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Literatura académica sobre el tema "Prescribing appropriatene"

Autor: Grafiati

Publicado: 11 de marzo de 2023

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Artículos de revistas sobre el tema "Prescribing appropriatene"

Aronson, J. K. "Rational prescribing, appropriate prescribing". British Journal of Clinical Pharmacology 57, n.º 3 (marzo de 2004): 229–30. http://dx.doi.org/10.1111/j.1365-2125.2004.02090.x.

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Onder, Graziano. "Appropriate prescribing". Journal of Gerontology and Geriatrics 69, n.º 4 (diciembre de 2021): 286–88. http://dx.doi.org/10.36150/2499-6564-n462.

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Tully, Mary Patricia. "Appropriate prescribing". Reviews in Clinical Gerontology 3, n.º 4 (noviembre de 1993): 359–66. http://dx.doi.org/10.1017/s0959259800003609.

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Tully, Mary P. "Appropriate prescribing". Reviews in Clinical Gerontology 6, n.º 1 (febrero de 1996): 49–56. http://dx.doi.org/10.1017/s0959259800004482.

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Drennan, Vari. "Appropriate antibiotic prescribing". Primary Health Care 25, n.º 9 (30 de octubre de 2015): 15. http://dx.doi.org/10.7748/phc.25.9.15.s19.

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Apisarnthanarak, Anucha, Kittiya Jantarathaneewat, Siriththin Chansirikarnjana, Nattapong Tidwong y Linda Mundy. "2022. Antibiotic Prescribing Behavior Among Surgeon". Open Forum Infectious Diseases 6, Supplement_2 (octubre de 2019): S679. http://dx.doi.org/10.1093/ofid/ofz360.1702.

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Abstract Background A comparative study was conducted to evaluate prescribed antibiotic (AB) use in surgical patients with the Transtheoretical Model of Behavior (TTM) and Theory of Planned Behavior (TPB). Methods A survey was conducted at Thammasat University Hospital from January 1 to 31, 2019. We evaluated the appropriateness of AB uses in the surgical department reported per the hospital’s Drug Use Evaluation (DUE) form. After review of the DUE, in-depth interviews were conducted to all prescribers to explore antibiotic prescribing behavior based on TTM vs. TPB, using a standardized data collection tool. Data collected included demographics, indications, appropriateness of AB uses, the individual prescriber’s behavior based on TTM and TPB. The five TTM stages of change were categorized precontemplation, contemplation, preparation, action, and maintenance. In TPB assessment, we evaluated attitude toward AB uses, subjective norm to AB uses behavior, and perceived behavior control of AB uses behavior. Results There were 92 AB uses from 64 prescribers; 70 (70/92; 76%) used antibiotics appropriately. The majority of AB uses (62/92; 67%) were for treatment of infections. The most common reasons for inappropriate AB uses included inappropriate AB choices for treatment and prophylaxis of SSIs (n = 11, 50%) and inappropriate duration (n = 8, 36%). Physicians categorized in higher stages of TTM (action and maintenance) were strongly correlated with appropriate AB uses, while there was no correlation between the total TPB score and appropriateness of AB uses. By multivariate analysis, the TTM action and maintenance (aOR = 7.95; P = 0.02) and self-reported prescribers who considered patients as first priority (aOR = 4.02; P = 0.04) were associated with appropriate AB uses, while neurosurgical procedures (aOR = 0.13; P = 0.003) and antibiotic prescriptions for surgical prophylaxis (aOR = 0.15; P = 0.04) were associated with inappropriate AB uses. Conclusion Antibiotic prescribers categorized by TTM stages strongly correlated with appropriate AB uses. Additional studies to assess appropriate AB prescribing behavior, based on TTM stages of change, offer an opportunity to optimize surgical care. Disclosures All authors: No reported disclosures.

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Hamill, Laura M., Julia Bonnett, Megan F. Baxter, Melina Kreutz, Kerina J. Denny y Gerben Keijzers. "Antimicrobial Prescribing in the Emergency Department; Who Is Calling the Shots?" Antibiotics 10, n.º 7 (10 de julio de 2021): 843. http://dx.doi.org/10.3390/antibiotics10070843.

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Objective: Inappropriate antimicrobial prescribing in the emergency department (ED) can lead to poor outcomes. It is unknown how often the prescribing clinician is guided by others, and whether prescriber factors affect appropriateness of prescribing. This study aims to describe decision making, confidence in, and appropriateness of antimicrobial prescribing in the ED. Methods: Descriptive study in two Australian EDs using both questionnaire and medical record review. Participants were clinicians who prescribed antimicrobials to patients in the ED. Outcomes of interest were level of decision-making (self or directed), confidence in indication for prescribing and appropriateness (5-point Likert scale, 5 most confident). Appropriateness assessment of the prescribing event was by blinded review using the National Antibiotic Prescribing Survey appropriateness assessment tool. All analyses were descriptive. Results: Data on 88 prescribers were included, with 61% making prescribing decisions themselves. The 39% directed by other clinicians were primarily guided by more senior ED and surgical subspecialty clinicians. Confidence that antibiotics were indicated (Likert score: 4.20, 4.35 and 4.35) and appropriate (Likert score: 4.07, 4.23 and 4.29) was similar for juniors, mid-level and senior prescribers, respectively. Eighty-five percent of prescriptions were assessed as appropriate, with no differences in appropriateness by seniority, decision-making or confidence. Conclusions: Over one-third of prescribing was guided by senior ED clinicians or based on specialty advice, primarily surgical specialties. Prescriber confidence was high regardless of seniority or decision-maker. Overall appropriateness of prescribing was good, but with room for improvement. Future qualitative research may provide further insight into the intricacies of prescribing decision-making.

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Campbell, M., D. N. Bateman, S. J. Roberts y J. M. Smith. "Appropriate prescribing in asthma". BMJ 310, n.º 6986 (22 de abril de 1995): 1069. http://dx.doi.org/10.1136/bmj.310.6986.1069b.

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Naish, J., C. Griffiths, P. Sturdy y P. Toon. "Appropriate prescribing in asthma". BMJ 310, n.º 6992 (3 de junio de 1995): 1472. http://dx.doi.org/10.1136/bmj.310.6992.1472a.

