BACKGROUND: Medication Reconciliation and Medication Safety are two themes emphasized in a variety of healthcare organizations. As a result, health care facilities have established methods for obtaining a patient's medication history. However, these methods may vary among institutions or even among the health care professionals in a single institution, and ...

BACKGROUND: The aim of this work is to estimate the French frequencies of dispensed psychotropic prescriptions in children and adolescents. Prevalence estimations of dispensed prescriptions are compared to the frequencies of use of psychotropic reported by 17 year-old adolescents. METHODS: Prescription data is derived from national health insurance databases. Frequencies ...

BACKGROUND: Obesity is associated with morbidity, mortality, and increased health care costs. Few studies have examined the impact of obesity on outpatient office visits. The purpose of this study was to determine if outpatient visits by obese persons required more time with the provider and more prescription medication management compared ...

BACKGROUND: Public drug insurance plans provide limited reimbursement for Alzheimer's disease (AD) medications in many jurisdictions, including Canada and the United Kingdom. This study was conducted to assess Canadians' level of support for an increase in annual personal income taxes to fund a public program of unrestricted access to AD ...

This paper presents Part 2 of a literature review examining medication safety in the Australian acute care setting. This review was undertaken for the Australian Commission on Safety and Quality in Health Care, updating the 2002 national report on medication safety. Part 2 of the review examined the Australian evidence ...

Despite concerns about drug safety, current information on older adults' use of prescription and over-the-counter medications and dietary supplements is limited. To estimate the prevalence and patterns of medication use among older adults (including concurrent use), and potential major drug-drug interactions. Three thousand five community-residing individuals, aged 57 through 85 ...

BACKGROUND: Medication samples are commonly dispensed by prescribers. Written consumer medication information (CMI) provided with sample packaging is an important source of patient information. Although one-third of Americans have health literacy deficiencies, previous studies have found that CMI is often too complex for many patients to understand. This may prevent ...

The impact of medications on the physiology of swallowing has received much attention in dysphagia literature. This article reviews the potential effects of medications commonly prescribed in an adult continuing care and rehabilitation facility on swallowing. An audit of medications prescribed to 153 adults accessing age-related respiratory, neurology, and learning ...

BACKGROUND: Persons with profound intellectual and multiple disabilities (PIMD) suffer from a wide range of health problems and use a wide range of different drugs. This study investigated for frequently used medication whether there was a health problem documented in the medical notes for the drug prescribed. METHOD: Persons with ...

To establish consensus oral dosing guidelines for primarily renally cleared medications prescribed for older adults. Literature search followed by a two-round modified Delphi survey. A nationally representative survey of experts in geriatric clinical pharmacy. Eleven geriatric clinical pharmacists. After a comprehensive literature search and review by an investigative group of ...

BACKGROUND: Electronic prescribing (e-prescribing) with formulary decision support (FDS) prompts prescribers to prescribe lower-cost medications and may help contain health care costs. In April 2004, 2 large Massachusetts insurers began providing an e-prescribing system with FDS to community-based practices. METHODS: Using 18 months (October 1, 2003, to March 31, 2005) ...

Drug and Therapeutics Committees (DTCs) serve as a forum to bring together various stakeholders to improve drug use. DTCs are a key intervention to promote rational use of medicines. DTCs are however, functioning in only a limited number of hospitals in Nepal. A Medicine and Therapeutics Committee (MTC) was started ...

To improve medication-taking behavior, it is important to identify factors that may contribute to suboptimal compliance and persistence with osteoporosis medications. The purpose of this descriptive analysis was to identify concurrent prescription medication use (number and type) among women receiving daily or weekly oral bisphosphonate therapy. Patient prescription data were ...

OBJECTIVE: The aim of this study was to describe persistence with migraine prophylactic treatment and acute migraine medication utilization in patients prescribed migraine prophylaxis. METHODS: For this retrospective cohort study, the Health Core Integrated Research Database provided pharmacy/medical claims data from 5 commercial health insurance plans (ie, excluding Medicare and ...

The medical management of many diseases and conditions can include either restriction or provision of specific essential nutrients. When such nutrients are needed, there are often both prescription and nonprescription products available, as in the case of nicotinic acid or omega-3 fatty acids. Although they may seem to contain similar ...

The objectives of this study were to validate an algorithm for identifying patients with painful diabetic peripheral neuropathy (pDPN) and demonstrate its practical applications. Using the Kaiser Permanente Colorado Diabetes Registry, an algorithm was developed with selected ICD-9 diagnosis codes combined with automated pharmacy data for medications prescribed for pDPN ...

Little is known about prescription medication abuse by rural youth. We surveyed 849 rural high school students and found that 34% reported lifetime nonmedical use of prescription medication higher than the 12% reported nationally. Boys and marijuana users had higher odds of nonmedical use of prescription medication than did girls ...

