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Owczarczyk, Anna, Magdalena Bogdan, Pawel Zuk, Marika Guzek, and Andrzej Sarnowski. "A role of nurse e-prescription in GPs’ time reorganization." International Journal of Integrated Care 23, S1 (December 28, 2023): 507. http://dx.doi.org/10.5334/ijic.icic23531.
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The digitization of Polish health care began before 2000, but recent years, especially the period of the COVID pandemic, accelerated it. The basis of the digital ecosystem of medical services is the e-health system P1. P1 consists of digital services: e-prescription, e-referral, DMR, and applications: Internet Patient Account, MojeIKP, office.gov.pl, as well as solutions improving the processes of planning and implementing health care services.
One of the most popular e-tools used in medical services is the e-prescription. It was first issued in 2018, and since 2020 it has been a permanent element of e-services. Its advantages are, for example:
-accelerating and facilitating the process of issuing prescriptions,
-ensuring the correctness of issuing an e-prescription,
-this prescription cannot be lost, because it is ""in the patient's phone"" and on his electronic account
-the doctor has an access to all e-prescriptions filled by the patient
-it enables the National Health Fund to keep accurate statistics on issued and dispensed prescriptions
Since January 2016, nurses and midwives in Poland have had the right, with some restrictions, to prescribe basic medicines (on their own) and to continue prescription medicines ordered by a doctor, with the exception of narcotics and psychotropic drugs. That has given an easier access to certain health services for Polish patients.
Currently, both e-prescriptions and the nurse prescribing, as a systemic solution, allow Polish doctors for saving their time and spending it more effectively on the complex needs of their patients.
The aim of this study is to present the data of nursing prescribing as well as to show how nurse e-prescription influences the time saving by doctors.
The study is based on the statistical data and the initial simulation was carried in Medical and Diagnostic Center LTD. An in-depth analysis may deliver crucial knowledge not only for single doctors, but also health managers and politicians.
The study covers the years 2016-2022 and answers the following research questions:
1.How many e-prescriptions have been issued since the implementation of the e-prescription by doctors and nurses/midwives?
2.How has nursing prescription evolved due to digitalization – comparative study of statistical data
3.How many nurses do regularly issue e-prescriptions (at least once a month)?
4.What is the possibility of saving time by the doctors when prescription visits are carried out by nurses?
5.What challenges do e-prescriptions face as a tool that serves the medical personnel, patients and the whole health system?
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Firas Widianto, Izhhar, Akhmad Kharis Nugroh, and Chairun Wiedyaningsih. "The Role of E-Prescription in Reducing Medication Error in The Prescribing Stage at The Puskesmas Mojoanyar, East Java." BIO Web of Conferences 75 (2023): 05019. http://dx.doi.org/10.1051/bioconf/20237505019.
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Electronic prescription or e-prescription has been considered as a solution to overcome errors in the early stage of medicines use. However, the electronic prescribing is still not widely implemented in Indonesia. The purpose of this study was to identify the role of electronic prescription in minimizing the incidence of medication errors at the prescribing stage. A cross-sectional study was conducted to compare errors between electronic and hand-written prescriptions in primary health care Mojoanyar. Mojokerto, East Java. Prescriptions were collected retrospectively using purposive and quota sampling based on predetermined criteria. A checklist form was used to collect and review prescriptions during the period February March 2021 (hand-written prescriptions) and December 2022 January 2023 (e-prescriptions). Errors in prescribing were identified in aspects related to the prescription writing process (incompleteness information; illegibility writing) and aspects related to drug selection decisions (drug interaction, drug dosage form, drug dosing and therapeutic duplication). The Chi-square test was used for testing relationships between categorical variables as appropriate. The data were presented in frequency and percentage using descriptive statistics. A total of 2570 prescriptions from 656 patients were reviewed for errors in which 1275 (328 patients) hand-written and 1295 (328 patients) electronic prescriptions. The results showed that incompleteness information was found to be significantly higher in hand-written compared to electronic prescriptions (p < 0.05). Illegible writing was only found in 92 (7.22%) hand-written prescriptions. The risk of drug interactions and other errors in drug selection decisions were not reduced by electronic prescribing. Electronic prescription was able to reduce prescribing errors, especially in the writing process, while for treatment decision it was necessary to add feature to the electronic support system.
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Poudel, R. S., R. M. Piryani, S. Shrestha, A. Prajapati, and B. Adhikari. "Prescription errors and pharmacist intervention at outpatient pharmacy of Chitwan Medical College." Journal of Chitwan Medical College 5, no. 2 (August 14, 2015): 20–24. http://dx.doi.org/10.3126/jcmc.v5i2.13150.
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Prescribing errors are harmful to the patients. The role of pharmacist in reducing potential harm from prescription errors have been highlighted by several studies. This study aimed to evaluate the drug related prescription error and pharmacist intervention at outpatient pharmacy of Chitwan Medical College Teaching Hospital. A cross-sectional study was conducted in the outpatient Pharmacy of Chitwan Medical College Teaching Hospital from November 2014 to December 2014. The outpatient pharmacist randomly selected 5000 prescription and checked for drug related prescription error using prescription error checklist. The pharmacist discussed the prescription errors with the prescriber. The prescriptions that were corrected by the prescribers were considered as pharmacist intervened prescriptions (pharmacist intervention). Descriptive statistics including Chi-square test were done for statistical analysis using IBM-SPSS version 20. Out of 5000 prescriptions 176 drug related prescription error was found. The commonest error was dose and dosing frequency error (39.2%), duplication (33.5%) and dosage form related error (19.3%). Most of the prescription errors were noted while prescribing antimicrobial drugs (27.8%), proton pump inhibitors (15.9%) and NSAIDs (12.5%). The pharmacist’s recommendation was accepted by prescriber in 90.3% of prescription . Chi-square test showed significant association (p=0.019) between prescription errors and pharmacist intervention. Pharmacist intervention can reduce the drug related prescription error, so the pharmacist and clinician need to strongly work together for reducing overall prescriptions error.
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Trivedi, Nitant, Hemangini R. Acharya, Manish J. Barvaliya, and C. B. Tripathi. "Prescribing pattern in patients of asthma visiting outpatient departments of a tertiary care hospital: a cross-sectional, observational study." International Journal of Basic & Clinical Pharmacology 6, no. 3 (February 24, 2017): 587. http://dx.doi.org/10.18203/2319-2003.ijbcp20170818.
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Background: Objective of the study was to evaluate the prescribing pattern in patients of asthma visiting outpatient departments.Methods: Collected prescriptions were analyzed for demographic variables, proportions of various comorbid conditions, average number of drugs per prescription, average number of anti-asthmatic drugs per prescription, proportion of prescription with antibiotics, fixed dose combinations, and generic/brand names, proportion of formulations utilized, proportion of concomitant medications and possible drug interactions, average cost per prescription, average cost of antiasthmatic drugs per prescription, proportion of irrational prescription and adverse drug reactions.Results: Total 139 prescriptions were evaluated. Deriphyllin was the most commonly prescribed anti-asthmatic drug followed by beta agonist- steroid combination. Majority drugs were prescribed by inhalational route. Deriphyllin, and dexamethasone were prescribed by oral route and salbutamol was by both oral and inhalational route of administration. Antibiotics were prescribed to 24 patients. Possible drug interaction with deriphyllin was found in 15 prescriptions. Average cost per prescription was Rs. 193.4 (95%CI: 171.6-215.3).Conclusions: Prescribing pattern of asthma in our hospital shows more use of anti-asthmatic drugs. Standard treatment guideline should be followed. Role of methylxanthine in long term management of asthma should be justified.
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Tasleem, P., M. Reshma, M. Sai Kiran, L. Reddenna, and V. Sreedhar. "ROLE OF CLINICAL PHARMACIST IN CLINICAL AUDIT AT DEPARTMENT OF GENERAL MEDICINE." Journal of Biomedical and Pharmaceutical Research 10, no. 1 (February 9, 2021): 16–21. http://dx.doi.org/10.32553/jbpr.v10i1.826.
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Background of the study: Inaccuracy in writing and poor legibility of handwriting or incomplete writing of a prescription can lead to misinterpretation, thus leading to errors in dispensing and administration. Both individual and system related factors are responsible for prescribing errors. Recognition is the essential step in building safer systems and preventing errors. These errors can be detected by systematic analysis of prescriptions through a prescription audit. Hence, this project was proposed to improve the prescription practice by recommending the prescribing and therapeutic interventions in a selected setting of Anantapur.
Research Methodology: The study was approved by the ethical committee of the hospital. Before starting the study, the researcher obtained formal permission from Government General Hospital, Anantapuramu. The data collection period was for 6 months. A prospective observational design was adopted for this study. The prescriptions were selected on the basis of inclusion criteria. Descriptive statistics like frequency and percentage were calculated to describe the data.
Results and discussion: The overall observation made from this study was that clinical pharmacist could identify some drug related problems, provides clinical pharmacy services and contribute to better patient care being a part of the healthcare team.
Conclusion: There is enormous scope for the clinical pharmacist to play an important role in health care in various aspects like monitoring ADRs, provision of drug information, identifying DRPs and patient counseling which will bring better patient outcome.
Key words: Adverse drug reactions, Clinical audit, Clinical Pharmacist, prescription audit
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Talay, Louis, Matt Vickers, and Tiffany Cheng. "The Role of Pharmacists in Minimizing the Risk Inherent in Unbundled Telehealth Services: A 12-Month Retrospective Case Study." Pharmacy 12, no. 6 (November 25, 2024): 177. http://dx.doi.org/10.3390/pharmacy12060177.
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Pharmacists have often been viewed as the last line of defence against prescription errors in traditional care models. Although a large number of chronic care patients are using telehealth services to increase their access to continuous care, researchers have yet to investigate prescription safety in such settings in Australia. The absence of this literature is particularly concerning in the context of the Australian Government’s admission in a 2024 report that the national health system has not adequately addressed the World Health Organization’s ‘Medication without harm’ objective. One of the report’s key findings was that knowledge on digital direct-to-consumer services is insufficient. A defining feature of some of these services is their unbundling of the pharmacy component, which logically increases the risk for prescription errors. This study analyzed the frequency of which the Cloud pharmacy network intercepted prescription errors in an unbundled digital sexual dysfunction service for men. Investigators found that Cloud pharmacists were responsible for intercepting 22 (5.31%) the 414 prescribing errors observed in the Pilot Australia service in 2023, including 12 (8.05%) of the 149 prescription errors for premature ejaculation (PE) patients and 10 (3.77%) of the 265 errors for erectile dysfunction (ED) patients. Seven of the errors intercepted by Cloud pharmacists were of high or medium severity, including four drug contraindications, two cases of inadequate patient history reviews, and one case of inadequate counselling. This study also appears to be the first to provide digital prescribing error rate data in an Australian sexual healthcare setting, observing an error rate of 0.86% from 30,649 ED prescriptions, 1.13% from the 13,154 PE prescriptions, and a total prescription error rate of 0.95% (414 out of 43,792 prescriptions). These findings demonstrate the vital role of pharmacists in intercepting prescribing errors in unbundled telehealth services. Possible implications of these findings include the allocation of additional resources across the pharmacy sector and the establishment of regulatory safety standards for unbundled telehealth services.