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Lexchin, Joel. "Improving the Appropriateness of Physician Prescribing". International Journal of Health Services 28, n.º 2 (abril de 1998): 253–67. http://dx.doi.org/10.2190/abwy-yfpa-me5r-7bqp.

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Appropriate prescribing means that prescribers should try to maximize effectiveness, minimize risks and costs, and respect patients' choices. Evidence from studies on prescribing to individuals and from administrative databases reveals a significant level of inappropriate prescribing by Canadian physicians. Two important reasons for inappropriate prescribing seem to be physicians' level of knowledge and physicians' practice settings. A large number of methods have been tried to improve prescribing behavior, but most are unsuccessful. Academic detailing, and audit and feedback, have both been shown to work but may be difficult to implement in Canada, where most physicians practice in solo fee-for-service settings. Alternative forms of physician payment such as capitation or salary are probably necessary to make prescribing more appropriate.

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Tesis sobre el tema "Prescribing appropriatene"

Alotaibi, Fawaz M. "National and Local Antibiotic Prescribing Trends and Prescribing Appropriateness in Older Adults". VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5714.

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Background: Antibiotic overuse/misuse has been documented in several reports to increase the risk of Clostridioides difficile (C.diff) infection and antibiotic resistance. The older adult population is more prone to use antibiotic medications than any other age group due to decreased immune function, use of urinary catheters, ventilation during hospitalization and other factors. Antibiotic resistance and C.diff are major public health problems. However, studies examining the trends of antibiotic use and the association between the antibiotic use and negative health outcomes among older adults in the outpatient and emergency department settings are limited. Objectives: The main objectives of this dissertation were to: 1) calculate the national antibiotic trends among community-dwelling older adults in the United State; 2) evaluate the antibiotic trends and antibiotic appropriateness among older adult patients visiting the geriatrics clinic and adult internal ambulatory care clinic at VCU Health; and 3) examine the antibiotic trends and antibiotic appropriateness among older adult patients and middle-aged patients visiting the emergency department at VCU Health. Methods: For the first objective, data were obtained from Medical Expenditure Panel survey (MEPS) a nationally representative dataset (2011-2015). Descriptive analyses were conducted and multiple logistic regression was performed to assess the association between the antibiotic use and demographic and sociodemographic characteristics. In the second objective, data were obtained from VCU Health outpatient clinics (geriatrics, and Internal medicine ambulatory care clinic only). Descriptive statistics were calculated and multiple logistic regression was performed to assess the association between antibiotic appropriateness and type of clinics and other demographic characteristics. In the third objective, the emergency department electronic medical records at VCU were used. Trend analysis was performed across the dissertation studies using the Cochran–Armitage test. All variables were considered statistically significant at an α level of 0.05. All the statistical analyses were conducted using the Statistical Analysis Software Version 9.4 (SAS v.9.4), (SAS Institute Inc, Cary, NC). Results: There were 105,762,134 prescriptions dispensed to older adults in the outpatient setting in the US from 2011 to 2015. Antibiotic prescriptions were more common among women (18%) compared to men (12%). White participants received more antibiotics (27%) than African Americans (1.77%) and others (1.4%). Among the 3,515 patients who visited either Geriatrics or Internal Medicine ambulatory clinic at VCU Health from 2012-2017, 1,534 antibiotics were prescribed. Potentially inappropriate antibiotic prescriptions were similar between the two clinics (30% in Geriatrics clinic and 28% in Internal Medicine ambulatory clinic) with p-value of 0.08. In addition, 6,343 middle-aged or older adult patients were dispensed and prescribed an antibiotic in the ED at VCU Health from (2012 to 2017). Eighteen percent of the antibiotic prescriptions received by middle age group were considered potentially inappropriate, compared to 9% among the older adult patient (p < 0.0001). Conclusions: The rate of antibiotic use overall remains unchanged despite the national and international efforts to reduce antibiotic prescriptions and eventually to reduce antibiotic resistance. The changes in the patterns of use in some of the antibiotic categories appear to be driven more by the safety concerns rather than reducing overall use. Future research is needed to strengthen antibiotic stewardship programs for older adults in outpatient settings.

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Ljungberg, Christina. "Prerequisites and Responsibility for Appropriate Prescribing - the Prescribers' View". Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-132544.

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The overall aim of this thesis was to explore aspects of the subjective views and experiences of doctors as prescribers, focusing on responsibility for and factors of importance in achieving appropriate prescribing. To provide insights into the prescriber’s perspective the study designs were qualitative. In the first studies secondary care doctors’ perceptions of appropriate prescribing and influences in prescribing were investigated in interviews. The doctors perceived that appropriate prescribing needed continuous revision. From the perspective of the prescribers the definition of prescribing could be rephrased as: “the outcome of the recurring processes of decision making that maximises net individual health gains within society’s available resources”. Among the influences in prescribing were guidelines, colleagues and therapeutic traditions. In the subsequent studies the experiences of exchanging information regarding a patient’s drugs in an electronic patient medical record (e-PMR) shared between primary and secondary care and views of responsibility was explored, using focus groups with both primary and secondary care doctors. Considering the gap between health care levels, doctors’ views of responsibility in prescribing and exchange of information are of concern. The doctors expressed how they assume information to be in the e-PMR and active information transfer has decreased. On the other hand, they experienced an information overload in the e-PMR system. There is a need for improved and structured communication between health-care givers. Taking responsibility to review all the patient’s medications was perceived as important, but described as still not done. Lack of responsibility taken was often due to acts of omission, i.e. that doctors did not make needed changes to the list of medications due to different barriers. The barriers rested both with individual doctors and the system, but to ensure solutions that are realisable in practise, perspectives of the doctors need to be taken into consideration when overcoming those barriers.

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Adorka, Matthias Kofi Besa. "Prescribing patterns of antibiotics in Lesotho public health institutions / M.K.B. Adorka". Thesis, North-West University, 2010. http://hdl.handle.net/10394/4350.

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Gillespie, Ulrika. "Effects of Clinical Pharmacists' Interventions : on Drug-Related Hospitalisation and Appropriateness of Prescribing in Elderly Patients". Doctoral thesis, Uppsala universitet, Institutionen för farmaceutisk biovetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-167343.