BACKGROUND: Information on prescribing practices in Palestine is lacking, however, still essential for strategic planning. PURPOSE: To characterise prescribing patterns and specific medicine use indicators in selected non-governmental organisations' (NGO) primary healthcare clinics/centres (PHC) in the West Bank (WB) in Palestine. METHODOLOGY: A prospective cross-sectional survey of prescribing practices based ...

OBJECTIVE: To evaluate the impact of an automated dispensing system (ADS) on pharmacy staff work activities and job satisfaction. DESIGN: Cross-sectional, retrospective study. SETTING: Kaiser Permanente Colorado (KPCO) outpatient pharmacies in September 2005. PARTICIPANTS: Pharmacists and technicians from 18 outpatient pharmacies. INTERVENTION: All KPCO outpatient pharmacists (n = 136) and ...

OBJECTIVE: To determine the effect of medication burden on persistent use of newly added lipid-lowering (LL) drugs among patients with hypertension. STUDY DESIGN: This retrospective database study used medical and pharmacy claims from a mid-Atlantic managed care organization. The cohort was obtained from continuous member enrollment in pharmacy and medical ...

Many barriers exist to conducting pediatric cardiovascular (CV) trials, and the majority of therapies used are not evidence based. Recent legislation has aimed to stimulate pediatric research and improve drug labeling. This study describes off-label use of CV medications in children hospitalized with congenital and acquired CV disease. The 2005 ...

PURPOSE: To investigate the role that both patient and outpatient factors related to health care practice (HCP) play in physicians' early adoption of rosuvastatin. MATERIALS AND METHODS: Generalized estimation equations (GEEs) and alternating logistic regression (ALR) with pair-wise odds ratios (PWORs) were used to measure similarities in rosuvastatin prescription within ...

PURPOSE: Basic research has shown that early processes in the development of age-related macular degeneration (ARMD) are related to inflammation. The purpose of this manuscript is to evaluate the association of ARMD and the use of anti-inflammatory medications. METHODS: A nested case control study was carried out among male patients ...

In the environment of rapidly mounting medication costs, pharmaceutical manufacturers' assistance programs (PMAPs) have become increasingly important in supplying medications to financially vulnerable patients. At Shenandoah Valley Compassionate Pharmacy, Winchester, Virginia, a nonprofit facility serving low-income seniors, a pharmacist and a patient advocate implement PMAPs by helping to enroll patients, ...

OBJECTIVE: This study evaluated the impact of Medicare's new drug benefit (Part D) on utilization of psychotropic medications and the consequent financial burden for the elderly population. METHODS: The effect of Medicare Part D was measured by analyzing 24-month pharmacy claims collected from one of the largest retail pharmacy chains ...

PURPOSE: To assess the relative incidence of peptic ulcer bleeding and perforation (PUBP) in users of selective cyclooxygenase-2 (COX-2) inhibitors and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). METHODS: This was a retrospective case-control study based on insurance claims, with chart review to confirm cases. The base population consisted of 2.2 million ...

Polypharmacy, besides representing a risk in and of itself, points to the potential risk the underlying diseases that necessitated the drugs can present in the dental office. These diseases and medications can also present a risk to oral health. A sequence for categorizing drugs in a medication list is presented ...

BACKGROUND: Multi-tier copayment designs in pharmacy benefit plans are intended to steer patients and prescribers to preferred drug therapies that have lower out-of-pocket costs for patients. OBJECTIVE: To describe and assess physicians' prescribing experiences and opinions in a multi-tier, primarily 3-tier formulary environment in 2 Midwestern states. METHODS: This was ...

OBJECTIVE: In May 2006, Health Canada released a statement advising against the use of stimulant medications for patients with cardiac disease after isolated reports of sudden death. The objectives of this study were to determine whether the Health Canada advisory has had an impact on cardiovascular screening of all children ...

Gastroenterology is full of examples of drugs being enthusiastically promoted only to be withdrawn or prescription curtailed once the harms of the medication are realized. Cox-2 inhibitors, alosetron, and tegaserod are all recent examples of this phenomenon. The problem is that potential harms of drugs are being highlighted in the ...

BACKGROUND: In recent years, there is a growing interest to assess patients' satisfaction which further triggers the existing debate on the severe methodological issues regarding the interpretation of comparative surveys results. OBJECTIVE: This cross-sectional national survey aimed to examine satisfaction of Greek households with specific aspects of medication use and ...

Recent discoveries about the effects of drugs of abuse on the brain and the mechanisms of their addictions; new chemical compounds, including immunotherapies; and new actions of available medications are offering many opportunities for the discovery and development of novel medications to treat addictive disorders. Furthermore, advancements in the understanding ...

In India perfumes and scented articles were in use from pre Vedic and Vedic periods for religious practices, social customs, and domestic rituals and later gradually became part and parcel of human life. Perfumes were also used in cosmetics and beauty aids. Medicinal values of many perfumes were well known ...