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Elfowiris, Abdulsalam F. "Pattern of PPIs dispensing and the role of pharmacists in control of inappropriate prescriptions." مجلة أكاديمية الجبل للعلوم الأساسية والتطبيقية 1, no. 1 (November 28, 2022): 23–28. http://dx.doi.org/10.58309/aajpas.v1i1.10.
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Even though Proton pump inhibitors (PPIs) are generally considered safe, they still have serious adverse effects in case of inappropriate use. The prescription of PPIs must be based on clear clinical need. This study was aimed to prospects the uncontrolled and inappropriate dispensing of PPIs, as well as the pattern of PPIs prescription. A total of 20932 prescriptions of PPIs were collected from the community and private pharmacies, and the prescribed and non-prescribed dispensing PPIs were evaluated. The results of the study have shown that there is an irrational prescription of PPIs with a huge demand for non-prescribed PPIs. For omeprazole, the percentage of prescribed to non-prescribed was 12% and 88%, respectively. While, Pantoprazole and Esomeprazole were 40% and 60%, and Lansoprazole was 27% and 73%. In summary, PPIs need more control from qualifying pharmacists to avoid the dangers of misuse and drug interaction.
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Eteraf Oskouei, Tahereh, Elaheh Vatankhah, and Moslem Najafi. "The Status of Potentially Inappropriate Medication Prescription by General Physicians for The Elderly in Tabriz (Iran) According to Beers Criteria." Salmand 16, no. 2 (July 1, 2021): 274–87. http://dx.doi.org/10.32598/sija.16.2.3045.1.
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Objectives: Prescribing medication for the elderly is an important health issue. This study aimed to investigate the status of Potentially Inappropriate Medications (PIMs) prescription for the elderly by general physicians in Tabriz, Iran. Methods & Materials: This descriptive cross-sectional study was conducted in 2019 on the prescriptions of general physicians for the elderly in Tabriz, Iran. After initial screening of 16842 prescriptions belonged to two insurance systems (social security insurance and health insurance), 1500 prescriptions were selected. The Beers criteria 2019 was used to assess PIM prescription status and their alternatives were suggested if needed. Data were expressed as Mean±Standard Deviation (SD) and No. (%), and analyzed in SPSS v. 21 software. The Mann-Whitney U test was used to examine the differences in the study factors between the prescriptions related to two insurance systems. The relationship between patients’ age and PIM prescription was examined using Spearman correlation test. Results: The Mean±SD number of drugs in each prescription was 3.93±1.5 and the Mean±SD number of prescribed PIMs was 0.74±0.8. Polypharmacy was observed in 32.6% of the prescriptions, and 53.9% had at least one PIM. Non-steroidal anti-inflammatory drugs, antihistamines and benzodiazepines were the most PIM groups (45.6, 10.9 and 10.6%, respectively). The most common prescribed PIMs were Adult cold, Diclofenac, Glibenclamide, Ketorolac and Diphenhydramine. Number of PIMs in each prescription did were not statistically different between the prescriptions related to two insurance systems (P=0.343). Moreover, patients’ age and gender had no significant relationship with PIM prescription (P=0.312 and P=0.660, respectively). Conclusion: About 54% of the prescriptions issued by general physicians for the elderly in Tabriz contain PIMs, and polypharmacy is present in about one third of the prescriptions. In order to improve this condition, it is necessary to hold appropriate training and continuous retraining courses in geriatric medicine for general physicians. Supervisions by the Iranian Ministry of Health and Iranian Medical Council can also play an important role in improving the current situation.
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Lim, Dong Woo, Jung Yun Ahn, Ga Ram Yu, Jai Eun Kim, and Won Hwan Park. "Study on the distribution in major disease category and frequency of clinical usage of national health insurance herbal prescription based on analysis on KCD8 disease code of indications." Journal of Korean Medicine 44, no. 1 (March 1, 2023): 1–15. http://dx.doi.org/10.13048/jkm.23001.
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Objectives: National health insurance herbal prescription of Korean medicine has been serving important role in public healthcare in spite of continuous demand on revision of system. However, the categories of insurance herbal prescriptions are not equally distributed throughout the KCD-based major disease categories. We analyzed statistical database of claimed national health insurance classified as major disease categories by years. We classified all 56 herbal prescriptions as per their total medical indications into 22 major disease categories to analyze their distribution. Significant increase of M and S-T code claims were found, whereas decrease of U code claims by years. We figured out that the 56 prescriptions were unequally distributed along with enrichment of certain codes such as K and J. Meanwhile, the insurance claim of each prescription was positively correlated with number of code types of their indications. As a result, we believe that the reform of national health insurance herbal prescription list is necessary to promote use of it in clinic.
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Kim, Heekyung, Mangyeong Lee, Jaegon Kim, and Juhee Cho. "General prescription pattern of insured herbal preparation in South Korea: A nationwide cohort study." Journal of Korean Medicine 45, no. 3 (September 1, 2024): 14–30. http://dx.doi.org/10.13048/jkm.24034.
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Objectives: Research on the general prescription patterns of insured herbal preparations in Korea has been limited. This study aimed to analyze prescription patterns of insured herbal preparations, utilizing the National Health Insurance Service (NHIS) sample cohort 2.0 data from 2010 to 2019.Methods: NHIS sample cohort 2.0 database, which represents a sample of 2.2% of the Korean population, was analyzed. We analyzed data related to prescriptions recognized as insured herbal preparations. Variables included patient demographics, diagnosis codes, prescription details, and healthcare institution characteristics. We examined trends over the decade, focusing on herbal formulae and single herb extracts.Results: During the study period, 275,358 patients visited Korean traditional medicine clinics and received at least one prescription of herbal preparations, representing 27.5% of the total sample. The number of prescriptions increased by 209%, from 34,621 in 2010 to 72,553 in 2019. Females accounted for 67% of these prescriptions, and 77% were for patients aged 70 and older. The top ten herbal formulae (TTHF), including Ojeok-san and Gungha-tang, constituted 76% of all prescriptions. Herbal formulae were used more frequently than single herb extracts, with certain prescriptions being commonly utilized. There was a notable focus on musculoskeletal disorders, with low back pain being the most common diagnosis.Conclusion: The study demonstrates a significant increase in the use of insured herbal preparations, primarily in small clinics and among the elderly. Prescription patterns showed a preference for specific single herb extracts and herbal formulae, with consistent trends over time. These findings provide valuable insights for future clinical research and policy development, particularly as herbal medicine's role in the national healthcare system continues to expand.
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Dimassi, Hani, Aline Bou Maroun, Marguerita Saadeh, Joanne Khabsa, Jessica Lynn Abdou, and Shadi Saleh. "Views of community pharmacists in Lebanon on the unified prescription: a mixed method study." Eastern Mediterranean Health Journal 26, no. 12 (December 1, 2020): 1539–47. http://dx.doi.org/10.26719/emhj.20.127.
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Background: The unified prescription was introduced in Lebanon in 2011; an aim was to save on medication expenditure. Aims: The aim of this study was to evaluate the views of community pharmacists on the effect and usefulness of the unified prescription. Methods: A cross-sectional telephone survey of community pharmacists from all governorates of Lebanon was conducted. A questionnaire was used to collect demographic data, pharmacists’ views on the effect of the unified prescription on their work, the percentage of prescriptions in which the prescriber had indicated that the medicine should not be substituted with a generic equivalent and the percentage needing clarification from the prescriber. Face-to-face interviews were held with 12 pharmacists to explore their views further. Results: Of 251 pharmacists interviewed, 56.8% did not think the unified prescription was useful, 34.8% thought it complicated their work and 24.0% that it reduced their autonomy. The in-depth interviews showed that autonomy was perceived to be restricted because of the difficulty in convincing patients to accept a substitute generic medicine, which the unified prescription allowed. The unified prescription complicated pharmacists’ work because of increased paperwork and the need for more storage. Pharmacists felt that the large number of prescriptions in which the prescriber had indicated that the medicine should not be substituted undermined the purpose of the unified prescription. Conclusion: The implementation of the unified prescription was not considered a success by community pharmacists in Lebanon. Efforts are needed to improve communication with prescribers and educate the public about pharmacists’ role and generic medicines.
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Baghel, Ruchi, Sandeep K. Adwal, Vivek Singh, and Ashutosh Chourishi. "Prescribing Pattern and drug utilization study in inpatients of department of Orthopaedics in a rural teaching hospital of Ujjain, Madhya Pradesh, India." International Journal of Basic & Clinical Pharmacology 7, no. 9 (August 23, 2018): 1763. http://dx.doi.org/10.18203/2319-2003.ijbcp20183486.
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Background: Drug utilization study can increase our understanding of how drugs are being used. This study was done to evaluate the current drug prescribing trend in management of indoor patient of orthopaedic department and to comment on rationality of the prescribed medicines.Methods: This is a prospective observational study conducted for 12 months, in Chandrikaben Rashmikant Gardi Hospital, a 600 bedded tertiary care rural based, teaching hospital. Total 611 patients were included in this study.Results: Total 5416 drugs were prescribed in 611 prescriptions. Average number of drugs per prescription was 8.86. Average duration of prescription was 10.7 days. Percentage of drugs prescribed by generic name was 28.8%. Percentage of encounter with an Antibiotic prescribed was 60.23% i.e. out of 611 prescriptions antibiotics were prescribed in 368. Percentage of encounter with an Injection prescribed was 63% which means out of 611 prescriptions, injectables were prescribed in 385. Percentage of drugs prescribed from National Essential Medicine List was 52.63%. Percentage of drugs prescribed from WHO model List was 32.46%. Diclofenac (14.25%) was most commonly prescribed drug. Incidence of polypharmacy was quite high in context of Analgesics. Almost 40% of prescriptions had 2 drugs. Orally prescribed Analgesics were 62.6%, Injectables 34.38% and Topical 3.02%.Conclusions: This study reveals that the pattern of prescription in terms of rationality is poor. Special attention needs to be given to the irrational prescribing in terms of polypharmacy and long duration. Continuing medical education regarding appropriate use of drugs, knowledge of adverse effects and standard prescription guidelines will play pivotal role in rational prescription of drugs.
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Rathore, Aryan, Reva Bharara, and Krishna Kumar Tiwari. "Cost-effective Digital Prescription using Pharmaceutical Knowledge Graph." Asian Journal of Research in Computer Science 16, no. 4 (December 11, 2023): 336–43. http://dx.doi.org/10.9734/ajrcos/2023/v16i4395.
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In the current era of the advancing medical domain and the ever-evolving use of technology in fields of pharmaceutical research, remote monitoring, and decision support systems in healthcare, prescription management has transformed from handwritten prescriptions to digital ones. This transition however does not imply that these prescriptions are comprehensive and provide optimized treatment outcomes. These digital prescriptions still reflect the formerly used handwritten prescriptions. Thus, recipients face the daunting challenge of making cost-effective, holistic, informed, and personalized decisions without compromising the legitimacy and authenticity of the original prescription, all due to a lack of readily available alternative medicine options. This problem can be addressed by utilizing the knowledge graph that we built, which contains carefully curated medical information collected from reliable and diverse sources, ensuring the authenticity and relevance of the information. Delving into the intricate interconnections among diverse medical entities and their properties, the medical knowledge graph presents an invaluable solution, empowering the generation of smart digital prescriptions in a fast and precise manner. Specifically, this study focuses on the transformative potential of digital prescriptions, elucidating their role in streamlining healthcare processes and enhancing communication between healthcare providers and patients. By leveraging the insights derived from our medical knowledge graph, we aim to contribute to the advancement of digital prescription systems, fostering more effective, personalized, and technology-driven healthcare solutions.