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The overall aim of this thesis was to evaluate clinical pharmacist interventions with the focus on methods aiming to improve the quality of drug therapy and increase patient safety. Adverse drug events caused by medication errors, suboptimal dosages and inappropriate prescribing are common causes of drug-related morbidity and mortality. Clinical pharmacists integrated in multi-professional health-care teams are increasingly addressing these issues. A randomised controlled trial (RCT) was conducted to investigate the effectiveness of clinical pharmacists’ interventions in reducing morbidity and use of hospital care for patients 80 years or older. The results showed that the intervention group had fewer visits to hospital and that the intervention was cost-effective. In a subsequent study based on the population in the RCT, the appropriateness of prescribing was assessed using three validated tools. The results indicated improved appropriateness of prescribing for the intervention group as a result of the intervention. The tools and the number of drugs at discharge were then tested for validity in terms of causal links between the scores at discharge and hospitalisation. No clear correlations between high scores for the tools or a high number of drugs and increased risk of hospitalisation could be detected. During the inclusion period of the RCT a survey based study was conducted where the perceived value of ward-based clinical pharmacists, from the perspective of hospital-based physicians and nurses as well as from general practitioners (GPs) was evaluated. The respondents were positive to the new collaboration to a high degree and stated increased patient safety and improvements in patients’ drug therapy as the main advantages. In the last study the frequency and severity of prescription and transcription errors, when patients enrolled in the multidose-dispensed medications (MDD) system are discharged from hospital, was investigated. The results showed that errors frequently occur when MDD patients are hospitalised.

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GALIMBERTI, FEDERICA. "STRATEGIES TO ASSESS AND PROMOTE APPROPRIATE DRUG PRESCRIBING AND USE AMONG ADULT OUTPATIENTS IN CAMPANIA AND LOMBARDY REGIONS". Doctoral thesis, Università degli Studi di Milano, 2019. http://hdl.handle.net/2434/694021.

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L'intervento farmacologico è un elemento essenziale nella promozione della salute. Tuttavia, il processo che prevede la formulazione di una diagnosi e la scelta di un trattamento appropriato è complesso e, spesso, molti farmaci vengono prescritti e/o assunti in modo inappropriato, specialmente nei pazienti anziani. La conseguenza più frequente è un incremento degli eventi avversi da farmaco, del tasso di ospedalizzazione e della mortalità, in parallelo a un utilizzo non razionale delle risorse assistenziali e una spesa sanitaria onerosa. Gli obiettivi primari della presente tesi sono stati: (1) indagare la pratica prescrittiva tra i medici di medicina generale (MMG) di due regioni italiane, (2) valutare l'uso appropriato del farmaco da parte dei loro pazienti, (3) sviluppare e implementare un intervento educativo e/o informativo su misura rivolto ai MMG e ai loro pazienti, al fine di promuovere l’appropriatezza prescrittiva e l’uso adeguato del farmaco. Nella presente tesi è stata descritta l’analisi al basale del progetto EDU.RE.DRUG (finanziato dall’Agenzia Italiana del Farmaco), che ha incluso tutti i MMG e i loro pazienti adulti (≥40 anni) di otto ASL/ATS in Campania e Lombardia (rispettivamente, 4.8 milioni e 4.7 milioni di soggetti adulti inclusi, di cui 1.6 milioni e 1.7 milioni avevano un’età ≥65 anni). Sono stati individuati una serie di indicatori espliciti di prescrizione (politerapia, consumo di alcune classi di farmaci, potenziali interazioni farmaco-farmaco, duplicati terapeutici, farmaci da evitare negli anziani secondo la lista ERD [lista EDU.RE.DRUG], carico anticolinergico e carico sedativo negli anziani) e d’uso del farmaco (aderenza alle terapie croniche) potenzialmente inappropriati, che sono stati, quando necessario, adattati al formulario farmaceutico italiano. Sono stati determinati in modo retrospettivo i tassi di prevalenza annui degli indicatori selezionati, utilizzando i database amministrativi sanitari delle ASL/ATS coinvolte, relativi agli anni 2014-2016. Nonostante alcune differenze a livello geografico e nei trend temporali, nel complesso sono stati osservati alti tassi di politerapia e consumo dei farmaci e un'elevata prevalenza di prescrizione inappropriata nel setting della medicina generale italiana. In dettaglio, dei soggetti anziani (over 65 anni) circa il 40-50% e il 10-20% ha ricevuto 5-9 farmaci e almeno 10 farmaci, rispettivamente; circa il 25-35% in Lombardia e il 50-65% in Campania aveva almeno una prescrizione inappropriata dei farmaci inclusi nella lista ERD; circa il 5-9% presentava un elevato carico anticolinergico; e meno del 2% mostrava un elevato carico sedativo. Inoltre, il 10-25% dei pazienti adulti era esposto ad almeno una potenziale interazione farmaco-farmaco, mentre il 3-7% ad almeno un duplicato terapeutico. Infine, è stato osservato un livello non ottimale di aderenza alle terapie croniche: per tutti i trattamenti a lungo termine analizzati, il livello medio di aderenza era di gran lunga inferiore all'80%, soglia sopra la quale il farmaco ha una ragionevole probabilità di raggiungere il massimo beneficio clinico. Questi risultati evidenziano una diffusa e profonda necessità di intervento per migliorare la qualità della prescrizione e dell’utilizzo dei farmaci. In questo contesto, le strategie implementate nell’ambito della presente tesi contribuiranno a definire il metodo più efficace per affrontare in maniera ottimale questa grave problematica.
Pharmacological intervention is an essential step in health promotion. However, the process of setting a diagnosis and choosing appropriate drug treatment is complex and lots of drugs are often prescribed and used in inappropriate ways, especially in elderly patients. The direct consequence is an increase of adverse drug events, hospitalization and mortality rates, along with healthcare resource wastage, and additional healthcare costs. Therefore, the main objectives of the present thesis were to: (1) deeply investigate the prescribing practice among general practitioners (GPs) in two Italian regions, (2) evaluate the appropriate drug use by their patients, (3) develop and administer tailored educational and/or informative intervention addressed to GPs and their patients, in order to promote appropriate drug prescribing and use. The present thesis was based on baseline data from the EDU.RE.DRUG project (funded by the Italian Medicines Agency), including all GPs and their adult patients (≥40 years) from eight local health units (LHUs) in Campania and Lombardy (respectively, 4.8 million and 4.7 million of adult subjects included, of which 1.6 million and 1.7 million were 65 years or older). We defined a set of explicit indicators for potential inappropriate prescription (polypharmacy, drug consumption, potential drug-drug interactions, therapeutic duplication , drug to be avoided in the elderly according to the ERD-list [EDU.RE.DRUG-list], anticholinergic and sedative load in the elderly) and drug use (adherence to chronic therapies) and we adapted them to the Italian drug formulary. Using administrative health-care databases from the involved LHUs, we retrospectively assessed the annual prevalence rates of the selected indicators during the period 2014-2016. Despite some remarkable geographical differences and time trend variability, overall we observed high rates of polypharmacy and drug consumption, and a high prevalence of inappropriate drug prescription in primary care setting in Italy. In particular, among older people (≥65 years) about 40-50% and 10-20% received 5-9 drugs and at least 10 drugs, respectively; around 25-35% in Lombardy and 50-65% in Campania were prescribed at least one inappropriate drug included in the ERD-list; nearly 5-9% had a high anticholinergic load; and less than 2% showed a high sedative load. Furthermore, 10-25% of adult patients were exposed to at least one potential drug-drug interaction, and 3-7% to at least one therapeutic duplicate. In addition, a suboptimal level of adherence to chronic therapies was observed: for all the long-term therapies analysed, the mean adherence level was far lower than 80%, which is the threshold above which the medication has a reasonable likelihood of achieving the most clinical benefit. These results highlight a widespread need for intervention to improve the quality of prescribing and drug use. In this regard, the strategies we implemented will contribute to define the optimal way to address this critical issue.

