated, and patient-focused, primary care practices are increasingly adopting patient-centered medical home (PCMH) models of care. In 2008, the Indian Health Service (IHS) launched its own PCMH initiative, Improving Patient Care (IPC), to improve the quality of care for American Indians and Alaska Natives (AI/ANs) who seek care

2018 Rand health quarterly

7. Prescrire's annual review of drug packaging: Authorities should direct more efforts towards medication safety

Prescrire's annual review of drug packaging: Authorities should direct more efforts towards medication safety Prescrire IN ENGLISH - Spotlight ''Prescrire's annual review of drug packaging: Authorities should direct more efforts towards medication safety '', 1 May 2015 {1} {1} {1} | | > > > Prescrire's annual review of drug packaging: Authorities should direct more efforts towards medication safety Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |    (...) |   |   |   |   |   |   |   |  Spotlight Prescrire's annual review of drug packaging: Authorities should direct more efforts towards medication safety In 2014, Prescrire examined the packaging quality of about 250 drugs. A few advances stand out, mainly involving recent drugs, but on the whole, the situation is worrisome in terms of medication safety. Abstract Although pharmaceutical companies and drug regulatory agencies seem to be taking

2015 Prescrire

8. Deep learning for named entity recognition on Chinese electronic medical records: Combining deep transfer learning with multitask bi-directional LSTM RNN. Full Text available with Trip Pro

Deep learning for named entity recognition on Chinese electronic medical records: Combining deep transfer learning with multitask bi-directional LSTM RNN. Specific entity terms such as disease, test, symptom, and genes in Electronic Medical Record (EMR) can be extracted by Named Entity Recognition (NER). However, limited resources of labeled EMR pose a great challenge for mining medical entity terms. In this study, a novel multitask bi-directional RNN model combined with deep transfer learning

2019 PLoS ONE

9. Mediators of medication adherence and glycaemic control and their implications for direct outpatient medical costs: a cross-sectional study. Full Text available with Trip Pro

Mediators of medication adherence and glycaemic control and their implications for direct outpatient medical costs: a cross-sectional study. To investigate the effects of diabetes-related distress and perception of hyperglycaemia on self-reported medication adherence and glycaemic control, as measured by HbA1c , and to compare the cost outcomes in patients with sub-optimally vs uncontrolled Type 2 diabetes mellitus.We conducted a retrospective cross-sectional study that involved the review (...) and perception of hyperglycaemia were significantly associated with medication adherence and HbA1c concentration. Mediation analyses showed a significant indirect effect of diabetes-related distress and perception of hyperglycaemia on medication adherence and HbA1c concentration. People with uncontrolled diabetes were found to incur significantly higher total direct medical costs than those with sub-optimally controlled diabetes (P = 0.034), with medication cost as the main cost driver (66.6%).Identifying

2018 Diabetic Medicine

10. Incidence and risk factors of medical complications and direct medical costs after osteoporotic fracture among patients in China Full Text available with Trip Pro

Incidence and risk factors of medical complications and direct medical costs after osteoporotic fracture among patients in China We analyzed the incidence of medical complications after osteoporotic fractures and estimated its risk factors and cost impacts. Osteoporotic fractures can result in lots of serious medical complications, which is associated with patients' baseline characteristics such as patients' disease history and significantly increased patients' direct medical costs.The purpose (...) was estimated within 12 months before and after fracture. Direct medical costs were measured and compared between patients with at least one medical complication and without any medical complications. Logistic regression was applied to identify risk factors for any medical complications.Three thousand seven hundred nineteen patients were identified; 45.0% had hip fracture, and 56.2% had vertebral fracture. After osteoporotic fracture, the accumulative incidence of the most common medical complications

2018 Archives of osteoporosis

11. Exploring Personal Medicine as Part of Self-Directed Care: Expanding Perspectives on Medical Necessity. Full Text available with Trip Pro

Exploring Personal Medicine as Part of Self-Directed Care: Expanding Perspectives on Medical Necessity. Self-directed care (SDC) offers flexibility in and control over mental health services. This study examined the types of goods and services that individuals with serious mental illness request in an SDC intervention.Data were from a randomized controlled trial that enrolled adult participants receiving Medicaid-reimbursed services, with two years of expenditures at the 50%-90% level of all (...) personal-medicine strategies to address needs that are currently unmet by traditional mental health services. Self-directed care may be a service delivery option that allows consumers to access their own personal medicine and better address their needs.