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Razdan, Danish, Shikha Yadav, Kavita Rajesh Gudibanda, Vibhor Dudhraj, Shailja Anand, Suneet Kaur, and Arti Bahl. "Assessing prescribing practices in Indian health facilities: a comprehensive review." International Journal Of Community Medicine And Public Health 10, no. 12 (November 30, 2023): 5095–101. http://dx.doi.org/10.18203/2394-6040.ijcmph20233814.
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Prescription patterns play a critical role in healthcare delivery, affecting the efficacy of medication therapy and resource utilization. Rational prescribing practices are essential for safe and effective healthcare, necessitating comprehensive prescriptions containing medication details, prescriber information, and patient instructions. This review explores prescription completeness and rationality, utilizing WHO prescribing indicators and other completeness metrics, across Indian healthcare facilities. A systematic search was conducted in PubMed and Google Scholar for original research articles published between 2013 and 2023, focusing on WHO-recommended prescribing indicators and completeness criteria. Inclusion criteria covered articles in English, spanning primary, secondary, or tertiary care settings. Data from selected articles were extracted and analysed. Data were synthesized from sixty-seven studies, depicting various prescribing practices. The assessment encompassed prescribing, patient care, and facility indicators. Findings highlighted challenges such as illegible prescriptions, incomplete details, polypharmacy, brand name dominance, and inappropriate antibiotic use. Despite WHO recommendations, generic prescribing was limited. This review reiterates the need for interventions to enhance prescription quality, patient safety, and cost-effectiveness. Recommendations include adopting electronic prescribing systems, standardizing prescription formats, conducting regular prescription audits, implementing educational programs, promoting generic drug use, and adhering to essential medicines lists. These multifaceted strategies can improve prescribing practices and ultimately contribute to enhanced healthcare outcomes in India.
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Kumar, Aravinda. "Patterns of drug use and drug dispensing in dermatology outpatient prescriptions in a tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 7, no. 8 (July 23, 2018): 1494. http://dx.doi.org/10.18203/2319-2003.ijbcp20182932.
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Background: Periodic assessment of drug prescribing and dispensing pattern in a hospital facility shall play a major role in avoiding the inappropriate use of drugs which leads to potential hazards and expenses for the patients.Methods: The objective of the study was to analyse the patterns of drug use and dispensing in dermatology outpatient prescriptions from a tertiary care teaching hospital in south India. Data were collected over a period of one month from patients attending dermatology outpatient department by scrutinizing 100 prescriptions and analyzed using WHO formulated “core drug use indicators” like the format, prescribing pattern and rationality of prescriptions.Results: The total number of drugs prescribed in 100 prescriptions was 233 i.e. on average 2.33 drugs were prescribed per patient. The patient's name and age were mentioned in all the prescriptions while diagnosis, dose, route of administration, dosage form, duration of therapy and prescriber's identity was written in 43.29%, 68.04%, 69.07%, 100%, 49.48% and 63.91% prescriptions respectively. Out of all drugs, 42.91% were generic drugs and 57.08% were from National Essential Drug List of India. Steroids (18.02%) were the most common group of drugs used, followed by keratolytics and emollients (15.87%). Most of the drugs were given by topical route (47.63%).Conclusions: A prescription by a doctor is a reflection of physicians’ attitude towards the disease and the role of drug in its treatment. It also provides an insight into the nature of health care at that facility. Interventions to rectify over proper prescription format and prescription of generic drugs are necessary to further improve rational drug use in this facility.
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Spigelmyer, Amy, Catessa Howard, Ilya Rybakov, Sheena Burwell, and Douglas Slain. "96. Impact of Hospital-Based Pharmacist Discharge Prescription Review on the Appropriateness of Antibiotic Therapy." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S163. http://dx.doi.org/10.1093/ofid/ofab466.298.
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Abstract Background Inappropriate antibiotic prescribing upon hospital discharge poses an increased risk of excess costs, adverse drug reactions, readmission, and resistance. Despite high rates of antibiotic prescription errors upon discharge, there is no widely accepted antimicrobial stewardship initiative to prevent such errors. This study evaluated the impact of hospital-based clinical pharmacist discharge prescription review on the appropriateness of antibiotic prescriptions. Methods This was a retrospective assessment of patients with discharge antibiotic prescriptions for treatment of pneumonia, urinary tract infections, Clostridioides difficile infections, acute skin and skin structure infections (ABSSSI), or Gram-negative bacteremia between January 2019 and July 2020. The two cohorts that were studied were patients on Hospitalist services versus patients on Medicine services, in which only the Medicine services had rounding pharmacists who perform discharge prescription reviews. Outcomes included demographics, appropriateness of therapy, 30-day readmission rates, and error types in discharge prescriptions. Appropriateness of therapy was validated by evidence-based guidelines and three Infectious Diseases-trained pharmacists. Results Our study included 300 patients, 150 per cohort. Baseline characteristics were similar between groups, with the exception of increased age (p=0.025) and fewer cases of ABSSSI (p=0.001) in the Hospitalist cohort. A statistically significant higher rate of inappropriateness was seen in the Hospitalist group versus Medicine (pharmacist) group, [69/150 (46% versus 25/150 (17%, respectively (p< 0.00001)]. The difference in appropriateness was mainly driven by pneumonia and UTI prescriptions. Thirty day readmission rates were 17% (26/150) for the Hospitalist cohort versus 11% (16/150) in the Medicine (pharmacist) cohort (p=0.134). The most common prescription error was the duration of therapy. Conclusion Appropriateness of antibiotic discharge prescriptions significantly improved in the setting of pharmacist discharge prescription review. This initiative highlights the important role of clinical pharmacists in the setting of outpatient antimicrobial stewardship. Disclosures All Authors: No reported disclosures
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Daheim, Jacob, Shin Ye Kim, Ashley Neduvelil, and Nguyen P. Nguyen. "Men, Chronic Pain, and Prescription Pain Medication Use: The Role of Gender Role Beliefs in a Longitudinal Moderated Mediation Model." Pain Medicine 21, no. 12 (September 10, 2019): 3603–14. http://dx.doi.org/10.1093/pm/pnz200.
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Abstract Objective Although past research has established that men with chronic pain are more likely to misuse prescription pain medications in a myriad of ways compared with women, little is known about men’s medication use in the context of their gender role beliefs. The aim of the present study was to examine the role of men’s domestic gender role beliefs on their use of prescription pain medication for chronic pain. Methods Using a nationally representative data set with 304 men with chronic pain, this study examined a longitudinal moderated mediation model in which pain interference mediates the longitudinal relationship between somatic amplification and prescription pain medication use, with domestic gender role beliefs as a moderator of the aforementioned mediated relationship. Results Results indicated a significant moderated mediation model in which pain interference fully mediated the relationship between somatic amplification and prescription pain medication use, with men’s domestic gender role beliefs moderating this mediated relationship. Specifically, domestic gender role beliefs moderated the relationship between pain interference and prescription pain medication use. Men with higher levels of traditional domestic gender role beliefs strengthened the mediated relationship, contributing to increased prescription pain medication use. Conclusions These findings suggest that although men’s perceptions of somatic stimuli through its perceived interference contribute to their medication use, the extent to which they consume prescription pain medication depends on their beliefs in domestic gender roles during chronic pain.
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Pettitt-Schieber, Brian, Robert P. Lesko, Fei Wang, Jinesh Shah, and Joseph A. Ricci. "Opioid prescribing patterns for distal radius fractures in the ambulatory setting: A 10-year retrospective study." Journal of Opioid Management 20, no. 2 (April 1, 2024): 109–17. http://dx.doi.org/10.5055/jom.0862.
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Objective: Distal radius fractures (DRFs) are one of the most common orthopedic injuries, with most managed in the nonoperative ambulatory setting. The objectives of this study are to examine National Health Center Statistics (NHCS) data for DRF treated in the nonoperative ambulatory setting to identify opioid and nonopioid analgesic prescribing patterns and to determine demographic risk factors for prescription of these medications. Design, setting, patients, and measures: This study is a retrospective analysis of data collected by the NHCS from 2007 to 2016. Utilizing International Classification of Diseases codes, all visits to emergency departments and doctors’ offices for DRFs were identified. Variables of interest included demographic data, expected payment source, and prescription of opioid or nonopioid analgesics. Results: During the study timeframe, 15,572,531 total visits for DRFs were recorded. DRF visits requiring opioid and nonopioid analgesic prescriptions increased over time. Patients aged 45-64 years were significantly more likely to receive an opioid prescription than any other age group (p < 0.05). Opioid prescription was positively correlated with the use of workers’ compensation and negatively correlated with patients receiving services under charity care (p < 0.05). Conclusions: Prescriptions of both opioid and nonopioid analgesic medications for DRF have been steadily increasing over time in the nonoperative ambulatory setting, with middle-aged adults most likely to receive an opioid prescription. Opioid prescription rates differ significantly between patients utilizing workers’ compensation and patients receiving services under charity care, suggesting that socioeconomic factors play a role in prescribing patterns.
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Brander, Caila, Jessica Nouhavandi, and Terri-Ann Thompson. "Online Medication Abortion Direct-to-Patient Fulfillment Before and After the Dobbs v Jackson Decision." JAMA Network Open 7, no. 10 (October 4, 2024): e2434675. http://dx.doi.org/10.1001/jamanetworkopen.2024.34675.
