BACKGROUND: Self-medication practices and polypharmacy are common among human immunodeficiency virus (HIV)-infected patients. Inappropriate use of over-the-counter (OTC) medications potentiates the risk for drug misuse and adverse drug events (ADEs). OBJECTIVES: To investigate use and misuse of OTC medications in HIV-infected patients and determine related ADEs. METHODS: A nonexperimental cross-sectional ...

BACKGROUND: The actions taken for the treatment of illness or symptom of an illness vary depending on the perceptions and experiences of individuals and other factors. A significant portion of all care in illness is self-care. In many cases, self-medication is an important initial response to illness. Although some health-care ...

BACKGROUND: Some UK evidence exists, which suggests that the cost of prescription charges can pose a barrier to accessing medication. However, little evidence exists on patients' more general views on the policy of prescription charges. OBJECTIVES: The aim of this study was to explore the views of nonexempt patients, suffering ...

BACKGROUND: Although increasing attention has been given to the evaluation of use of potentially inappropriate medication in the older European Union (EU) member countries, information on this topic from Central and Eastern Europe is scarce. OBJECTIVES: The aims of the present study were: to identify risk factors enhancing the probability ...

To provide estimates of the growth in out-of-pocket (OOP) medical expenditures for persons with arthritis. OOP medical expenditures were estimated for 1998-2004 based on 7 panels of the Medical Expenditures Panel Survey, which provide nationally representative data. A simple simulation then extrapolated the data through 2006, for which the potential ...

Analysis of the 2007 Commonwealth Fund Biennial Health Insurance Survey finds the proportion of working-age Americans who struggled to pay medical bills and accumulated medical debt climbed from 34 percent to 41 percent, or 72 million people,between 2005 and 2007. In addition, 7 million adults age 65 and older had ...

The Prescription Opioid Misuse Index (POMI) was developed and used in a larger study designed to assess correlates of OxyContin abuse in pain patients prescribed OxyContin, patients treated for OxyContin addiction, and individuals incarcerated for OxyContin-related charges. The POMI was administered to 40 subjects with addiction problems and 34 pain ...

BACKGROUND: despite evidence of limited efficacy, psychotropic medications are widely used as a first line treatment for those with behavioural and psychological symptoms of dementia (BPSD). Clearly various factors must be influencing their continued use; these are explored here. AIMS: to examine the process by which consultant old age psychiatrists ...

BACKGROUND: Although there is no strong evidence of benefit, chest physiotherapy (CP) seems to be commonly used in simple pneumonia. CP requires equipment and frequently involves the assistance of a respiratory therapist, engendering a significant medical workload and cost. AIM: To measure and compare the efficacy of two modalities of ...

The purpose of this work was to estimate the incidence of medically treated thyroid disease in children with Down syndrome enrolled in Tennessee Medicaid (TennCare) during 1995-2005 and to determine whether rates increased after rerelease of American Academy of Pediatrics guidelines in 2001. We conducted a population-based retrospective cohort study ...

Background: The risk of medication misadventure for patients is greatest during times of change, particularly on discharge from hospital. Patients at high risk of medication misadventure post- discharge should be identified and provided with interventions to ensure the quality use of medicines and positive health outcomes. Home medicines reviews (HMRs) ...

Complementary and alternative medicine use has been increasing worldwide. Although many studies have attempted to elucidate the levels of herbal medicine use in certain communities, many factors have led to limitations on the data collected. Self-report surveys are currently the only studies that have been done to quantify the actual ...

PURPOSE: A collaborative effort between two pharmacy specialty areas for ensuring compliance with United States Pharmacopeia (USP) chapter 797 for compounded sterile preparations (CSPs) is described. SUMMARY: In September 2005, an investigational drug service (IDS) satellite was opened at a 1157-bed, level 1 trauma, academic hospital in Minnesota. After construction ...

BACKGROUND: Despite the proven efficacy of prescription regimens in reducing disease symptoms and preventing or minimizing complications, poor medication adherence remains a significant public health problem. Medicare beneficiaries have high rates of chronic illness and prescription medication use, making this population particularly vulnerable to nonadherence. Failure to fill prescribed medication ...

There are no uniform protocols in the United States for safe, environmentally acceptable disposal of controlled substances by patients. In addition, there are conflicting protocols used by various institutions for the disposal of narcotic medications. Although the US Drug Enforcement Administration oversees the prescribing, acquisition, and distribution of controlled substances ...

The introduction of conscience clauses after the 1973 US Supreme Court decision in Roe v. Wade allowed physicians and nurses to opt out of medical procedures, particularly abortions, to which they were morally opposed. In recent years pharmacists have requested the same consideration with regard to dispensing some medicines. This ...

The objective of this study was to examine the prevalence of potentially inappropriate medications (PIMs) and potential adverse drug effects (ADEs) in older adults presenting to the emergency department (ED). This was a prospective observational study of a convenience sample of adults 65 years and older presenting to the ED ...

