The diagnostic criteria and management strategy of transient ischemic attack (TIA) have drastically changed for these years. In Europe and the United States, community and hospital-based studies demonstrated a higher risk of stroke immediately after a TIA than previously considered. Urgent evaluation and immediate initiation of treatment reduces stroke after ...

Background. This study was conducted with the aim of evaluating the role of Ligamentotaxis in the management of neglected clubfeet managed by ligamentotaxis using Joshi's External Stabilisation System (JESS). Method & Material. Total 20 subjects (28 feet) were studied, which were corrected by differential ligamentotaxis using JESS. All were evaluated ...

Whether written feedback on drug prescribing in general practice affects prescribing habits is controversial. Most short-term studies showed no effect. However, the issue has not been tested in long-term studies involving the local general practitioner community. To assess whether prescribing levels in general practice are affected by long-term, unsolicited, systematically ...

patient co-payments for prescription medicines in Wales were abolished in April 2007 and there has been much speculation on the possible effects. We analysed patient-reported use of medicines before and after abolition of the prescription charge, noting changes in the number of items prescribed, number of non-prescription medicines purchased and ...

Overprescribing of antibiotics in primary care is a worldwide phenomenon. Prescriptions can be used to reduce the uncertainty inherent in general practice. We assumed a heightened prescribing rate on Fridays because of more uncertainty before the pending weekend. Cross-sectional study from a general practice research database with 102 140 patients of ...

Inappropriate antibiotic use and antibiotic resistance are now major global issues. Antimicrobial stewardship programmes are increasingly being used to optimize antibiotic prescribing in acute care. The central tenet of these programmes tends to be policy and guidelines aimed at prescribers. However, rules and guidelines alone may not be sufficient to ...

To examine the prescribing of prochlorperazine secondary to the prescribing of a medicine which could lead to symptoms for which prochlorperazine is indicated and commonly used. Given the range of potential hypotensive, sedative, dystonic and other extra-pyramidal side effects associated with prochlorperazine, its association with hip fracture was also examined. ...

This study aims to explore the relationship between doctor characteristics and prescribing behaviour for patients with urinary tract infections (UTIs) using a 2-year population-based data set in Taiwan. This study used data from the Taiwan National Health Insurance Research Database. Our study sample consists of first-time ambulatory care visits for ...

Few would argue that the ability to match individual patients with the safest and most effective drugs and doses would be a major advance for clinical medicine. But while clinicians have been reluctant to routinely use pharmacogenomic analyses to guide their prescribing practices, pharmacy benefit managers and drugstores are proceeding ...

Addiction to opioids, or opioid dependence, encompasses the biopsychosocial dysfunction seen in illicit heroin injectors, as well as aberrant behaviours in patients prescribed opioids for chronic nonmalignant pain. To outline the management of opioid dependence using opioid pharmacotherapy as part of a comprehensive chronic illness management strategy. The same principles ...

With too few conservative options in the current medical system, increasing numbers of osteoarthritis (OA) sufferers are using untested folk remedies and self-prescribed dietary supplements. There is enormous popular demand for noninvasive and nonpharmacologic therapies for OA, and there is a pressing need for clinicians to respond to this demand ...

Inappropriate medication prescribing by doctors is an important preventable cause of morbidity and mortality in the elderly. This study investigates doctor knowledge about potentially inappropriate prescribing (PIP) in elderly, their confidence in prescribing for the elderly and explores perceived barriers. Family and Internal Medicine resident and attending doctors at three ...

Physician practices may adopt and use electronic prescribing (eRx) in response to mandates, incentives, and perceived value of the technology. Yet, for the most part, diffusion has been limited and geographically confined, and even when adopted, use of eRx in many practices has been low. One explanation for this phenomenon ...

Advanced Access practices provide quicker access to appointments and this may lead to patients being seen earlier in the course of acute self-limiting illnesses, and therefore increased antibiotic prescribing. We examined the impact of Advanced Access on antibiotic prescribing. We undertook a controlled before and after study in 24 Advanced ...

Objectives: A retrospective analysis of databases was performed to describe trimethoprim and ciprofloxacin prescribing and resistance in Escherichia coli within general practices in the West of Ireland from 2004 to 2008. METHODS: Antimicrobial susceptibility testing was performed by disc diffusion methods according to the CLSI methods and criteria on significant ...

This article considers the impact on district nurse practice of changes to medicines law introduced by the Medicines (Exemptions And Miscellaneous Amendments) Order 2009 that allows independent nurse prescribers to prescribe unlicensed medicines. These changes include the right to mix medicinal products so that they can be administered together as ...

Headache is a worldwide health problem which affects quality of life. OBJECTIVE: To identify the prevalence and management of headache and examine its impact. METHOD: A cross-sectional study with 240 participants was performed to collect data related to (a) headache occurrence, (b) its impact through the "Migraine Disability Assessment Test" ...