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Bokhary, Hamid. "Policy Making by Tackling Antimicrobial Resistance in Mass Gatherings: Clinical Assessment and Tools for Prescribing Antibiotics for Upper Respiratory Tract Infections Among Hajj Pilgrims". Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/27099.

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Hajj is an annual religious mass gathering and Islamic pilgrimage that is a potential focal point for the global importation and exportation of infectious and antimicrobial resistant (AMR) organisms. Although, upper respiratory tract infections (URTIs) are common in Hajj, however, there is a lack of knowledge regarding the causative agents and any associated AMR profiles. Moreover, there is compelling evidence of inappropriate antibiotic prescription by Hajj deployed health care workers (HCWs) during the event. This thesis aims to address some of the factors that may arise when treating URTIs during Hajj. In this thesis I provide an overview by reviewing published studies of potential AMR organisms and profiles that are associated with international travel and Hajj. Then, I assess the available published tools that are used to aid HCWs in diagnosing and treating URTIs. Subsequently, I conduct a survey on Hajj deployed HCWs’ knowledge, attitude, and perceptions of URTI diagnosis and treatment and other associated information. Later, I conduct a clinical field study during Hajj to assess the precision of HCWs’ decision-making when treating URTIs during Hajj. Finally, I use this knowledge together with previous studies to produce a tool for treating URTIs that is specific for Hajj. In our studies we found that: travelling is associated with high traffic of enteric AMR organisms from Asia that are beta-lactam and/or quinolone resistant. Comparably in Hajj, enteric and respiratory AMR organism profiles were well studied and are also beta-lactam resistant. Moreover, URTIs can be predicted to be of bacterial aetiology through following certain clinical presentations and tools. However, in Hajj, such prediction tools have not been devised and Hajj deployed HCWs are lacking such knowledge. This is reflected in their low appropriateness for antibiotic prescriptions when treating URTIs in Hajj. Finally, a tool was devised to help Hajj deployed HCWs in their decision-making during the crowded event. Complementary studies are required to complete the overview on the profile of AMR agents that circulate around the globe through human travel and mass gathering focal points. Furthermore, there should be multisectoral cooperation between health authorities to control the emergence of AMR associated with travelling, medical repatriation, and Hajj.

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Ncube, Nondumiso Beauty Queeneth. "A systematic approach to improve rational medicine use in Eswatini". University of Western Cape, 2020. http://hdl.handle.net/11394/7843.

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Philosophiae Doctor - PhD
Studies on rational medicine use (RMU) have mainly focused on identifying, quantifying, and addressing irrational use without exploring reasons behind this irrational use. In addition, minimal work has been conducted on irrational use of medicines in the context of the growing burden of non-communicable diseases (NCDs). This PhD research examined medicine use in Eswatini, (previously Swaziland) between April 2017 and March 2019, with a focus on prescribing practices linked to specific diagnoses. It further explored factors influencing RMU, which included testing the effects of a short intervention - prescription audit and feedback coupled with small group education - on prescribing practices in health facilities.

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Renom, Guiteras Anna. "Quality issues in caring for older people: Appropriateness of transition from long-term care facilities to acute hospital care. Potentially inappropriate medication: development of a European list". Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/330370.