OBJECTIVE: Validation studies of self-reported medication use in adolescents have been scarce. The objective of this study was to estimate the sensitivity and specificity of self-reported use of medication using a prescription database as reference standard. STUDY DESIGN AND SETTING: The study population consisted of a cohort of 2,613 adolescents ...

PURPOSE: A formalized policy was developed to warn of the potential for adverse events associated with the use of intramuscular olanzapine in combination with injectable benzodiazepines. SUMMARY: Administrators in the psychiatry department at Lutheran Hospital proposed that concomitantly active orders for both intramuscular olanzapine and parenteral benzodiazepines be prohibited as ...

STUDY OBJECTIVE: Medication errors during hospitalization can lead to adverse drug events. Because of preoccupation by health care providers with life-threatening injuries, trauma patients may be particularly prone to medication errors. Medication reconciliation on admission can result in decreased medication errors and adverse drug events in this patient population. The ...

OBJECTIVES: Most medical conditions that community residents experience are managed in that setting. Often this involves prescription and/or non-prescription medicines and a visit to a community pharmacy. This study explores actions taken by mobile community residents to seek relief from their symptoms and pharmacy's role in symptom mitigation. METHODS: Five ...

OBJECTIVES: To examine the effectiveness of a quality improvement program to decrease prescribing of high-risk medications. DESIGN: Single cohort, pre- and postintervention. SETTING: Regional network of Department of Veterans Affairs medical facilities. PARTICIPANTS: Outpatient veterans aged 65 and older who received one or more high-risk medications and the prescribing clinicians. ...

BACKGROUND: Medication-taking behavior is influenced by many factors, as described by the Health Belief Model. Information on withdrawals of drugs from the market may be an example of negative external stimuli that might influence patients' decisions to persist with long-term drug therapy. OBJECTIVE: To evaluate the association between the withdrawal ...

OBJECTIVES: To evaluate adverse effects of herbal remedies consumed by menopausal women for control of the climacteric syndrome. METHODS: We examined the long term safety and herb-drug interactions of commonly used herbal therapy such as soy, black cohosh, dong quai, ginseng and vitamin E. RESULTS: Even carefully designed studies on ...

BACKGROUND: Studies that have assessed antibiotic appropriateness in acute respiratory tract infections (RTIs) with a likely bacterial etiology have focused only on antibiotic choice and ignored other important aspects of prescribing, such as dosing, drug-drug interactions, and duration of treatment. OBJECTIVE: The aim of this study was to determine the ...

OBJECTIVES: To describe acetylcholinesterase inhibitor (AChEI) and memantine use among persons over the age of 65 admitted to hospice with a primary diagnosis of dementia and identify patient and hospice program characteristics associated with the use of these agents. DESIGN: Retrospective, cross-sectional study. SETTING: Administrative database of a national hospice ...

BACKGROUND: Older adults take multiple medications and are at high risk for adverse drug effects. OBJECTIVE: This systematic review was conducted to describe the impact of computer decision support (CDS) interventions designed to improve the quality of medication prescribing in older adults. METHODS: PubMed and EMBASE databases were searched from ...

OBJECTIVE: In Europe, little information exists on the pediatric use of psychotropic medication. This study aimed to describe the extent and patterns of psychotropic medication use in children and adolescents enrolled in a large health plan (MGEN) in France, and its evolution in recent years. METHODS: MGEN affiliates aged 0 ...

Implementation of Medication Therapy Management (MTM) services under the Medicare Modernization Act of 2003 has highlighted the innovative roles that pharmacists are assuming in progressive, community-based practice settings. MTM underscores the vital role that community pharmacists have in helping patients achieve desirable therapeutic outcomes and reduce health care expenses. Pharmacists ...

BACKGROUND: Health plans in the United States are struggling to contain rapid growth in their spending on medications. They have responded by implementing multi-tiered formularies, which label certain brand medications 'non-preferred' and require higher patient copayments for those medications. This multi-tier policy relies on patients' willingness to switch medications in ...

OBJECTIVE: To evaluate the appropriateness of prescribing select neuropathic pain medications to diabetes patients based on the potential for drug-drug interactions with medications diabetes patients were prescribed continuously for > or =3 months (chronic use). METHODS: Medical records of patients with a diagnosis of diabetes or use of antidiabetic medications ...

OBJECTIVES: To measure the proportions of patients switching from generic to branded drugs among users of antiepileptic drugs (AED) compared to other therapeutic areas and to investigate medical services utilization associated with generic switching of lamotrigine. METHODS: Medical and pharmacy claims data from Régie de l'Assurance Maladie du Québec database ...

OBJECTIVES: To evaluate the feasibility of developing consensus recommendations for appropriate prescribing for patients with advanced dementia using a new conceptual framework and to determine the frequency of inappropriate medication use based on these recommendations in a small sample of patients with advanced dementia. DESIGN: Medication data were obtained using ...

The purpose of this study was to describe the level of opioid-taking self-efficacy amongst Taiwanese outpatients with cancer pain, and to examine the associations between various demographic and medical characteristics and opioid-taking self-efficacy. This was a cross-sectional study. Ninety-two outpatients who had taken prescribed opioid analgesics for cancer related pain ...