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ImportanceOnline pharmacies have emerged as stakeholders in abortion care since the US Food and Drug Administration (FDA) relaxed in-person dispensing requirements in 2020. The role of online pharmacies in dispensing abortion medications following the Dobbs v Jackson Women’s Health Organization decision on June 24, 2022, is understudied.ObjectiveTo describe medication abortion prescription fulfillment patterns for 1 online pharmacy 1 year before and after the Dobbs v Jackson decision, considering patient, prescriber, and state policy characteristics.Design, Setting, and ParticipantsThis cross-sectional study assesses deidentified medication abortion prescription fulfilment data from 1 online pharmacy. Prescribers sent prescription requests to the online pharmacy, which dispensed abortion medications to patients by mail. The study sample included prescription requests fulfilled by the online pharmacy between June 20, 2021, and June 24, 2023, for patients aged at least 18 years who received the combined medication abortion regimen. Data were analyzed from July 2023 to July 2024.ExposuresThe US Supreme Court Dobbs v Jackson decision on June 24, 2022.Main Outcomes and MeasuresPatient and prescriber characteristics are described, including patient age, state to which the prescription was sent, medications prescribed, and prescribing prescriber’s clinic care modality (in-person only, hybrid [in-person and virtual], and virtual only). States were grouped according to the Guttmacher Institute classification of policy support for abortion (most or very supportive, somewhat supportive, and somewhat restrictive). Fulfillment trends were disaggregated by prescriber modality and state policy environment; 2 states with similar telehealth but differing coverage policies (Illinois and Colorado) were compared.ResultsThe dataset included 87 942 observations. Most prescriptions were sent to individuals younger than 30 years (57.1%), with a mean (SD) age of 28.7 (6.4) years. Throughout the study period, the greatest volume of prescription requests came from states with most or very supportive policies and from prescribers at virtual-only platforms. More prescriptions were sent in the year after Dobbs v Jackson (daily mean [SD], 88.5 [47.2] prescriptions in March 2022 vs 201.5 [97.5] prescriptions in March 2023) with fulfillment spikes following the Dobbs v Jackson leak on May 2, 2022, and decision on June 24, 2022. State policy contexts mirrored the overall trends, while prescriber modality trends were unique, with a big spike in fulfillment at 12 weeks after the Dobbs v Jackson decision for hybrid clinics compared with in-person-only clinics and telehealth-only platforms, which saw their largest spikes in mean daily prescription fulfillment the week immediately after Dobbs v Jackson. Illinois and Colorado had similar fulfillment trends, with spikes immediately following the Dobbs v Jackson decision and overall higher fulfillment after Dobbs v Jackson, with a daily mean (SD) of 10.5 (7.0) prescriptions in Illinois and 8.8 (5.7) prescriptions in Colorado in March 2022 versus 26.6 (13.6) prescriptions in Illinois and 16.7 (10.1) prescriptions in Colorado in March 2023.Conclusions and RelevanceThese findings illustrate the increasingly critical role online pharmacies play in direct-to-patient abortion care provision in the US and the strong linkages between virtual-only prescribers and online pharmacies. These findings suggest that barriers to accessing online pharmacies for abortion care should be removed.
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Wilson, Debbie L. "Preventing Prescription Drug Abuse: A Pharmacy Technician Tool Kit." Journal of Pharmacy Technology 36, no. 5 (July 4, 2020): 218–19. http://dx.doi.org/10.1177/8755122520939639.
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The misuse of prescription medications in the United States is a worsening public health problem. Pharmacy technicians are often the first pharmacy staff member to receive newly dropped off prescriptions and to interact with patients in the pharmacy. Having a tool kit of the knowledge and skills needed to distinguish prescriptions that may result in misuse from the legitimate ones and to respond appropriately and professionally to each is essential to pharmacy technicians performing their role and function in the dispensing process.
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Belova, Olga. "Etiology of Prohibitions and Regulations in the Mirror of Folk Legends and Beliefs." Slavic & Jewish Cultures: Dialogue, Similarities, Differences, no. 2018 (2018): 246–65. http://dx.doi.org/10.31168/2658-3356.2018.17.
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The author's task is to formulate some general statements on how prohibitions and regulations addressed to or attributed to the “other” (ethnic, religious) tradition are formed in the Slavic folk culture, and what cultural stereotypes affect the form and content of the prescriptive texts originating and existing in a multi-confessional cultural environment and in the cultural borderlands. We are interested in prohibitions and regulations in the context of folk legends that explain their appearance, and in connection with beliefs that play the role of a kind of fixator of certain prescriptive norms. In the etiological texts (legends, fairy tales) containing the interpretation of the ban / prescription, in addition to the motivation of the described ban / prescription (why something is prohibited or allowed), there may be a reference to the precedent, i.e. the etiology itself (what exactly was the reason, the impetus, the primary source of the ban / prescription).
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Zeino, Miriam, Romain Léguillon, Pauline Brevet, Baptiste Gerard, Catherine Chenailler, Johanna Raymond, Lucas Bibaut, et al. "An Overview of Opioid Prescription Patterns among Non-Opioid Users Following Emergency Department Admission." Healthcare 12, no. 11 (June 3, 2024): 1138. http://dx.doi.org/10.3390/healthcare12111138.
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The evolving landscape of opioid prescription practices necessitates a comprehensive understanding of emerging patterns, particularly among new opioid users discharged from emergency departments. This study delves into the intricate realm of opioid utilization by elucidating the prevalence of their prescriptions. A retrospective analysis of electronic health records was conducted, including a cohort of 71 patients who received opioid prescriptions upon discharge from emergency departments from 1 January 2022 to 30 June 2022. Demographic characteristics and prescription details were systematically examined. This study illuminates tramadol’s prominence, with 84% of prescriptions and a Defined Daily Dose (DDD) morphine equivalent of 60 mg, as the primary choice as a new opioid, a finding that draws attention due to the closely aligned dosages with morphine equivalents. This discovery prompts a critical reassessment of tramadol’s therapeutic role, considering its multifaceted nature encompassing serotonergic effects and heightened fall risks. This study advocates for a nuanced and vigilant approach to tramadol prescription, cognizant of its potential risks and therapeutic implications, and highlights the imperative of optimizing data quality and traceability within electronic health records to enhance patient care and facilitate future research endeavors.
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Dr.Nasreen Jan, Dr Nasreen Jan, Dr Raja Ruhail, Dr Masrat Nabi, Dr Sami Magray, Dr Sheikh Hanan, Dr Asra Jabeen, and Dr Rehab Rafi. "Prescription Auditing in Outpatient Departments of Associated Hospitals of Government Medical College Anantnag." International Journal of Pharmaceutical Research and Applications 09, no. 05 (May 2024): 567–75. https://doi.org/10.35629/4494-0905567575.
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Background: A prescription audit is a quality improvement tool for ensuring the rational use of drugs and is based on documented evidence of diagnosis, treatment, and instructions to achieve the same. A periodic prescription audit is required to identify common deficiencies in prescriptions and to undertake corrective measures to improve prescribing practices. In this study, we aim to understand the prescription practices and identify the bottlenecks and opportunities for improvement and prescribing behavior of physicians using the WHO-recommended core prescribing indicators and the National Health Mission proposed additional indicators at a teaching hospital. Methods: A Prospective, Observational study is going on in outpatient departments of a tertiary care hospital of GMC Anantnag and we present the data in this study of the initial two years of the audit. A total 1125 prescriptions were audited on the checklist formulated by NHM as per standard auditing parameters. 17 parameters were evaluated. Prescriptions collected from OPDs of various clinical departments were analyzed in the department of pharmacology. RESULTS: The audit revealed that the average number of antibiotics prescribed was 26.8%in 2021& 7.5% in 2022and only 19.67% in 2021&0.3%in 2022 of the drugs were prescribed by generic name. Whereas, the percentage of prescriptions duly signed was 15.5%&12%in 2021and 2022 respectively and the prescription of injectables was 27% in 2021&12.6%in 2022 which was less than the ideal recommendations as per WHO, and 1265 (88%) of the drugs were prescribed from the National List of Essential Medicines Prescription auditing gives a current scenario of prescribing practices in a tertiary care hospital setting. Conclusion: This prospective observational study points towards the great need for improvement in prescribing patterns in areas of antibiotic prescribing, generic names, dose, and dosage forms, thus reducing the practice of polypharmacy. Through a comprehensive review of relevant literature, coupled with empirical data collection and analysis, this endeavors to shed light on the role of prescription auditing as a proactive measure in promoting rational prescribing habits and mitigating potential risks associated with medication use.
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Bevan, Amanda, and Niesh Patel. "AN ELECTRONIC PRESCRIPTION ALERTING SYSTEM-IMPROVING THE DISCHARGE MEDICINES PROCESS." Archives of Disease in Childhood 101, no. 9 (August 17, 2016): e2.55-e2. http://dx.doi.org/10.1136/archdischild-2016-311535.59.
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BackgroundWhilst the prescribing of both in-patient and discharge medicines is electronic, there was no automatic notification to clinical pharmacists when a discharge prescription was ready to be screened. The notification required a member of medical or nursing staff to bleep their pharmacist informing them of a prescription's availability. This manual process led to a delay in pharmacist screening which impacted on discharge. Prescriptions designated for pre-packed or patient's own medicine use were not seen at all by a clinical pharmacist. The initial intention was to develop a text messaging service; however this was not possible due to significant cost implications and its inflexibility.AimTo decrease the time to clinical pharmacist screening for children's discharge prescriptions.MethodA clinical pharmacist prescription alerting system was designed and implemented. The hospital's eDischarge Summaries are created and stored in the Trust's EPR database. A database query is executed that examines documents that have been signed by a prescriber which contain drug orders. The query runs every 15 minutes, Monday to Friday from 0800–2000. The database query exports a HTML data extract which is then packaged and sent using Exchange.Email was preferred as users access hospital WiFi, only receiving notifications on those laptops or smartphones connected to the Trust's email application. The HTML is embedded within the email body. The email is sent to named individuals within a given distribution list. The function is scalable to support all areas using Trust eDischarge Summaries.The system was introduced in April 2015. Data from before (June 2014–January 2015) and after (June 2015) implementation was compared.ResultsPrior to the introduction of an electronic alerting system the average time from a prescriber signing a prescription to clinical pharmacist screening was 93 minutes. Three months after starting the new system this time has reduced to 62 minutes, a reduction of 31 minutes or 33%. During the same time period, the number of discharge prescriptions screened by pharmacists rose from 172 to 218, an increase in workload of 26%.It has been possible to intervene on prescriptions containing errors which the clinical pharmacists would not previously have screened.ConclusionThe use of an electronic messaging system has met its primary aim to decrease the time delay from signing to pharmacist screening it has also increased pharmacist efficiency as evidenced by the increased workload.One limitation of this system is that it requires a regular e-mail check, for available prescriptions. The report runs every 15 minutes, an email is only sent if a prescription is found.The notification of all discharge prescriptions containing medicines has led to the identification of errors which have required intervention, in those prescriptions that a pharmacist would not have previously seen. These interventions have been for children who have received pre-packed antibiotics directly from the wards or for those where we have provided one-stop dispensing.It is hoped to role out this system across other areas of the organisation which should also enjoy this significant improvement in discharge prescription turnaround.
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Chua, Kao-Ping, Thuy D. Nguyen, Jennifer F. Waljee, Romesh P. Nalliah, and Chad M. Brummett. "Association Between State Opioid Prescribing Limits and Duration of Opioid Prescriptions From Dentists." JAMA Network Open 6, no. 1 (January 11, 2023): e2250409. http://dx.doi.org/10.1001/jamanetworkopen.2022.50409.