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Aquesta tesi doctoral és una tesi per compendi de publicacions que engloba dos aspectes de qualitat de l’atenció a l’ancià. El primer aspecte és l’adequació del trasllat des de centres residencials a hospitals d’aguts. Les persones que viuen en centres residencials sovint presenten diferents graus de comorbiditat, estat cognitiu i funcional i estadis de les patologies. La seva derivació o admissió a urgències o a hospital d’aguts pot ser beneficiosa en algunes ocasions, però en altres ocasions pot representar una discontinuïtat en l’atenció poc favorable. En aquest primer article, els autors van dur a terme una revisió sistemàtica de la literatura per identificar els estudis realitzats internacionalment que han avaluat el concepte d’adequació del trasllat des de centres residencials a hospitals d’aguts. Van identificar vint-i-nou articles, els quals foren heterogenis respecte els seus dissenys, els entorns estudiats, els instruments utilitzats per determinar adequació dels trasllats, i els resultats obtinguts. La proporció d’admissions considerades inadequades varià del 2% al 77%. Entre els estudis, els autors van identificar setze instruments els quals variaren quant als conceptes estudiats, el seu format i la seva administració. L’equip investigador va aïllar els sis aspectes més prominents avaluats pels instruments: diagnòstics mèdics específics, agudesa/severitat dels símptomes, característiques dels residents prèvies al trasllat, desitjos dels residents o de les famílies, existència d’un pla d’atenció, i disponibilitat o requeriment de recursos. Cinc dels instruments avaluaren adequació tenint en compte només un d’aquests aspectes. Únicament sis instruments tingueren en compte quatre o més dels aspectes. Només tres instruments avaluaren els desitjos dels pacients o de les famílies, i sis instruments avaluaren les característiques dels residents prèvies al trasllat. Els autors conclouen que la majoria dels instruments no són globals i no tenen en compte els aspectes individuals dels residents. També conclouen que calen més estudis per desenvolupar un instrument que estigui basat en evidència, i que sigui global i generalitzable a diferents regions o països per tal d’avaluar l’adequació de l’admissió hospitalària dels ancians que viuen en centres residencials. El segon aspecte és la prescripció de medicaments potencialment inadequats (PIM) per a l’ancià. PIM són els medicaments que no s’hauria de prescriure a aquesta població perquè el seu risc de reaccions adverses supera els seus beneficis clínics, particularment quan existeix evidència a favor d’un tractament alternatiu per la mateixa condició més segur o efectiu. Diversos autors han desenvolupat llistes PIM per ajudar a identificar i reduir la prescripció de PIM als seus països. Aquest article descriu la preparació d’una llista PIM que incorpora medicaments dels mercats de set països europeus. En primer lloc, es preparà una llista PIM preliminar a partir de quatre llistes PIM internacionals. A continuació, trenta experts en prescripció geriàtrica d’Estònia, Finlàndia, França, Holanda, Espanya i Suècia participaren ampliant la llista preliminar amb nous medicaments i avaluant l’adequació dels medicaments mitjançant el mètode Delphi en dues voltes. Els experts també suggeriren ajustaments de dosi i alternatives terapèutiques. Finalment, un grup reduït d’experts respongueren un breu qüestionari final per obtenir un acord sobre alguns aspectes. Els experts arribaren al consens de que 282 substàncies químiques o classes de medicaments són considerats PIM pels ancians. Alguns dels PIM es refereixen a una dosi o duració d’ús específiques. Els autors presenten la llista anomenada “European Union (EU)(7)-PIM list” i conclouen que es tracta d’una eina de cribatge que permet la identificació de PIM i comparació de patrons de prescripció entre països europeus, i que també pot ser utilitzada com a guia per a la pràctica clínica. Conclouen també que calen més estudis que investiguin la factibilitat i aplicabilitat de la llista així com els beneficis clínics del seu ús.
This doctoral thesis is a cumulative thesis and covers two quality issues in the care of older people, each of which is approached in an individual article. The first issue is the appropriateness of transferring older people from long-term care facilities to acute hospital care. Residents in long-term care facilities often differ in terms of comorbidity, cognitive and functional status, and stage of disease. Their referral or admission to an emergency department or acute hospital may be beneficial on some occasions, but on others it may represent an unfavourable discontinuity of care. In this first article, the authors performed a systematic review of the literature to identify those international studies that have evaluated the concept of appropriateness of transition from long-term care facilities to hospital care. They identified twenty-nine articles, which were heterogeneous regarding their study designs, the settings investigated, the assessment tools used to determine appropriateness of transition, and the results obtained. The proportion of admissions considered as inappropriate ranged from 2% to 77%. Throughout the studies, the authors identified sixteen different assessment tools, which varied regarding the concepts studied, their format and application. The research team isolated the six most prominent aspects considered by the assessment tools: specific medical diagnoses, acuteness/severity of symptoms, residents’ characteristics prior to admission, residents’ or families’ wishes, existence of a care plan, and availability or requirement of resources. Five tools assessed appropriateness taking only one of these aspects into consideration. Only six tools took four or more aspects into consideration. Only three of the tools assessed residents’ or families’ wishes, and six tools assessed the residents’ characteristics prior to admission. The authors conclude that most assessment tools are not comprehensive and do not take the individual aspects of the residents into account. They also conclude that further research is needed to develop a tool that is evidence-based, comprehensive and generalizable to different regions or countries in order to assess the appropriateness of hospital admissions among long-term care residents. The second issue is the prescription of potentially inappropriate medication (PIM) to older people. PIM are those drugs that should not be prescribed for this population because the risk of adverse events outweighs the clinical benefit, particularly when there is evidence in favour of a safer or more effective alternative therapy for the same condition. Several authors have developed country-specific PIM lists to help identifying and improving prescription in their country. This article describes the development of a PIM list that covers the drug markets of seven European countries. First, a preliminary PIM list was prepared which contained PIM from four international lists. Next, thirty experts on geriatric prescribing from Estonia, Finland, France, the Netherlands, Spain and Sweden participated in the development process by first expanding the preliminary list with further medications, and then assessing the appropriateness of the drugs and suggesting dose adjustments and therapeutic alternatives in a two-round Delphi survey. Finally, a reduced number of experts participated in a last brief survey to agree on last discussion issues. Experts reached the consensus that 282 chemical substances or drug classes are PIM for older people, with some PIM being restricted to a certain dose or duration of use. The authors present the European Union (EU)(7)-PIM list and conclude that this is a screening tool that allows identification and comparison of PIM prescribing patterns for older people across European countries, and that it can also be used as a guide in clinical practice. They conclude also that further research is needed to investigate the feasibility and applicability of the list and the clinical benefits of its application.

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Alexander-Goreá, Trenika. "Development of a Guideline for Hospice Staff, Patients, and Families on Appropriate Opioid Use". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4496.