2018 Psychiatric services (Washington, D.C.) Controlled trial quality: uncertain

12. Vasoconstricting Sprays with Direct Compression versus Direct Compression for Acute Anterior Epistaxis: Comparative Clinical Effectiveness

vasoconstricting sprays prior to direct compression for management of acute anterior epistaxis? Key Message No relevant literature was identified regarding vasoconstricting sprays with direct compression versus direct compression for acute anterior epistaxis. Tags epistaxis, nasal decongestants, nasal sprays, oxymetazoline, vasoconstriction, vasoconstrictor agents, cardiovascular, ear, nose, and throat, medical devices, nasal, intranasal, nosebleed, nose bleed, nasal spray, nasal sprays Files Rapid Response (...) Vasoconstricting Sprays with Direct Compression versus Direct Compression for Acute Anterior Epistaxis: Comparative Clinical Effectiveness Vasoconstricting Sprays with Direct Compression versus Direct Compression for Acute Anterior Epistaxis: Comparative Clinical Effectiveness | CADTH.ca Find the information you need Vasoconstricting Sprays with Direct Compression versus Direct Compression for Acute Anterior Epistaxis: Comparative Clinical Effectiveness Vasoconstricting Sprays with Direct

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

13. Association between medication adherence and illness perceptions in atrial fibrillation patients treated with direct oral anticoagulants: An observational cross-sectional pilot study. Full Text available with Trip Pro

Association between medication adherence and illness perceptions in atrial fibrillation patients treated with direct oral anticoagulants: An observational cross-sectional pilot study. The aim of this study was to examine the association between medication adherence and illness perceptions, and to explore the factors associated with poor medication adherence in atrial fibrillation (AF) patients receiving direct oral anticoagulants (DOACs) in a real-world clinical setting.An observational cross (...) -sectional pilot study was conducted at a single Japanese university hospital. One hundred and twenty-nine patients who were diagnosed with AF and who were taking DOACs were recruited from outpatients between January 4th and April 25th, 2017. We evaluated medication adherence to DOACs using the Morisky Medication Adherence Scale-8 (MMAS-8) and illness perceptions using the Brief Illness Perception Questionnaire (BIPQ). The patients' characteristics and clinical data were collected from electronic medical

2018 PLoS ONE

14. A comprehensive assessment of patient reported symptom burden, medical comorbidities, and functional well being in patients initiating direct acting antiviral therapy for chronic hepatitis C: Results from a large US multi-center observational study. Full Text available with Trip Pro

A comprehensive assessment of patient reported symptom burden, medical comorbidities, and functional well being in patients initiating direct acting antiviral therapy for chronic hepatitis C: Results from a large US multi-center observational study. Symptom burden, medical comorbidities, and functional well-being of patients with chronic hepatitis C virus (HCV) initiating direct acting antiviral (DAA) therapy in real-world clinical settings are not known. We characterized these patient-reported (...) outcomes (PROs) among HCV-infected patients and explored associations with sociodemographic, liver disease, and psychiatric/substance abuse variables.PROP UP is a large US multicenter observational study that enrolled 1,600 patients with chronic HCV in 2016-2017. Data collected prior to initiating DAA therapy assessed the following PROs: number of medical comorbidities; neuropsychiatric, somatic, gastrointestinal symptoms (PROMIS surveys); overall symptom burden (Memorial Symptom Assessment Scale

2018 PLoS ONE

15. Diagnostic pathways and direct medical costs incurred by new adult pulmonary tuberculosis patients prior to anti-tuberculosis treatment - Tamil Nadu, India. Full Text available with Trip Pro

Diagnostic pathways and direct medical costs incurred by new adult pulmonary tuberculosis patients prior to anti-tuberculosis treatment - Tamil Nadu, India. Tuberculosis (TB) patients face substantial delays prior to treatment initiation, and out of pocket (OOP) expenditures often surpass the economic productivity of the household. We evaluated the pre-diagnostic cost and health seeking behaviour of new adult pulmonary TB patients registered at Primary Health Centres (PHCs) in Vellore district (...) , Tamil Nadu, India.This descriptive study, part of a randomised controlled trial conducted in three rural Tuberculosis Units from Dec 2012 to Dec 2015, collected data on number of health facilities, dates of visits prior to the initiation of anti-tuberculosis treatment, and direct OOP medical costs associated with TB diagnosis. Logistic regression analysis examined the factors associated with delays in treatment initiation and OOP expenditures.Of 880 TB patients interviewed, 34.7% presented to public

2018 PLoS ONE

16. Promoting Health Security: Potential, Role, and Future Directions of a Medical University Full Text available with Trip Pro