Fentanyl has an analgesic effect 100 times greater than that of morphine; therefore, transdermal administration of fentanyl has been widely used to control pain. Due to misconceptions regarding the proper use of fentanyl, its simple method of administration, and the absence of regulatory rules regarding its use, both medical providers ...

BACKGROUND: Prescribing decisions are subject to a myriad of external forces, including patient requests for advertised medications. Although numerous factors influence prescribing, resources to support unbiased evidence-based prescribing are not widely available. METHODS: To guide future interventions, we surveyed clinicians about influences on prescribing, awareness of pharmaceutical costs and attitudes ...

OBJECTIVE: To identify characteristics associated with four potential medication problems among older adults at risk for nursing home placement. DESIGN: Cross-sectional survey. SETTING: Three sites of California's Multipurpose Senior Services Program (MSSP), a Medi-Cal waiver care management program. PARTICIPANTS: Six hundred fifteen dual-eligible, functionally impaired, community-dwelling adults aged 65 years ...

OBJECTIVES: To assess the impact of direct pharmacy access to emergency contraception (EC) and availability of EC in Albuquerque and rural New Mexico and to compare availability of EC in Albuquerque with that estimated in a 2002 study. DESIGN: Investigational study. SETTING: Albuquerque and rural New Mexico, between March and ...

OBJECTIVES: To better characterize medication-related problems among inner-city patients after hospital discharge and to suggest potential interventions. PATIENTS AND METHODS: Between August 9, 2005, and April 3, 2006, we interviewed 84 patients hospitalized with acute coronary syndromes at Grady Memorial Hospital in downtown Atlanta, GA, and contacted them by telephone ...

The objective of this study was to evaluate patient knowledge of newly prescribed medication after hospital discharge. We reviewed the charts of 172 patients who were discharged from February 1, 2006, through April 25, 2006, from the internal medicine residency service at a community-based teaching hospital with prescriptions for 1 ...

PURPOSE: Experience with a referral-based medication therapy management (MTM) clinic in a university medical center is described. SUMMARY: The MTM clinic's mission is to assist patients who take multiple medications due to multiple chronic conditions with the management of their drug therapy to improve or maintain their health and prevent ...

OBJECTIVE: To describe medication usage in nursing home residents with advanced dementia, to identify how this usage changed as patients advanced towards death, and to identify correlates of increased medication usage. METHODS: Prospective cohort study (CareAD) during which data on medication prescription were extracted from medical records at regular intervals ...

OBJECTIVE: To evaluate the use of antibiotics prescribed in hospital outpatient and emergency clinics in King Hussein Medical Centre (KHMC) using WHO prescribing indicators in an attempt to rationalize the use of antibiotics in the Royal Medical Services. METHODS: We retrospectively surveyed a sample of 187,822 antibiotic prescriptions obtained from ...

While the public health problem of psychoactive drug use is well recognized, the emerging phenomenon of non-medical use of prescription opioids has been largely ignored in Canada. Most evidence on this issue and related harms in North America to date come from the United States (US), where the prevalence of ...

PURPOSE: Results of the 2007 ASHP national survey of pharmacy practice in hospital settings that pertain to prescribing and transcribing are presented. METHODS: A stratified random sample of pharmacy directors at 1264 general and children's medical-surgical hospitals in the United States were surveyed by mail. SMG Marketing Group, Inc., supplied ...

OBJECTIVES: We sought to document the frequency, circumstances, and consequences of prescription medication-sharing behaviors and to use a medication-sharing impact framework to organize the resulting data regarding medication-loaning and -borrowing practices. METHODS: One-on-one interviews were conducted in 2006, and participants indicated (1) prescription medicine taken in the past year, (2) ...

Angioedema is a rare but potentially serious complication of angiotensin-converting enzyme inhibitor (ACE) use. We conducted a study to estimate incidence of ACE-related angioedema and explore its determinants in a large racially diverse patient population. We used linked medical and pharmacy records to identify all patients in the US Veterans ...

To measure the length of time spent discussing all aspects of new prescriptions and guideline-recommended aspects of counseling, and to evaluate factors associated with duration of discussion. We analyzed tape recordings in which 181 patients received 234 new medication prescriptions from 16 family physicians, 18 internists, and 11 cardiologists in ...

OBJECTIVE: To explore the causes of preventable drug-related admissions (PDRAs) to hospital. DESIGN: Qualitative case studies using semi-structured interviews and medical record review; data analysed using a framework derived from Reason's model of organisational accidents and cascade analysis. PARTICIPANTS: 62 participants, including 18 patients, 8 informal carers, 17 general practitioners, ...

Since 2006, end-stage renal disease (ESRD) patients enrolled in Medicare are also eligible to enroll in the voluntary prescription drug program, Medicare Part D, which is administered by private sector entities called prescription drug plans (PDPs) or Medicare Advantage Part D plans. Approximately 84% of ESRD patients should be eligible ...