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There is an identified problem with patients receiving suboptimal pain management at a hospice agency in the northwestern United States. At this agency, undertreatment of pain is prevalent. Evidence indicates that this may be a result of a lack of guidelines, education, and knowledge of appropriate prescribing. Known barriers to the correct prescription and administration of potent opioids in the hospice setting include prevailing beliefs, knowledge, skills, and attitudes, all of which can impact care negatively. Contextually, hospice principles mandate patient comfort and caregiver involvement in continuous quality improvement, which includes adequate and informed pain management. Moreover, hospice metrics demand requisite knowledge, skills, and attitudes for optimal care, including pain management at the end of life. The Academic Center for Evidence-Based Practice (ACE) star model was used to guide the development of an evidence-based, guideline-supported educational program that will improve pain management at the hospice agency when implemented. The purpose of this project was to use transdisciplinary expertise and team collaboration to develop the program and then to conduct a formative and summative evaluation utilizing experts to prepare the guidelines and process for implementation. Ten experts reviewed the guideline, the educational materials, the process, and the evaluation plan and conducted reviews using the AGREE II tool. The panel of experts agreed within the 6 AGREE domains. Future implementation of this guideline, translation process, and evaluation tool will impact social change through the empowerment of the clinical staff, patients, and caregivers to provide the best pain control and comfort at end of life, a vulnerable time for all patients.

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Sibani, Marcella. "SAVE ‘Stewardship antibiotica Verona’: Result of an enabling and multidimensional Antimicrobial Stewardship intervention promoting prescribing appropriateness across the entire surgical path of care". Doctoral thesis, 2022. http://hdl.handle.net/11562/1073787.

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Background: As a part of the hospital-wide Antimicrobial Stewardship (AS) SAVE project, a Quality Improvement (QI) intervention was implemented in the surgical area of the Verona University Hospital. Rather than focusing on specific elements (i.e. Surgical Antibiotic Prophylaxis, SAP), the intervention was aimed at globally improving the antimicrobial prescribing practice across the entire surgical pathway. An enabling approach was adopted to foster surgeons to play a leading role in the optimizations of antimicrobial use in their wards. Methods: The QI intervention encompass a prolonged on the field training with an Infectious Disease (ID) specialist attending the clinical rounds daily for 4-8 weeks, followed by a 9-months auditing and feedback; an educational workshop, CME-accredited, was held between the two. The first phase was also capitalized for the development of ward-dedicated guidelines. The primary outcome was the variation in antibiotic consumption measured by Days of Therapy (DOTs) and Daily Defined Doses (DDDs) per 1000 patient-days (PDs). Variation in consumption, stratified according to the WHO AWaRe and the main classes of interest considering the epidemiological context (fluoroquinolones, carbapenems, and anti-MRSA agents), in-hospital mortality, length of hospital stay (LOS), incidence of Clostridium difficile infections (CDI), and carbapenem-resistant Enterobacteriaceae bloodstream infections (CRE-BSI) were the secondary outcomes. The interrupted-time-series analysis (ITSA) was used to evaluate the AS intervention effectiveness, comparing the 12-month pre- and post-intervention periods. Results: Eighty-six surgeons and 18 anesthesiologists were involved in 5 surgical and one surgical-dedicated Intensive Care Unit (ICU). Overall, 710 prescriptions were reviewed and the mean prevalence of patients receiving antibiotics ranged from 22% in the cardiac surgery to 74% in the ICU. Post-intervention global prescribing appropriateness exceeded 70% in all the wards, SAP appropriateness levels ranging 61-73 and not exceeding the 24-hours duration in more than 60%. The ITSA identified significant reduction in overall antimicrobial consumption in 3/5 wards, with downward slope in urology (-65 DOTs*1000PDs/month, P=0.038) and abruptly level change in traumatology and cardiac surgery (-111.6 DOTs*1000PDs P=0.032, -167 DOTs*1000PDs P=0.027). Although raw data showed lower WATCH usage in all the wards (from -27% to -43%), the ITSA confirmed significant desirable effects of the intervention only in the Cardiothoracic area (post-intervention: Cardiac surgery -10.9 DOT*1000PDs/month, P<0.001; ICU -83 DDDs*1000PDs/month, P< 0.001) where a significant reduction in the level of RESERVE (-142 DOTs*1000PDs, P<0.01; -251 DDDs*1000PDs, P=0.007), carbapenems, and anti-MRSA agents was also observed. Fluoroquinolones raw consumption decreased more than 60% everywhere; however, when assessed by ITSA, significant downward trends emerged only in Urology and General surgery (starting from higher baseline levels) as opposed to Traumatology and General Surgery, showing positive change in slope, presenting a sharp decrease in the pre-intervention year then stabilizing. The absence of significant variation in the in-hospital mortality and LOS confirmed the safety of the intervention. The incidence of C.difficile and CRE-BSI was low, with no significant trends emerging. Conclusion A QI intervention targeting the entire surgical pathways can enhance prescribing appropriateness and safely achieve valuable variation in antibiotic consumption. As great variability exists across different surgical specialities, a tailored approach in the intervention implementation and pre-definition of the desirable variation of targeted antimicrobial class consumption represent key elements for success. The study also provides useful insights prompting a reorganization of the ID consultation service to adequately address the peculiarity of the surgical area.

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Libros sobre el tema "Prescribing appropriatene"

Royal College of Physicians of London. Nutrition Committee., ed. Anti-obesity drugs: Guidance on appropriate prescribing and management. London: Royal College of Physicians of London, 2003.

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Miller, Frances Elizabeth. Perceived patient demand as a barrier to appropriate prescribing of oral anti-infectives. Ottawa: National Library of Canada, 1996.

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Office, General Accounting. Defense health care: Reimbursement rates appropriately set; other problems concern physicians : report to Congressional committees. Washington, D.C: The Office, 1998.

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Rose, Mark, NetCE y CE Resource. Strategies for Appropriate Opioid Prescribing: The Florida APRN/PA Requirement. CE Resource, Incorporated, 2019.

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Rose, Mark, NetCE y CE Resource. Strategies for Appropriate Opioid Prescribing: The Florida APRN/PA Requirement. CE Resource, Incorporated, 2022.

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Spizzirri, Diana. A randomized cefotaxime drug use evaluation to measure the impact of pharmacist interventions on appropriate prescribing. 1999.

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U. S. Government Accountability Offi Gao. Dod and Va Health Care: Actions Needed to Help Ensure Appropriate Medication Continuation and Prescribing Practices. Independently Published, 2019.

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Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne y Gareth Morris-Stiff. Late effects of chemotherapy and radiotherapy. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0007.