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ImportanceIn part to prevent the harms associated with dental opioid prescriptions, most states have enacted policies limiting the duration of opioid prescriptions for acute pain. Whether these limits are associated with changes in the duration of opioid prescriptions written by dentists is unclear.ObjectiveTo evaluate the association between state opioid prescribing limits and the duration of opioid prescriptions from dentists.Design, Setting, and ParticipantsThis difference-in-differences cross-sectional study used data from the IQVIA Longitudinal Prescription Database, an all-payer database reporting prescription dispensing from 92% of retail pharmacies in the US. The sample included opioid prescriptions from dentists dispensed to children aged 0 to 17 years and adults 18 years or older from January 2014 through February 2020. Treatment states were those that implemented limits between January 2016 and December 2018. Control states were those that did not implement limits during the study period. Data on opioid prescribing limits were derived from the Prescription Drug Abuse Policy System. Data were analyzed from January 1 to September 30, 2022.ExposuresState opioid prescribing limits.Main Outcomes and MeasuresThe outcome was opioid prescription duration, as measured by days’ supply. The association between limits and duration was evaluated using a linear model with a 2-way fixed-effects specification. Covariates included patient characteristics, prescription characteristics, and indicators of implementation of prescription drug monitoring program use mandates. Separate analyses of data from adults and children were conducted owing to differences in the number of treatment states and restrictiveness of limits by age.ResultsThe adult analysis included 56 607 314 opioid prescriptions for 34 364 775 patients (18 448 788 females [53.7%]; mean [SD] age at the earliest fill, 44.0 [17.4] years) in 22 treatment states and 12 control states. The child analysis included 3 720 837 opioid prescriptions for 3 165 880 patients (1 740 449 females [55.0%]; mean [SD] age at the earliest fill, 14.4 [3.5] years) in 23 treatment states and 12 control states. In both analyses, the median (25th-75th percentile) duration of opioid prescriptions was 3.0 (2-5) days. Implementation of limits, most of which allowed up to a 7-day supply of opioids, was not associated with changes in the duration of opioid prescriptions for adults (mean days’ supply: −0.06 days; 95% CI, −0.11 to &lt;0.001 days) or children (mean days’ supply: −0.07 days; 95% CI, −0.15 to 0.02 days).Conclusions and RelevanceIn this study of national pharmacy dispensing data, opioid prescribing limits were not associated with changes in the duration of opioid prescriptions from dentists. Future research should investigate the potential role of alternative interventions in reducing opioid prescribing by dentists.
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Gentile, Ivan, Nicola Schiano Moriello, Rogier Hopstaken, Carl Llor, Hasse Melbye, and Oliver Senn. "The Role of CRP POC Testing in the Fight against Antibiotic Overuse in European Primary Care: Recommendations from a European Expert Panel." Diagnostics 13, no. 2 (January 15, 2023): 320. http://dx.doi.org/10.3390/diagnostics13020320.
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Tackling antibiotic resistance represents one of the major challenges in modern medicine, and limiting antibiotics’ overuse represents the first step in this fight. Most antibiotics are prescribed in primary care settings, and lower respiratory tract infections (LRTIs) are one of the most common indications for their prescription. An expert panel conducted an extensive report on C-reactive protein point-of-care (CRP POC) testing in the evaluation of LRTIs and its usefulness to limit antibiotic prescriptions. The expert panel stated that CRP POC testing is a potentially useful tool to limit antibiotic prescriptions for LRTI in a community setting. CRP POC must be used in conjunction with other strategies such as improved communication skills and the use of other molecular POC testing. Potential barriers to the adoption of CRP POC testing are financial and logistical issues. Moreover, the efficacy in limiting antibiotic prescriptions could be hampered by the fact that, in some countries, patients may gain access to antibiotics even without a prescription. Through the realization of a better reimbursement structure, the inclusion in standardized procedures in local guidelines, and better patient education, CRP point-of-care testing can represent a cornerstone in the fight against antimicrobial resistance.
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Verulava, Tengiz. "THE PROBLEMS OF THE IMPLEMENTATION OF PRESCRIPTION INSTITUTION IN THE INSTITUTIONAL DEVELOPMENT OF HEALTH CARE IN GEORGIA." Economic Profile 18, no. 2(26) (December 19, 2023): 32–42. http://dx.doi.org/10.52244/ep.2023.26.05.
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Ministry of Labour, Health and Social Affairs realized reform from 1th february till 1th september in 2014 for prescription system implementation. According to these changes pharmaceutical products of second group becamethe prescription medicines. In Georgia, access to and supply Rx medicines is governed by a regulatory framework. Second group drugs are only available to the public when prescribed by doctors on new prescription form N 3. The aim of research is to reveal and evaluate positive and negative sides of new prescription system; to study it, sinfluence on achievement process to drugs. As part of the quantitative research, doctors and pharmacists of the medical institution were interviewed. As part of the qualitative research, in-depth interviews with healthcare experts were conducted. The special questionnaire was designed for each aimed group. The questionnaires consist of open and closed questions. The results of the study revealed the positive aspects of the Prescription Institute: with this reform, the system returned to the logic of normal clinical medicine; The role of the doctor in relation to the patient's pharmacotherapy has been strengthened; The competence of the pharmacist was included in the appropriate framework and the specific skills of selling medicinal products by prescription were developed; The culture of purchasing medicines with prescriptions has been established among the population; At the same time, the results of the research revealed such actual problems that are an obstacle to the introduction of the prescription institute: prescription drugs are sold without a prescription; In the doctor's offices opened next to the pharmacies, the doctor is limited to prescribing only prescriptions; In case of chronic or long-term diseases, patients' access to prescription drugs is complicated; Doctors do not have complete information about the dispensing mode of this or that pharmaceutical product from the pharmacy. Pharmacists talk about the lack of specific skills in prescribing prescriptions: in the case of more than one medicine prescribed on one prescription form, the prescription is cancelled; Prescriptions not certified with a seal are invalid; Incorrectly indicated generic name, inconsistency between generic and trade names, prescription of a combined pharmaceutical product with a generic name prolongs the service of the user; Incorrectly indicated course of treatment, drug release forms, medicinal dose are the cause of misunderstanding; e.g. A pharmacist is prohibited from selling a 10 mg tablet of the same name medicine instead of a specified 5 mg tablet. One of the goals of the reform planned by the Ministry of Health is the correct treatment, the reduction of the share of expenses on medicine and the harm caused by self-medication. It is too early to talk about these achievements within the framework of the conducted research, however, one of the details was revealed that will contribute to the reduction of expenses on medicines, namely: it is necessary to indicate the diagnosis in the prescription according to ACD-10; The doctor's prescription should always be consistent with the diagnosis; The institute of prescriptions should reveal the rationality of the prescription issued by the doctor, compliance with the guidelines, which will partially reduce the costs of medicines. The reform implemented in connection with the restoration and establishment of the Institute of Recipes in Georgia is a step forward. The medical community unequivocally welcomes this change. The competence and authority of the doctor increased; the specific rules for prescribing by a doctor and issuing prescription medication by a pharmacist are gradually being established. Along with the highlighted positive aspects, significant systemic errors and technical flaws are visible. The sale of drugs of the second group without a prescription is an obstacle to the introduction of the Institute of Prescriptions. At this stage, fining the pharmacy cannot solve the problem. The Ministry of Health considers the establishment of an electronic prescription system to eliminate this problem. The current activity of the "pharmacy" doctor also hinders the reform. Access to medicines for patients with chronic diseases is complicated. The existing classification of medicines has flaws. Recommendations Based on the conducted research, the following recommendations were developed: • Improving the administration of the prescription institute implementation process; • Study of the activities of "pharmacy" doctors by the Agency for the Regulation of Medical Activities; • Refinement of regulatory normative base, administration tools; • Revision of the classification of pharmaceutical products and periodically making rational changes taking into account the data of AMEA, WHO, PSUR; • In order to use medicines rationally, it is advisable to introduce a system of electronic prescriptions.
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Bansal, Preety, Seema Baishnab, and Ashima Singla. "Drug prescribing pattern of antifungal drugs for local fungal infections in a tertiary care hospital: MAMC, Agroha." International Journal of Basic & Clinical Pharmacology 10, no. 6 (May 25, 2021): 689. http://dx.doi.org/10.18203/2319-2003.ijbcp20212079.
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Background: Drug utilization research or studies are the powerful exploratory tools to ascertain the role of drugs in the society which refers to the marketing, distribution, prescription and use of drugs with special emphasis on the medical, social and economic consequences. Periodic prescription audit in form of drug utilization study is a way to improve the quality of prescription and promote rational prescribing.Methods: This was a prospective and an observational study. Prescriptions included all newly diagnosed patients with cutaneous fungal infection of both sexes who attended dermatology OPD. Factors considered were sociodemographic parameters and WHO prescribing indicators.Results: 1000 prescriptions were analysed of patients between 18 to 65 years of age with cutaneous fungal infections. The average number of drugs per encounter was 3.68. The percentage of drugs prescribed by generic name was 50.33% and the percentage of drugs prescribed from NLEM was 20.93%.Conclusions: This study indicates that prescribing practices of drugs in tertiary care hospital can be improved by promoting generic name drug prescribing, prescribing drugs from NLEM and by reducing polypharmacy.
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Owczarek, Artur, Dominik M. Marciniak, Rafał Jezior, and Bożena Karolewicz. "Assessment of the Prescribing Pharmacist’s Role in Supporting Access to Prescription-Only Medicines—Metadata Analysis in Poland." Healthcare 11, no. 24 (December 5, 2023): 3106. http://dx.doi.org/10.3390/healthcare11243106.
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In 2020, pharmacists in Poland received additional authority to prescribe drugs. In this study, we analyzed prescribing after the implementation of this new responsibility. We assessed how the new regulation works in practice and what it means for the healthcare system in the area of access to prescription-only medicines. Data analysis included information on the prescriptions written, the type of substance according to the ATC classification, and data on the prescribing pharmacists. The study used over 2.994 million e-prescriptions written by pharmacists in Poland, which were made available by the e-Health Center. The largest group of drugs prescribed were drugs used in the treatment of cardiovascular diseases, accounting for 25% of all prescribed medications during the time of the analysis. The next prescription groups were for drugs used in gastrointestinal diseases and metabolic disorders, and those acting on the central nervous system, the respiratory system, and the musculoskeletal system. Among pharmaceutical prescriptions, 73% were pharmaceutical prescriptions issued in pharmacies at full price to the patient. The results indicate that pharmacists are eager to use their permission to prescribe drugs in authority situations. Almost three million records showed improved patient access to medicines in the healthcare system (approximately 5% of repeat prescriptions for all patients during the study period). These data confirm the possibility of cooperation between physicians and pharmacists in strengthening the efficiency of the patient healthcare system. An important conclusion from this work is the need to create the possibility for the pharmacist to access the information resources of the implemented Internet Patient Account system, including therapeutic indications for the drugs used.
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Chaaban, Taghrid, Mathieu Ahouah, Wissam Nasser, Wafaa Hijazi, Pierre Lombrail, Jean-Manuel Morvillers, and Monique Rothan-Tondeur. "Nurses’ role in medical prescription: Systematic review." Journal of Nursing 5, no. 1 (2018): 2. http://dx.doi.org/10.7243/2056-9157-5-2.
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Carnwath, Tom. "Heroin prescription: a limited but valuable role." Psychiatric Bulletin 29, no. 4 (April 2005): 126–27. http://dx.doi.org/10.1192/pb.29.4.126.
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Luty (2005, this issue) performs a valuable service by directing attention to the new guidelines from the National Treatment Agency. He explains clearly why he thinks these guidelines are wrong. I was a member of the expert advisory group that produced the guidelines, and will therefore attempt to defend them (my arguments do not necessarily reflect the views of all members of the group).
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Kern, Winfried V., and Karel Kostev. "Prevalence of and Factors Associated with Antibiotic Prescriptions in Patients with Acute Lower and Upper Respiratory Tract Infections—A Case-Control Study." Antibiotics 10, no. 4 (April 16, 2021): 455. http://dx.doi.org/10.3390/antibiotics10040455.