This final rule implements requirements regarding the termination of non-random prepayment complex medical review as required under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. This final rule sets forth the criteria CMS contractors will use for terminating a provider or supplier from non-random prepayment complex medical review.

Over the past decade, advances in addiction neurobiology have led to the approval of new medications to treat alcohol and opioid dependence. This study examined data from the IMS National Prescription Audit (NPA) Plus database of retail pharmacy transactions to evaluate trends in U.S. retail sales and prescriptions of FDA-approved ...

PURPOSE: To evaluate the effect of a combined or a single educational intervention on the prescribing behaviour of general practitioners (GPs). The primary endpoint was effect on inappropriate prescribing according to the Medication Appropriateness Index (MAI). METHODS: General practitioners were randomised to either (1) a combined intervention consisting of an ...

Drug-induced hypersensitivity syndrome (DIHS) is a life-threatening idiosyncratic drug reaction, and an early accurate diagnosis is essential for its treatment. We describe a 14-year-old boy with localization-related epilepsy, who developed severe adverse cutaneous and systemic reactions after 3 weeks of carbamazepine administration. During the course of the clinical symptoms, reactivation ...

BACKGROUND: There are effective treatments to prevent osteoporotic fractures, but these treatments are underutilized. OBJECTIVE: To evaluate the influence of patient characteristics, perceptions, knowledge and beliefs about osteoporosis on the decision to initiate osteoporotic treatment. PARTICIPANTS: We identified female members of a managed care plan who had a dual energy ...

A large body of information about medications prescribed during pregnancy is readily available to internists and patients either on-line or through books and medical journals. Much of the evidence about many prescribed drugs is either anecdotal or presented with sufficient warnings about its use during pregnancy. This article discusses specific ...

BACKGROUND: Opioids are frequently prescribed for moderate to severe pain. A side effect of opioid usage is the inhibition of gastrointestinal (GI) motility, known as opioid-induced bowel dysfunction (OBD). OBD is typically treated prophylactically with laxatives and/or acid suppressants. AIM: The present study describes the prevalence of outpatient opioid dispensing, ...

BACKGROUND: This research study examined the prevalence of prescription medication use in persons many years following moderate-to-severe traumatic brain injury (TBI). DESIGN: Retrospective cohort study. SETTING AND SUBJECTS: Consecutive records were examined of persons with moderate-to-severe TBI who were discharged from a large rehabilitation hospital in Pennsylvania from 1973-1989. Consenting ...

OBJECTIVE: To investigate the contents of home medicine chests and their relationship with self-medication in children and adolescents in the towns of Limeira and Piracicaba, SP, Brazil. METHODS: This is a descriptive population study based on a home survey of a simple random sample from both towns, comprising 705 households ...

INTRODUCTION: Pharmaceutical residues and other organic wastewater contaminants (OWC) have been shown to survive conventional water-treatment processes and persist in potable water supplies. OBJECTIVE: To estimate the geographical distribution of the Predicted Environmental Concentration (PEC) of selected drugs prescribed by office based physicians in the United States (US), after non-metabolized ...

Older adults constitute just 13% of the U.S. population, but consume 35% of all prescription drugs. They are at a particularly high risk of serious adverse events due to errors in medication-taking, but little is known about the instructions community-dwelling elders receive about their medications, or how they organize their ...

The lessons from the Great Hanshin-Awaji Earthquake and Chuuetsu Earthquake showed us how difficult it is to keep chronic disease management for survivors of such large-scale earthquakes, particularly for elderly people. To solve the problem, an ordinance for enforcement on exceptional practices was issued for the Pharmaceutical Affairs Law Article ...

OBJECTIVE: To determine whether drug samples are associated with physicians prescribing fewer generic, less costly medications. METHODS: We conducted a retrospective study at a large university-affiliated internal medicine practice containing over 70 physicians. Using a pharmacy database, we identified all prescriptions written to uninsured or Medicaid patients that belonged to ...

Acne is the most common disease of the skin, yet only a fraction of acne sufferers are treated with prescription products by physicians. There is, however, a large and expanding market for over-the-counter (OTC) medications, many of which are not only effective but also well tolerated and cosmetically elegant. Given ...

OBJECTIVE: To determine whether community pharmacist-initiated interventions containing a recommendation to adjust prescribed medication therapy and delivered via fax are viewed as helpful by prescribers and to what extent prescribers accept those recommendations. DESIGN: Cross-sectional. SETTING: Columbus Air Force Base (Columbus, MS) during a 3-month period in August through October ...

When nurses in orthopaedic settings are educating a patient about the medications, they address not just those medications related to the current orthopaedic problem, but all medications the patient is using. During these education sessions, nurses will often be asked about new medications, changes in medications, or medication recalls the ...

BACKGROUND: Self-medication refers to using drugs which have not been prescribed, recommended or controlled by a licensed health care specialist. Marketing, in Chile only admitted for over-the-counter medications, influences the practice of self-medication and extends it to prescription drugs. Thus, a complex self-medication process is started, due to reuse of ...