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An introduction to the theory of palliative care, followed by a practical step-by-step guide to the management of physical and psychological symptoms, including advice on appropriate prescribing in this complex group of patients.

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Lonergan, Daniel F. Addiction and Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190217518.003.0007.

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Patients who struggle with both pain and addiction present with some of the most challenging scenarios in clinical medicine. An understanding of the neurophysiologic basis of addiction is a key element in the proper management of acute and chronic pain. Physicians should appropriately screen for addiction and employ a comprehensive and safe approach to pain management, especially for patients with risk factors or a history significant for opioid addiction. Physicians should also understand the legal and regulatory issues governing the prescribing and dispensing of controlled substances in the course of treatment for acute pain, chronic pain, and addiction.

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Paice, Judith A. Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190204709.003.0001.

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To provide safe and effective pain relief, the palliative advanced practice registered nurse (APRN) must possess exceptional pain assessment skills including thorough history-taking and physical examination. Biological, psychological, social, and spiritual factors should be considered part of a complete assessment and serve as a guide for the development of a comprehensive plan of care. APRNs must have comprehensive knowledge of pain management options including appropriate pharmacologic and nonpharmacologic therapies. The chapter includes a discussion of various pain syndromes, physical therapy, interventional techniques, and cognitive-behavioral strategies in addition to medical management of pain. Universal precautions to detect aberrant behavior is described, and safe prescribing practices are outlined.

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Capítulos de libros sobre el tema "Prescribing appropriatene"

Spencer, Michael. "Appropriate prescribing in hospitals". En Releasing Resources to Achieve Health Gain, 45–49. CRC Press, 2018. http://dx.doi.org/10.1201/9781315379753-7.

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Aviles, David A. Sotello y Walter C. Hellinger. "Antibiotics in the Intensive Care Unit". En Mayo Clinic Critical and Neurocritical Care Board Review, editado por Eelco F. M. Wijdicks, James Y. Findlay, William D. Freeman y Ayan Sen, 375–80. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190862923.003.0059.

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Antimicrobial therapy is a critical component in the management of many infections. Antimicrobial therapy should not be initiated before infection with a susceptible pathogen is suspected or confirmed or before appropriate diagnostic specimens, including those for cultures, are collected. Recognizing indications for antibiotic administration and appropriately selecting antimicrobial agents based on clinical and microbiologic findings are required. Distinguishing between empiric prescribing, when infection syndromes and pathogens are suspected, and therapeutic prescribing, when infection syndromes are confirmed and pathogens identified, is critically important.

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Aviles, David A. Sotello y Walter C. Hellinger. "Antibiotics, Antivirals, and Antifungals". En Mayo Clinic Critical and Neurocritical Care Board Review, editado por Eelco F. M. Wijdicks, James Y. Findlay, William D. Freeman y Ayan Sen, 981–89. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190862923.003.0137.

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Antimicrobial therapy should not be initiated before infection with a susceptible pathogen is suspected or confirmed or before appropriate diagnostic specimens, including those for cultures, are collected. Recognizing indications for antibiotic administration and appropriately selecting antimicrobial agents based on clinical and microbiologic findings is required. Distinguishing between empiric prescribing, when infection syndromes and pathogens are suspected, and therapeutic prescribing, when infection syndromes are confirmed and pathogens identified, is critically important. Working knowledge of antimicrobial drug dosing, adjustment of dosing for renal or hepatic insufficiency, drug-drug interactions, and antimicrobial allergies or intolerances is required, and ready access to and liberal use of reference guides help ensure good patient care.

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Lachman, Peter, John Brennan, John Fitzsimons, Anita Jayadev y Jane Runnacles. "Safe prescribing in paediatrics". En Oxford Professional Practice: Handbook of Patient Safety, editado por Peter Lachman, John Brennan, John Fitzsimons, Anita Jayadev y Jane Runnacles, 223–34. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780192846877.003.0021.

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Medication safety in children has additional challenges, besides the ones that are present in adults. The challenges related to medication safety in children have a specific character, too. At every stage, the child is at risk of harm. Prescribing is more complex than in adults, because the dose is related to age and is calculated according to the weight of the child. Weight is often not obtained accurately, so doses can be overprescribed or underprescribed. Children are growing, and therefore dosage changes with age, as their weight changes. The therapeutic index is narrow in children and doses are extrapolated, as there are few clinical trials in children. In addition, the dispensing of medications may be more complex, unless the pharmacy holds the appropriate formulations of the drug. This has an impact on administration, where the smallest error can have a significant impact.

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Branford, David, Reena Tharian, Regi Alexander y Sabyasachi Bhaumik. "Pharmacotherapy for Mental Illness and Behaviours that Challenge in People with Intellectual Disabilities". En Oxford Textbook of the Psychiatry of Intellectual Disability, 191–202. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198794585.003.0019.

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Psychotropic medications are widely prescribed for people with an intellectual disability (ID) both for the management of mental illnesses and behaviours that challenge. It is generally agreed that people with ID are as likely or more likely as the general population to develop mental illnesses and therefore this has to be treated actively. However the appropriateness and extent of prescribing medication to manage behavior that challenges is a matter of debate and legitimate concern. This chapter summarizes the evidence in this field and sets out a practice framework to minimize the risk of inappropriate prescribing practice.

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Bynum, Debra L. "Drug Therapy in the Elderly: Appropriate Prescribing for the Older Patient". En Netter's Internal Medicine, 1241–43. Elsevier, 2009. http://dx.doi.org/10.1016/b978-1-4160-4417-8.50185-6.

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Rangraz Jeddi, Fatemeh, Mansooreh Momen-Heravi, Ehsan Nabovati, Felix Holl, Hossein Akbari y Razieh Farrahi. "Effects of Computer-Aided Decision Support Systems on Appropriate Antibiotic Prescribing by Medical Interns: A Quasi-Experimental Study". En Studies in Health Technology and Informatics. IOS Press, 2022. http://dx.doi.org/10.3233/shti210920.