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Background: The goal of the present study was to estimate the prevalence of patient and physician related variables associated with antibiotic prescriptions in patients diagnosed with acute lower and upper respiratory tract infections (ALURTI), treated in general practices (GP) and pediatric practices, in Germany. Methods: The analysis included 1,140,095 adult individuals in 1237 general practices and 309,059 children and adolescents in 236 pediatric practices, from the Disease Analyzer database (IQVIA), who had received at least one diagnosis of an ALURTI between 1 January 2015 and 31 March 2019. We estimated the association between 35 predefined variables and antibiotic prescription using multivariate logistic regression models, separately for general and pediatric practices. The variables included the proportion (as a percentage) of antibiotics or phytopharmaceuticals on all prescriptions per practice, as an indicator of physician prescription preference. Results: The prevalence of antibiotic prescription was higher in patients treated in GP (31.2%) than in pediatric practices (9.1%). In GP, the strongest association with antibiotic prescription was seen in the practice preference for antibiotic use, followed by specific diagnoses (acute bronchitis, sinusitis, pharyngitis, laryngitis, and tracheitis), and higher patient age. In pediatric practices, acute sinusitis and bronchitis were the variables with the strongest association, followed by practice preference for antibiotic prescription. The strongest association with the non-prescription of antibiotics was practice preference for phytopharmaceuticals and the specific diagnosis of a viral infection. Conclusion: This study shows a high prevalence of antibiotic prescribing for patients with ALURTI in a primary care setting, especially in adult patients; physician related factors play an important role that should be addressed in interventions to reduce potentially inappropriate antibiotic prescribing.
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Hossain, Fariha Binte, Sanjay Jayasinghe, Katrina Blazek, Wen-Qiang He, and Bette Liu. "Pneumococcal vaccination and primary care presentations for acute respiratory tract infection and antibiotic prescribing in older adults." PLOS ONE 19, no. 4 (April 18, 2024): e0299924. http://dx.doi.org/10.1371/journal.pone.0299924.
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Background While the 23-valent pneumococcal polysaccharide vaccine (PPV23) has demonstrated its role in preventing severe pneumococcal disease, its impact on more non-specific conditions like acute respiratory tract infection (ARI) and lower respiratory tract infections (LRTI) remains unclear. We aimed to investigate the role of PPV23 in prevention of presentations for ARI and LRTI and related antibiotic prescriptions among older adults in primary care. Methods Using a nationwide general practice dataset, we followed a cohort of regularly attending patients aged ≥65 years from 1 January 2014 until 31 December 2018 for presentations for ARI, LRTI, and related antibiotic prescriptions. Associations between PPV23 receipt and each outcome were assessed using a multiple failures survival model to estimate hazard ratios (HR) adjusted for age, sex, socioeconomic status, and various health measures. Results A cohort of 75,264 patients aged ≥65 years (mean 75.4, 56% female) in 2014 was followed. The incidence of presentations for ARI, ARI-related antibiotic prescription, LRTI, and LRTI-related antibiotic prescription was 157.6, 76.0, 49.6, and 24.3 per 1000 person-years, respectively. Recent PPV23 vaccine receipt was associated with a small reduction in ARI presentations (adjusted HR vaccinated vs. unvaccinated 0.96; 95%CI 0.94–0.98; p = 0.002); however, there was no reduction in ARI-related antibiotic prescription, LRTI presentation, nor LRTI-related antibiotic prescription (adjusted HR were 0.99[95%CI 0.96–1.03], 1.04[95%CI 0.99–1.09], 1.07[95%CI 1.00–1.14]). Conclusion PPV23 vaccination in older adults may result in a small reduction in the incidence of total ARI presentations in primary care. However, the effect is small and residual confounding cannot be excluded.
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Shah, Anjali, and Ajita Pillai. "A study of prescribing pattern of micronutrients in dermatology outpatient department at tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 11, no. 5 (August 24, 2022): 401. http://dx.doi.org/10.18203/2319-2003.ijbcp20222134.
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Background: Skin is the first line of defence for protecting our bodies against external perturbations, including ultraviolet (UV) irradiation mechanical/chemical stress, and bacterial infection. Different vitamins and trace elements are vital for skin health. The present study was planned to define the prescription pattern of micronutrients in the different skin diseases.Methods: An observational and cross-sectional conducted in the out-patient department of dermatology at a tertiary care teaching hospital in Rajkot, Gujarat over a period of two months. Prescriptions of 200 patients were analysed.Results: In our study, 200 prescriptions were evaluated. The average number of micronutrients per prescription was 1.95. In male average number of micronutrients per prescriptions was 2.01 while in female it was 1.91. Multivitamin B complex was the most commonly prescribed micronutrient.Conclusions: We observed that multivitamin B complex was the most commonly prescribed micronutrients followed by vitamin C in skin diseases. Though micronutrients play an important role in the body for healthy skin, it is overprescribed.
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Hendricks, Michelle A., Sanae El Ibrahimi, Grant A. Ritter, Diana Flores, Michael A. Fischer, Roger D. Weiss, Dagan A. Wright, and Scott G. Weiner. "Association of Household Opioid Availability With Opioid Overdose." JAMA Network Open 6, no. 3 (March 17, 2023): e233385. http://dx.doi.org/10.1001/jamanetworkopen.2023.3385.
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ImportancePrevious studies that examined the role of household opioid prescriptions in opioid overdose risk were limited to commercial claims, did not include fatal overdoses, and had limited inclusion of household prescription characteristics. Broader research is needed to expand understanding of the risk of overdose.ObjectiveTo assess the role of household opioid availability and other household prescription factors associated with individuals’ odds of fatal or nonfatal opioid overdose.Design, Setting, and ParticipantsA retrospective cohort study assessing patient outcomes from January 1, 2015, through December 31, 2018, was conducted on adults in the Oregon Comprehensive Opioid Risk Registry database in households of at least 2 members. Data analysis was performed between October 16, 2020, and January 26, 2023.ExposuresHousehold opioid prescription availability and household prescription characteristics.Main Outcomes and MeasuresOpioid overdoses were captured from insurance claims, death records, and hospital discharge data. Household opioid prescription availability and prescription characteristics for individuals and households were modeled as 6-month cumulative time-dependent measures, updated monthly. To assess the association between household prescription availability, household prescription characteristics, and overdose, multilevel logistic regression models were developed, adjusting for demographic, clinical, household, and prescription characteristics.ResultsThe sample included 1 691 856 individuals in 1 187 140 households, of which most were women (53.2%), White race (70.7%), living in metropolitan areas (75.8%), and having commercial insurance (51.8%), no Elixhauser comorbidities (69.5%), and no opioid prescription fills in the study period (57.0%). A total of 28 747 opioid overdose events were observed during the study period (0.0526 per 100 person-months). Relative to individuals without personal or household opioid fills, the odds of opioid-related overdose increased by 60% when another household member had an opioid fill in the past 6 months (adjusted odds ratio [aOR], 1.60; 95% CI, 1.54-1.66) and were highest when both the individual and another household member had opioid fills in the preceding 6 months (aOR, 6.25; 95% CI, 6.09-6.40).Conclusions and RelevanceIn this cohort study of adult Oregon residents in households of at least 2 members, the findings suggest that household prescription availability is associated with increased odds of opioid overdose for others in the household, even if they do not have their own opioid prescription. These findings underscore the importance of educating patients about proper opioid disposal and the risks of household opioids.
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Gossage, Seth, Vicky Kalogera, and Meng Sun. "Magnetic Braking with MESA Evolutionary Models in the Single Star and Low-mass X-Ray Binary Regimes." Astrophysical Journal 950, no. 1 (June 1, 2023): 27. http://dx.doi.org/10.3847/1538-4357/acc86e.
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Abstract Magnetic braking has a prominent role in driving the evolution of close low-mass binary systems and heavily influences the rotation rates of low-mass F- and later-type stars with convective envelopes. Several possible prescriptions that describe magnetic braking in the context of 1D stellar evolution models currently exist. We test four magnetic braking prescriptions against both low-mass X-ray binary orbital periods from the Milky Way and single-star rotation periods observed in open clusters. We find that the data favor a magnetic braking prescription that follows a rapid transition from fast to slow rotation rates, exhibits saturated (inefficient) magnetic braking below a critical Rossby number, and that is sufficiently strong to reproduce ultra-compact X-ray binary systems. Of the four prescriptions tested, these conditions are satisfied by a braking prescription that incorporates the effect of high-order magnetic field topology on angular momentum loss. None of the braking prescriptions tested are able to replicate the stalled spin down observed in open cluster stars aged 700–1000 Myr or so, with masses ≲0.8 M ⊙.
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Vakili Arki, Hassan, Ehsan Nabovati, Mohammad Reza Saberi, Pourya Eslami, Zhila Taherzadeh, and Saeid Eslami. "Evaluation of the effect of informing patients through text messaging on antibiotic prescription by physicians in outpatient setting: a study protocol." Frontiers in Health Informatics 10, no. 1 (May 14, 2021): 76. http://dx.doi.org/10.30699/fhi.v10i1.281.
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Introduction: Irrational prescription of antibiotics has become a major global concern, and not only does it have health-related consequences, but it also affects countries’ overall economy. Based on reports and studies, antibiotics are prescribed in approximately 50% of prescriptions in Iran which can demand by patients as a major cause. It is anticipated that increasing the awareness and understanding of both physicians and patients, regarding the antibiotic use and resistance, could play an important role in the rational prescription of antibiotic medications. In this study, we will examine the effect of informing patients via text message right before their appointment on the proportion of prescribed antibiotic medications.Material and Methods: In this study, a randomized control trial (RCT) will be conducted. The setting in which the study will be carry out, consists of 64 physicians (29 general physician and 35 specialist). Unit of randomization will be physicians based on the proportion of their prescriptions that include antibiotic medications (PIA). The first arm of the study is the intervention group, which consists of the patients receiving three text messages in the clinic’s waiting rooms. The second arm is the control group, and consists of the patients who won’t be receiving any text messages. The content of the text messages focuses on the consequences of self-medication with antibiotics, the fact that the use of antibiotics is not an option for curing viral diseases including cold, and it also asks the patients not to demand antibiotics by trusting their physicians.Results: The main variable that will be measured is the proportion of prescriptions that include antibiotic medications.Conclusion: This trial will be the first one to evaluate the patients’ role in the proportion of prescriptions that include antibiotic medications. It is hypothesized that patients’ demand for antibiotic medication is one of the main causes of irrational antibiotic prescription by physicians.
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Frahm, Niklas, Melanie Peters, Jörg Bätzing, David Ellenberger, Manas K. Akmatov, Judith Haas, Paulus S. Rommer, Alexander Stahmann, Uwe K. Zettl, and Jakob Holstiege. "Treatment patterns in pediatric patients with multiple sclerosis in Germany—a nationwide claim-based analysis." Therapeutic Advances in Neurological Disorders 14 (January 2021): 175628642110483. http://dx.doi.org/10.1177/17562864211048336.