Most NHS prescriptions for medicines are written generically. However, there are controversies around generic prescribing in epilepsy, with many specialists believing that changing the supply of an antiepileptic risks reduced seizure control or unwanted effects.23 Here we review the evidence and other issues around generic prescribing of medicines used in ...

PURPOSE: The goal was to determine the prevalence of medicine use and to provide population-based information on factors associated with medicine use, including prescribed and over-the-counter (OTC) medicines, in children aged under 12 years. METHODS: A cross-sectional population survey of a random sample of children aged under 12 years (n ...

We aimed to assess trends in the management of atrial fibrillation (AF) at various levels of medical care in Greece and to compare the treatment practices of cardiologists to those of non-cardiologists. From January to May 2007, 500 questionnaires were mailed to cardiologists, internists and general practitioners, randomly selected from ...

There is increasing concern that mental health nurses in UK are inadequately trained in medicines management. Recommended solutions entail proposals for further training to improve safety for service users. Although fundamentally important, these organizational approaches lack a conceptual framework to explain how individual practitioners develop competence in medicines management. This ...

OBJECTIVES: Supplementary prescribing has seen pharmacists assume greater responsibility for prescribing in collaboration with doctors. This study explored the context and experiences, in relation to the practice of supplementary prescribing, of pharmacists and physicians (who acted as their training mentors) at least 12 months after pharmacists had qualified as supplementary ...

Genomic discoveries in the field of perioperative medicine and anaesthesia have generated multiple publications and some hope that pharmacogenetic testing may guide clinicians to provide safe and effective medicine in a 'tailored' manner. Within the field of anaesthesia, many consider that 'titration of drugs to the desired effect works just ...

BACKGROUND: The Prescription Peer Academic Detailing (Rx-PAD) project is an educational intervention study aiming at improving GPs' competence in pharmacotherapy. GPs in CME peer groups were randomised to receive a tailored intervention, either to support a safer prescription practice for elderly patients or to improve prescribing of antibiotics to patients ...

BACKGROUND: The current health care reform in China launched in 2009 tackles the problem of access to appropriate medicines for its 1.3 billion people by focusing on providing essential medicines to all. To provide evidence for the reform process, we investigated the manufacturing, purchasing, and prescribing of essential medicines in ...

Antibiotics are prescribed by dentists for treatment as well as prevention of infection. Indications for the use of systemic antibiotics in dentistry are limited, since most dental and periodontal diseases are best managed by operative intervention and oral hygiene measures. However, the literature provides evidence of inadequate prescribing practices by ...

The aim of the present study was to describe the use of prescribed and non prescribed medicines in a non-institutionalised population older than 15 years of an urban area during the year 2000, in terms of age and gender, social class, employment status and type of Primary Health Care. Cross-sectional ...

Globally, suboptimal prescribing practices and medication errors are common. Guidance to health professionals and consumers alone is not sufficient to optimise behaviours, therefore strategies to promote evidence-based decision making and practice, such as decision support tools or reminders, are important. The literature in this area is growing, but is of ...

Many breastfeeding women seek medical care from general practitioners (GPs) for various health problems and GPs may consider prescribing medicines in these consultations. Prescribing medicines to a breastfeeding mother may lead to untimely cessation of breastfeeding or a breastfeeding mother may be denied medicines due to the possible risk to ...

BACKGROUND: Electronic clinical decision support (CDS) is increasingly establishing its role in evidence-based clinical practice. Considerable evidence supports its enhancement of efficiency in e-Prescribing, but some controversy remains. This study evaluated the practicality and identified the perceived benefits of, and barriers to, its future adoption in the West of Ireland. ...

OBJECTIVE: This study aimed to determine the prevalence of the use of medicines, particularly over-the-counter medicines (OTC medicines), and to analyse its association with different personal and lifestyle aspects. SETTING: The study sample was an adolescent population in the Valencian Community (East Spain) aged 14-17 years. METHOD: A total of ...

OBJECTIVE: This study sought to identify and characterize rates of clinically questionable prescribing in New York State. METHODS: As part of a quality improvement initiative, 34 national psychopharmacology experts identified a set of questionable prescribing practices recognizable from pharmacy claims data. Indicators of such practices were applied to Medicaid claims ...

Most NHS prescriptions for medicines are written generically. However, there are controversies around generic prescribing in epilepsy, with many specialists believing that changing the supply of an antiepileptic risks reduced seizure control or unwanted effects. Here we review the evidence and other issues around generic prescribing of medicines used in ...

Prescribing errors complicate a significant number of paediatric admissions. Ongoing training and monitoring of prescribing competency in junior doctors has occurred in Cardiff since 2001, alongside national measures aimed at improving training and competency. Ongoing monitoring of junior doctors' prescribing competency to assess the effect of these national and local ...