Promoting Health Security: Potential, Role, and Future Directions of a Medical University 28418747 2018 10 09 2018 10 09 2326-5108 15 2 2017 Mar/Apr Health security Health Secur Promoting Health Security: Potential, Role, and Future Directions of a Medical University. 192-193 10.1089/hs.2016.0112 Iqbal Usman U Wang Chia-Hui CH Atique Suleman S Kuo Nai-Wen NW eng Letter United States Health Secur 101654694 2326-5094 IM Delivery of Health Care Developing Countries Health Promotion Humans Security

2017 Health security

17. Direct Medical Costs of Type 2 Diabetes in France: An Insurance Claims Database Analysis Full Text available with Trip Pro

Direct Medical Costs of Type 2 Diabetes in France: An Insurance Claims Database Analysis Our objects was to estimate the direct healthcare costs of type 2 diabetes mellitus (T2DM) in France in 2013.Data were drawn from a random sample of ≈600,000 patients registered in the French national health insurances database, which covers 90% of the French population. An algorithm was used to select patients with T2DM. Direct healthcare costs from a collective perspective were derived from the database (...) and compared with those from a control group to estimate the cost of diabetes and related comorbidities. Overall direct costs were also compared according to the diabetes therapies used throughout the year 2013.Cost analysis was available for a sample of 25,987 patients with T2DM (mean age 67.5 ± standard deviation 12.5; 53.9% male) matched with a control group of 76,406 individuals without diabetes. Overall per patient per year medical expenditures were €6506 ± 10,106 in the T2DM group as compared

2017 PharmacoEconomics open

18. Position Statement on the medicinal use of Cannabinoids in Pain Medicine

Position Statement on the medicinal use of Cannabinoids in Pain Medicine Faculty Position Statement on the medicinal use of Cannabinoids in Pain Medicine Update following the publication of NICE Guidance NG144 (11 November 2019) This statement is focused on the issues relating to cannabis derived medicinal products in relation to Pain Medicine. It does not comment on other areas of medical practice or recreational use, which lie outside our remit. The issue of cannabis, its extracts (...) and the limited pharmaceutical armoury. If there are specific patient populations that will benefit they should not be denied access when the evidence is available. The use of unrefined dried plants containing a variety of cannabinoids and other pharmaco-active chemicals of varying quantity and quality cannot be supported and is clearly contrary to the direction of medical science. The potential for exposure to significantly harmful chemicals, in the short or long term, by such an unscientific ‘herbal

2020 Faculty of Pain Medicine

19. Comparison of smartphone ophthalmoscopy vs conventional direct ophthalmoscopy as a teaching tool for medical students: the COSMOS study. Full Text available with Trip Pro

Comparison of smartphone ophthalmoscopy vs conventional direct ophthalmoscopy as a teaching tool for medical students: the COSMOS study. To investigate the utility of smartphone ophthalmology for medical students for learning fundoscopy compared with direct ophthalmoscopy.After 1 hour of didactic instruction on ophthalmoscopy, second-year medical students in a small group setting were randomized to start training with the direct ophthalmoscope vs smartphone ophthalmoscope and crossed over (...) to the other instrument through the session.Ability to visualize the optic nerve and retinal blood vessels in an undilated pupil as well as a survey evaluating ease of use, confidence, and ability to visualize the optic nerve with the two instruments.One hundred and one medical students participated. Significantly more medical students were able to visualize the optic nerve with the smartphone ophthalmoscope vs the direct ophthalmoscope in an undilated pupil (82.3% vs 48.5%, P<0.0001). Students reported

2019 Clinical ophthalmology (Auckland, N.Z.) Controlled trial quality: uncertain

20. Impact of pharmacist educational intervention on disease knowledge, rehabilitation and medication adherence, treatment-induced direct cost, health-related quality of life and satisfaction in patients with rheumatoid arthritis: study protocol for a randomi Full Text available with Trip Pro

Impact of pharmacist educational intervention on disease knowledge, rehabilitation and medication adherence, treatment-induced direct cost, health-related quality of life and satisfaction in patients with rheumatoid arthritis: study protocol for a randomi The objective of this study is to evaluate the effectiveness of pharmacist intervention in improving disease knowledge, adherence to treatment, health-related quality of life (HRQoL) and direct cost of treatment. The study also documents (...) , in a ratio of 1:1, after providing signed written consent. The study will take place in two patient-visits over the course of 3 months. Patients in the intervention group would receive intervention from the pharmacist while those in the control group will receive usual care. Primary outcomes include change in mean score from baseline (week 0) and at follow up (week 12) in disease knowledge, adherence to medications and rehabilitation/physical therapy. The secondary outcomes include change in the mean

2019 Trials Controlled trial quality: uncertain

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