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Background: The manifestation of multiple sclerosis (MS) in childhood and adolescence occurs in 3%−5% of all MS cases. However, the immunomodulatory and symptomatic treatment options in this population group are still limited. Objective: We aimed to elucidate the prescription frequency of medications used in pediatric patients with multiple sclerosis (PwMS) compared with the general population, considering the entire spectrum of medications prescribed. Methods: Based on nationwide outpatient drug prescription data and statutory health insurance (SHI) physicians’ claims data from 2018, we conducted a population-based cross-sectional study in Germany. Children and adolescents aged ⩽17 years ( n = 11,381,939) diagnosed with MS ( n = 613), and a matched (age, sex, and health insurance sector) control group ( n = 6130) were included. The prescription prevalence was measured as the proportion of MS patients with ⩾1 prescription. Results: Of the 613 pediatric PwMS with a median age of 16 years, 403 (65.7%) were female. For 15 out of the 18 different active agents analyzed, PwMS had a significantly higher prescription prevalence than the control group (Fisher’s exact test: p ⩽ 0.037). The most frequently prescribed drugs in PwMS were ibuprofen (28.4%; anti-inflammatory drug), cholecalciferol (23.0%; vitamin D3), and interferon beta-1a (21.5%; disease-modifying drug, DMD). The proportions of DMD prescriptions and antibiotic prescriptions were higher among PwMS aged 15–17 years than among those ⩽14 years (DMD: 43.4% vs 34.2%, p = 0.05; antibiotic: 34.1% vs 24.8%, p = 0.031). In contrast, younger PwMS were more likely to receive a prescription for anti-inflammatory/anti-rheumatic drugs (36.6% vs 26.5%, p = 0.02). Conclusion: Our study analyzing real-world medication data showed that interferon beta, anti-inflammatory drugs, and vitamins play an essential role in the treatment of pediatric PwMS. Future research should evaluate longitudinal treatment patterns of pediatric PwMS, paying particular attention to the time of diagnosis, time of first DMD initiation, and therapy switches.
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Sexton, PharmD, Scott M., Christopher M. Herndon, PharmD, BCACP, and Jordan D. Sinclair, PharmD. "Patterns of heroin use following index prescription opioid exposure." Journal of Opioid Management 16, no. 1 (January 1, 2020): 49–57. http://dx.doi.org/10.5055/jom.2020.0550.
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Objective: This study examined the means of obtainment, indication, and prescriber of an index opioid in self-reporting heroin users.Design: Cross-sectional, observational study.Setting: A survey was submitted by participants in the United States with current or past heroin use.Participants: Three hundred twenty-three participants greater than 18 years of age completed the survey.Main outcome measure: Participants were surveyed regarding prescription opioid use prior to heroin initiation and specifically how they were obtained. Surveys were comprehensive in nature, divulging information including which opioid(s) was/were used, how they were obtained, by which prescriber (if prescribed), and if there was a diagnosis for chronic pain.Results: Roughly 47 percent of participants reported using prescription opioids prior to heroin. The most commonly used prescription opioid prior to heroin initiation was oxycodone (92.5 percent). The most common acquisition of opioids was through the prescribing of a physician, which occurred in roughly 63 percent of cases. These prescriptions were obtained most often from primary care physicians and emergency departments. Only 34 percent of participants reported being diagnosed with a chronic pain condition prior to using heroin.Conclusions: This study further supports the role that prescription opioids play in the transition to heroin use. It suggests that oxycodone is the most common prescription opioid used prior to heroin initiation. Additionally, it reports descriptive information as to how and where prescription opioids are obtained.
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Carro, George W., Bruce Brockstein, Thomas A. Hensing, Patrick Joseph Fleming, Shannon Maureen Gavin, Wayne Spath, Abigail Harper, Wendy Hui, William J. Uhlig, and Brad Hughes. "Evaluation of oral chemotherapy prescribing at an outpatient oncology clinic." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 191. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.191.
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191 Background: Oral chemotherapy’s exponentially increasing role in the treatment of malignancies continues to pose unique challenges to oncology. The American Society of Clinical Oncology (ASCO) and Oncology Nursing Society (ONS) drafted measures in the Chemotherapy Administration Safety Standards that help address some of these issues concerning oral chemotherapy. There is a lack of data describing the prescribing process for oral chemotherapy. In a retrospective chart review, prescriptions at a hospital-based outpatient oncology center were evaluated for completeness of prescribing and follow up measures. Methods: A retrospective chart review of ten oral chemotherapy medications from May 2012 to July 2012 was conducted. The primary outcome measure was compliance with ASCO and ONS Chemotherapy Administration Safety Standards. A secondary outcome was frequency of pharmacist interventions on oral chemotherapy prescriptions. Results: 412 prescriptions were evaluated. Prescriptions were graded on a scale from 1 to 8. One point was given for inclusion of each of the following: prescribing physician, patient name, drug name, dose, dosing methodology, quantity, refills, and accurate directions. Of all the prescriptions, 23% contained all aspects of a complete prescription. The most common reasons for point deductions were contradictory or unclear directions and allowing refills for oral chemotherapy which should not be refillable. Four percent of prescriptions had a documented pharmacist intervention. Conclusions: This study revealed areas for improvement in the prescribing process of oral chemotherapy. Targeting directions and refill fields within prescription templates will improve compliance with ASCO and ONS standards. This can be accomplished by implementing customized oral chemotherapy prescription templates within treatment plans in the electronic medical record system. Unlike chemotherapy administered in the clinic setting, oral chemotherapy prescriptions are not generally reviewed by oncology trained pharmacists. With the collaboration of medical and nursing staff, a new work flow was implemented which includes pharmacist review of electronic oral chemotherapy prescriptions.
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., Priyanki, Kusum Kumari, Manju Gari, and Anuj Kumar Pathak. "A study of the current prescribing and drug utilization pattern in Ophthalmology Department of a tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 8, no. 3 (February 23, 2019): 497. http://dx.doi.org/10.18203/2319-2003.ijbcp20190654.
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Background: The aim was to study the current prescribing and drug utilization pattern in Ophthalmology Department of a tertiary care teaching hospital. Drug utilization study is a part of pharmaco-epidemiological exercise quantifying the extent, nature and determinants of drug use in a population. Periodic audit of drug usage pattern forms an essential tool to ascertain the role of drug in a society, increase therapeutic efficacy and improve cost effectiveness of the therapy. It is an introspective and critical instrument providing positive impact on health care delivery to the patient. With this background, the present study was carried out to analyze the prescription pattern and drug utilization by measuring the WHO drug use indicators in ophthalmology department of a tertiary care teaching hospital.Methods: The prescriptions of 961 outpatients were included and analyzed using a predesigned case record form OPD prescription of each patient. Patient and prescription related parameters were analyzed.Results: Prescription analysis showed that the average number of drugs per prescription was 1.85. The drugs were prescribed in the form of eye drops (67.42%), followed by ointments (14.37%), capsules (15.45%), and tablets (2.71%). The dosage form and frequency of drug administration was indicated for all of the drugs prescribed, the duration of treatment for 60.97% of the drugs prescribed. Antimicrobial agents and tear substitute together constituted above 50% of all the drugs. Percentage of drugs prescribed by generic name and from NEDL was 31.62% and 37.22%, respectively. Patient’s knowledge of correct dosage was 70.44%.Conclusions: This study showed that there is scope for improvement in prescribing patterns in areas of writing generic names of drugs, essential drugs, writing legible and complete prescriptions.
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Hartung, Daniel M., Jennifer Hall, Sarah N. Haverly, David Cameron, Lindsey Alley, Christi Hildebran, Nicole O’Kane, and Deborah Cohen. "Pharmacists’ Role in Opioid Safety: A Focus Group Investigation." Pain Medicine 19, no. 9 (June 17, 2017): 1799–806. http://dx.doi.org/10.1093/pm/pnx139.
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Abstract Objective The pharmacist’s role and responsibilities in addressing the opioid epidemic have yet to be clearly defined, particularly from the patient’s point of view. This qualitative study explores the pharmacist’s role in promoting opioid safety from the perspective of pharmacists and patients. Design Focus groups. Setting Patient groups were held in person, and pharmacist groups were held online. Subjects Oregon pharmacists (N = 19, Mage = 39.0 years, range = 26–57 years, 58% female) and patients (N = 18, Mage = 60.1 years, range = 30–77 years, 71% female) with current experience dispensing or receiving opioid medications. Methods Pharmacists were asked about the challenges and opportunities for opioid safety monitoring and prescription dispensing. Patients were asked about their experiences accessing care, medications, and safety information. Focus group data were analyzed by a multidisciplinary team using an immersion-crystallization approach. Results Pharmacists and patients agreed that pharmacists are responsible for medication safety. Pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing. Patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers’ clinical decisions. Conclusions Feedback from both pharmacists and patient participants suggests that there is uncertainty in the degree to which pharmacists can and should confront the prescription opioid epidemic directly. Ambiguities in the pharmacist’s role may be best clarified through structured training promoting enhanced between-party communication.
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Canova, Cristina, Gisella Pitter, Jonas F. Ludvigsson, Pierantonio Romor, Loris Zanier, Renzo Zanotti, and Lorenzo Simonato. "Coeliac disease and asthma association in children: the role of antibiotic consumption." European Respiratory Journal 46, no. 1 (April 30, 2015): 115–22. http://dx.doi.org/10.1183/09031936.00185714.
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The relationship between coeliac disease and asthma has been scarcely investigated. Infant antibiotic exposure has been linked to both diseases. We evaluated the association between childhood coeliac disease and asthma and the role of antibiotics in the first year of life.We followed a cohort of children born in 1995–2011 in the Friuli-Venezia Giulia region (Italy). Prescriptions for antibiotics in the first year of life and subsequent treated asthma were retrieved from drug prescription records; coeliac disease incident cases were identified from pathology reports, hospital discharges and exemption from prescription charges for clinical tests. We estimated incidence rate ratios (IRRs) using multivariate Poisson regression models.Among the 143 144 children, we identified 717 coeliac children and 34 969 asthmatics. Children with asthma were at increased risk of coeliac disease (IRR 1.46, 95% CI 1.25–1.67). Restricting the analysis to asthma that occurred before the diagnosis of coeliac disease, the excess risk disappeared, except for coeliac disease diagnosed after 5 years of age (IRR 1.37, 95% CI 1.09–1.71). Antibiotics were not a confounding factor in these associations.Childhood treated asthma and coeliac disease are significantly associated. This association is not confounded by antibiotic exposure in the first year of life and may be explained by other shared risk factors.
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Linde, H. van der, J. H. B. Geertzen, C. J. Hofstad, J. van Limbeek, and K. Postema. "Prosthetic prescription in the Netherlands: An observational study." Prosthetics and Orthotics International 27, no. 3 (December 2003): 170–78. http://dx.doi.org/10.1080/03093640308726679.