This paper is a report of a study conducted to examine how irrational thinking affects people's adherence to multiple medicines prescribed to manage their diabetic kidney disease. Approximately 50% of people are non-adherent to their prescribed medicines and the risk of non-adherence escalates as the number of prescribed medicines increases. ...

It's best to use the generic name when referring to a medicine. This reduces the likelihood of accidental double prescribing or purchase of a drug, particularly if it has more than one brand name. Prescribing by generic name is also generally cheaper and avoids confusion because the name is internationally ...

BACKGROUND: Substantial variation in antibiotic prescribing rates between general practices persists, but remains unexplained at national level. AIM: To establish the degree of variation in antibiotic prescribing between practices in England and identify the characteristics of practices that prescribe higher volumes of antibiotics. DESIGN OF STUDY: Cross-sectional study. SETTING: 8057 ...

BACKGROUND: The representativeness of practice networks is important when using the information obtained to guide health policy. AIM: To develop a model for examining the representativeness of practice networks. METHODS: Comparison of surveyed population, practice structure and prescribing characteristics with the national data using the Weekly Returns Service (WRS) for ...

BACKGROUND: Wide variations in anxiolytic and hypnotic prescribing by GPs in England have been described, but are largely unexplained. AIM: To examine the relationships between the volume of anxiolytics and hypnotics prescribed by GPs and their practice characteristics, population demography, and performance indicators. DESIGN OF STUDY: Cross-sectional study. SETTING: All ...

The Palestinian Ministry of Health introduced an essential medicines list (EML) in 2000 to improve rational use of medicines and contain costs. We have examined the effects of the EML in the Palestinian healthcare public sector. We obtained data on prescription patterns for medicines from 3570 prescriptions given during outpatient ...

The Australian National Medicines Policy embodies four tenets: availability, quality, safety and efficacy of medicines; timely access to affordable medicines; quality use of medicines (QUM); and a responsible and viable medicines industry. The promotion of QUM requires a multidisciplinary approach, including contributions from government, the pharmaceutical industry, health professionals, consumers ...

The objective was to study the current narcotics regulations which are the most restrictive regarding prescription and dispensation practice in France, and their evolution over the period 1992-2007. This is an example of regulation in a European member state regarding medicines with a risk of abuse or dependence. Narcotics regulations ...

PURPOSE: The objective of this study was to analyse cardiovascular medicines utilisation patterns in Republic of Srpska (Bosnia and Herzegovina) over the 2002-2006 period. METHODS: A retrospective study was taken to analyse utilisation medicines reimbursed by the Health Insurance Fund (HIF), with a focus on cardiovascular medicines utilisation. ATC/DDD methodology ...

Using data from long-term glucocorticoid users and long-term care residents, we evaluated osteoporosis prescribing patterns related to physician behavior and common practice settings. We found no significant clustering effect for common practice setting, suggesting that osteoporosis quality improvement (QI) efforts may be able to ignore this factor in designing QI ...

OBJECTIVE: To evaluate availability, affordability and prescribing pattern of medicines in both public and private health sectors of Sudan. SETTING: Availability, affordability, and rational use of medicines were evaluated in primary health care centers in six states of Sudan. METHODS: The survey followed the WHO guidelines for monitoring and assessing ...

In this commentary on Zeldow's (2009) "In Defense of Clinical Judgment, Credentialed Clinicians, and Reflective Practice," the dialectical method is presented as a conceptual model and strategy for reconciling the division between clinical practitioners and clinical scientists in their acceptance of the need for empirically based psychological treatments and practices. ...

Although osteoporosis is common following spinal cord injury (SCI), no guidelines exist for its treatment, diagnosis, or prevention. The authors hypothesized that wide variations in diagnosis and treatment practices result from the absence of guidelines. This study sought to characterize the diagnosis and management practices within the VA health care ...

BACKGROUND: Translating scientific evidence into daily practice is problematic. All kinds of intervention strategies, using educational and/or directive strategies, aimed at modifying behavior, have evolved, but have been found only partially successful. In this article the focus is on (computerized) decision support systems (DSSs). DSSs intervene in physicians' daily routine, ...

BACKGROUND: Interest by prescribers and pharmacists in the provision of individualised pharmaceutical therapy in the form of compounded medicines has grown in recent times. However, there have also been a number of case reports of patient harm associated with these medicines. OBJECTIVE: To highlight areas for clinicians and pharmacists to ...

Specific immunotherapy (SIT) is the unique causal treatment for allergy, but its prescription is quite restricted. A perspective and cross-sectional survey based on telephone interviews was carried out in Italy to evaluate the profile of doctors prescribing SIT for allergic rhinitis. A total of 540 doctors were interviewed, 200 of ...