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Prosthetic prescription for lower limb amputees and the methodology used are primarily based on empirical knowledge. Clinical expertise plays an important role that can lead to an adequate prescription; however, a clear evidence based motivation for the choices made cannot be given. This can lead to local prescription variations with regard to overuse or underuse of prosthetic care and a lack of transparency for consumers and health insurance companies. Hence a clinical guideline may lead to a more consistent and efficient clinical practice and thus more uniformly high quality care. The purpose of this study was to get insight into potential similarities in prescription criteria in clinical practice in the Netherlands. Secondly, the authors were interested to know if prosthetic prescription was primarily based on the level of activity or intended use of the prosthesis. As part of the development of a consensus-based clinical guideline a multi-centred, cross-sectional study was carried out in order to observe the prosthetic prescription for a group of lower limb amputees. Therefore prescription data were collected from 151 amputees with trans-femoral amputation, knee disarticulation or trans-tibial amputation. Results of the multiple logistic regression show no relationship between the activity level and any of the variables included in the equation such as the hospital or medical doctor in Physical and Rehabilitation Medicine (MD in P&RM), prosthetic components, age of the amputee or reason of amputation. The criteria used are merely based on the clinical expertise and local experience whereas the actual prescriptions differ from location to location. In conclusion the development of a clinical guideline for prosthetic prescription in lower limb amputation is recommended. The information gained from this observational study will be used in a clinical guideline procedure for prosthetic prescription in the Netherlands.
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Muin, Fathul, and Anna Wahyuni Widayanti. "Using Simulated Patients to Understand Non-Prescription Antibiotic Dispensing in Indonesia: A Systematic Review." JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA 10, no. 2 (August 2, 2023): 193–201. http://dx.doi.org/10.20473/jfiki.v10i22023.193-201.
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Background: Dispensing antibiotics without a prescription at community pharmacies is a significant contributor to the ongoing global public health issue of antibiotic resistance. Objectives: To estimate the proportion of antibiotics that are dispensed without a prescription in community pharmacies in various Indonesian cities. Methods: A literature review was conducted via PubMed, Science Direct, Google Scholar, Garuda, and Neliti for articles published between January 2007 and December 2022 combined with Boolean operators. The literature search keywords were (simulated patientsOR mystery shopper OR sample patients OR dummy patients) AND ("antibiotics without prescription OR non-prescription antibiotics OR self-medication of antibiotics). The keywords are also used in Indonesian language (Bahasa), including “simulasi pasien” OR “sampel pasien” AND “antibiotik tanpa resep” OR “swamedikasi antibiotik”. Results: Seven studies from various cities have complied with the inclusion criteria and were considered when reviewing 199 articles. The findings of our studies were consistent with the extensive use of non-prescription antibiotics throughout the review. A simulation patient study design was used in all seven studies in this review. Amoxicillin recorded the highest percentage of dispensing without a prescription, while other drugs often purchased include chloramphenicol, ciprofloxacin, and cefadroxil. Among the studies reviewed, one study utilized the pre-test and post-test methods, while the others did not. Conclusion: The lack of prescriptions for antibiotics dispensing has often occurred in community pharmacies throughout Indonesia. The community pharmacist's role is needed as the final gate of pharmaceutical services in providing rational treatment and controlling the dispense of antibiotics without a prescription.
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Miszewska, Jagoda, Natalia Wrzosek, and Agnieszka Zimmermann. "Extended Prescribing Roles for Pharmacists in Poland—A Survey Study." International Journal of Environmental Research and Public Health 19, no. 3 (January 31, 2022): 1648. http://dx.doi.org/10.3390/ijerph19031648.
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Background: In recent years, a systematic increase in the role and powers of pharmacists has been observed. The COVID-19 pandemic has shown that this is a professional group that is extremely necessary for the smooth functioning of the health care system. One of the important powers of pharmacists is the possibility of issuing prescriptions for both patients in the pharmacy and for themselves and their family members. Polish pharmacists obtained extended entitlements in this field in March 2020. Due to the extension of pharmacists’ prescribing rights in Poland, it was decided in this study to determine the current practice of pharmaceutical prescribing, and pharmacists’ views on their new duties. Methods: The study used the method of a questionnaire, which was distributed to all pharmacists actively working in Poland. During the study, 309 completed questionnaires were obtained that gathered information about prescriptions written by pharmacists, as well as their opinions related to this entitlement. The results of the survey were analyzed using descriptive statistics. Results: Out of all authorized pharmacists, 75.62% use the new, extended authorization to issue pharmaceutical prescriptions. About half of them believe their prescriptions should be refundable. Only 11.52% of respondents do not use the entitlement to issue prescriptions for themselves or their family members. In addition, it was noticed that those who write such prescriptions most often use the fully paid version. Conclusions: Polish pharmacists use the new entitlements willingly but carefully. The legal provisions governing electronic prescription should be clearer. In addition, the idea of continued prescription should be developed as this is the most common reason that pharmacists issue prescriptions.
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Moore, G. E. "The role of exercise prescription in chronic disease." British Journal of Sports Medicine 38, no. 1 (February 1, 2004): 6–7. http://dx.doi.org/10.1136/bjsm.2003.010314.
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Wang, Zhendong, Yong Zhang, Qiuyun Zhang, Qiang Ao, Changyong Luo, Bochuan Wang, Chen Bai, et al. "On the Core Prescriptions and Their Mechanisms of Traditional Chinese Medicine in Hepatitis B, Liver Cirrhosis, and Liver Cancer Treatment." Journal of Oncology 2022 (September 23, 2022): 1–17. http://dx.doi.org/10.1155/2022/5300523.
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Background. As a frequent cause of death in cancer patients, liver cancer usually occurs in hepatitis B and cirrhosis. In China, Chinese people have been using traditional Chinese medicine (TCM) in treating various chronic liver diseases, which could effectively improve the symptoms and slow down the progression of liver diseases. However, due to the complexity rules of TCM prescription, their action mechanisms are still not clearly understood, which may affect the popularization of effective prescriptions. This study aims to identify the core TCM herbs in the treatment of hepatitis B, liver cirrhosis, and liver cancer so as to clarify the mechanism of action of the core herb networks. Methods. There were 1,673 prescriptions for chronic liver diseases collected in this study, of which 854 were hepatic B prescriptions, 530 were for liver cirrhosis, and 289 were for liver cancer. The basic characteristics of herbal medicine were firstly explained via descriptive analysis, then the core prescriptions of herbal medicine were analyzed through association rule, and finally, the mechanism of core prescriptions was explored with the help of systematic network pharmacology and by applying such databases as TCMIP, HERB, OMIM, GeneCards, KEGG, and software like RStudio and Cytoscape. Results. The rule of the core prescriptions in these cases was characterized by the application of herbs with both cold and warm properties, in which bitter herbs with cold property took priority. Tonifying deficiency, clearing heat, and activating blood circulations to remove stasis were common treatment principles for the three liver diseases. Turmeric Root Tuber (YuJin), White Peony Root (BaiShao), Bupleurum (ChaiHu), Salvia miltiorrhiza (DanShen), and Astragali Radix (HuangQi) were prescribed the most in hepatitis B treatment to invigorate the spleen and soothe the liver. Astragali Radix (HuangQi), Tuckahoe (FuLing), Atractylodis Macrocephalae Rhizoma (BaiZhu), Fructus Polygoni Orientalis (ShuiHongHuaZi), and Curcumae Rhizome (EZhu) were most frequently applied in liver cirrhosis treatment to replenish qi and activate blood. Oldenlandia (BaiHuaSheSheCao), Bearded Scutellaria (BanZhiLian), Curcumae Rhizome (EZhu), and Cardamom (DouKou) were most frequently prescribed to eliminate cancer toxin, invigorate the spleen, and activate blood. These core herbs mainly act through signal transduction and immune system pathways, in which the PI3K-Akt pathway plays a key role. The core prescription for liver cirrhosis regulated more endocrine system pathways than the hepatitis B prescription, and liver cancer prescription regulated more nervous system-related pathways. Conclusion. Three core prescriptions for hepatitis B, liver cirrhosis, and liver cancer treatment were identified, which acted mainly through signal transduction and immune system pathways to regulate immunity and cell growth and participate in inflammation inhibition, in which liver cancer prescription regulated more pathways, especially more nervous system-related pathways than the other two.
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Abdulla, Dalya. "Immigrant Usage Patterns of Natural Health Products: Role in Pharmacoeconomics." Current Nutrition & Food Science 16, no. 1 (January 13, 2020): 45–55. http://dx.doi.org/10.2174/1573401315666181206120420.
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Background: Understanding patterns and drivers for natural health product (NHP) usage among immigrants is essential in the provision of appropriate health care; many studies have elucidated NHP utilization among immigrants; however, few have considered impacts of concurrent NHP and prescription medication usage. Objective: The study aims to determine new immigrant NHP usage patterns (including concurrent usage with prescription medications) and to discern economic impacts driving concurrent usage. Methods: A survey questionnaire was administered to local new immigrants during English Language Training classes. Results: Most participants understood the NHP definition and would take an NHP for the same disease or condition they would normally take a prescription medication for. Many participants agreed that NHPs are not safe however were unable to provide robust examples of unsafe NHP usage. With regard to purchases of medicines for short and long term illnesses, a high percentage of participants would purchase the prescription medication for a short term illness over the NHP; however this percentage decreases in the event of a long term illness, with more participants relying on NHPs to remedy their long term illness symptoms. Conclusion: Pharmacoeconomics tends to be a major driver for immigrant utilization of NHPs, and is a stronger influencer of use compared to ethnicity or parenteral usage of such products. This pharmacoeconomic correlation in the preference to use NHPs over prescription medications tends to be more observable for chronic and long term conditions (compared to short term illnesses).
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Tan, Woan Shin, Jonathan SK Phang, and Lay Kheng Tan. "Evaluating User Satisfaction with an Electronic Prescription System in a Primary Care Group." Annals of the Academy of Medicine, Singapore 38, no. 6 (June 15, 2009): 494–500. http://dx.doi.org/10.47102/annals-acadmedsg.v38n6p494.
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Introduction: Electronic prescribing has been proposed as an important strategy to reduce medication errors, improve the quality of patient care and create savings in health care costs. Despite these potential advantages, user satisfaction plays a significant role in the success of its implementation. Hence, this study aims to examine users’ satisfaction and factors associated with satisfaction regarding an electronic prescription system implemented in the National Healthcare Group Polyclinics in Singapore. Materials and Methods: An anonymous survey was administered in October 2007 to all physicians, pharmacists and pharmacy technicians working in the 9 National Healthcare Group Polyclinics. Results: Respondents included 118 doctors and 61 pharmacy staff. The overall level of satisfaction with electronic prescribing was high. Doctors and pharmacists reported a high degree of agreement that electronic prescribing reduces prescribing errors and interventions, and they did not want to go back to the paper-based system. Users were generally satisfied with the functionality of the system but there was some degree of workflow interference particularly for the pharmacy staff. Only 56.9% of the pharmacy respondents expressed satisfaction with the review function of the electronic prescription system and only 51.8% and 60% were satisfied when processing prescriptions that included items to be purchased from an external pharmacy or prescriptions with amendments. The results also revealed that satisfaction with the system was more associated with users’ perceptions about the electronic prescription system’s impact on productivity than quality of care. Conclusion: The survey results indicate that the implementation of the electronic prescription system has gone reasonably well. The survey findings provide opportunities for system and workflow enhancement, which is important as these issues could affect the acceptability of a new technology and the speed of diffusion within an organisation. Key words: Information technology, Primary healthcare, Prescriptions