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Literature suggests that the adoption of guidelines for antibiotic prescribing has a significant impact on improving prescription practices of physicians; thus, this study aimed to assess the effectiveness of computer-aided decision support systems (CA-DSS) on antibiotic prescribing among medical interns. A prospective before-and-after interventional study was conducted on 40 medical interns. The interns were asked to use the CA-DSS during a one-month internship course at the infectious disease department. The main outcome measure was the knowledge of medical interns regarding the type, name, volume, usual dosages, and administration route of antibiotics prescribed. Paired t-test was applied to assess the change of medical interns’ knowledge before and after the study. There was a statistically significant difference between the mean score of interns’ medical knowledge before 5.4±2 and after 9.1±2.8 using the CA-DSS (p = 0.000). CA-DSS as an IT-based training intervention was effective for the knowledge of medical interns to prescribe the right antibiotics for acute respiratory infections.

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"Principles of drug use in palliative care". En Oxford Handbook of Palliative Care, editado por Max Watson, Rachel Campbell, Nandini Vallath, Stephen Ward y Jo Wells, 73–124. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198745655.003.0005.

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This chapter includes a formulary of the drugs most commonly used in the palliative care setting as well as advice surrounding common pharmacological challenges. These include drug interactions, prescribing in patients with co-morbidities, managing toxicity, the use of syringe drivers, and the impact of medications on driving. It provides a useful overview of current pharmacological practice in the UK in the context of end-of-life care and the need to consider both deprescribing as well as escalation of treatment when appropriate. By law in the UK, a medication must be given a MA (formally, a product license) by the Medicines and Healthcare Products Regulatory Agency (MHRA). The MA specifies the indication, dose, route and patient populations for which the drug can be marketed. Drugs can be used legally in clinical situations that fall outside the remit of the MA, referred to as ‘off-label’ (e.g. a different indication, dose, route, or method of administration than that specified in the MA). Off-label use of drugs in palliative care is routine, with the responsibility for prescribing under such circumstances lying with the prescriber. The prescriber must be fully informed about the actions and uses of the medicinal product and should provide information on the benefits and risks of off-license prescribing to the patient (or their proxy) to facilitate an informed decision regarding treatment options.

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Cherny, Nathan I. y Marie T. Fallon. "Opioid therapy". En Oxford Textbook of Palliative Medicine, editado por Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy y David C. Currow, 372–415. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0039.

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This chapter on opioids is in two parts: basic science and clinical. It includes the current evidence on where and how opioids work to mediate analgesia, non-analgesic effects, and unwanted side effects. In addition, the activity and impact of opioids in brain networks is discussed. These complex dynamic concepts are explained through functional magnetic resonance imaging findings and enables a greater understanding of opioid mechanisms. Mechanism and evidence of less studied side effects such as opioid-induced hyperalgesia along with immune and endocrine side effects are examined. Current genomic evidence and clinical application of this is discussed. The clinical part of the chapter gives complete information on the pharmacology of all opioids which are in clinical use, along with detailed information on when to prescribe and how to prescribe effectively and safely. Finally, the challenges of opioid prescribing in the twenty-first century are addressed. Identification of patient risk factors and appropriate prescribing and monitoring are presented in an agreed and practical way.

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Amaram-Davila, Jaya S. y Joseph A. Arthur. "Palliative Care in the Patient with Substance Use Disorder". En Handbook of Psychiatry in Palliative Medicine 3rd edition, editado por Harvey Max Chochinov y William Breitbart, 141—C10.P67. 3^a ed. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780197583838.003.0010.

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Abstract Opioids remain the mainstay for the treatment of pain among patients with advanced disease. Unfortunately, its nonmedical use and associated substance use disorder (SUD) have become of utmost concern among the medical community, especially in this era of the opioid crisis. There is an emerging need for palliative care among this subset of patients who develop these comorbid conditions. Current evidence suggests that nonmedical opioid use may be more prevalent among patients with advanced illness than previously thought. Data suggest that pain continues to be undertreated even among patients at the end of life. Clinicians therefore face the challenge to prescribe opioids to alleviate patients’ symptom burden while making all efforts to safeguard its appropriate use and mitigate the development of SUD. To overcome these challenges, clinicians can utilize a universal precautions approach while prescribing opioids. This chapter describes the scope of nonmedical use and SUD among patients with advanced disease and outlines practical strategies to ensure safe opioid prescribing practice. These may include obtaining comprehensive patient histories, screening all patients receiving opioid therapy using validated risk assessment questionnaires, and intensifying patient education on safe use, storage, and disposal of opioids. Best practices recommend using urine drug tests and prescription drug monitoring programs to monitor inappropriate opioid-related behaviors during routine chronic opioid therapy. Ultimately, the goal of all healthcare providers is to achieve the optimal risk-benefit ratio in opioid prescribing and provide improved quality care for palliative care patients with SUD.

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Actas de conferencias sobre el tema "Prescribing appropriatene"

Quintens, C., J. De Coster, L. Van Der Linden, B. Morlion, E. Nijns, B. Van Den Bosch, WE Peetermans y I. Spriet. "4CPS-336 Impact of check of medication appropriateness (CMA) in optimising analgesic prescribing". En 25th Anniversary EAHP Congress, Hospital Pharmacy 5.0 – the future of patient care, 23–28 March 2021. British Medical Journal Publishing Group, 2021. http://dx.doi.org/10.1136/ejhpharm-2021-eahpconf.168.

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Baan, Esmé J., Christina E. Hoeve, Maria A. J. De Ridder, Leis Demoen, Lies Lahousse, Katia M. C. Verhamme y Guy G. Brusselle. "(in)Appropriate LAMA Prescribing in Asthma patients: a Cohort Analysis (the ALPACA study)". En ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.2644.

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Elechi, Francis, Sotiris Antoniou y Vikas Kapil. "119 Appropriateness of prescribing of direct oral anticoagulants in a university teaching hospital network". En British Cardiovascular Society Annual Conference ‘Digital Health Revolution’ 3–5 June 2019. BMJ Publishing Group Ltd and British Cardiovascular Society, 2019. http://dx.doi.org/10.1136/heartjnl-2019-bcs.116.

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Cornish, Candida y Sarah French. "73 Introduction of a community palliative care drug chart to facilitate individualised and appropriate anticipatory prescribing". En The APM’s Annual Supportive and Palliative Care Conference, In association with the Palliative Care Congress, “Towards evidence based compassionate care”, Bournemouth International Centre, 15–16 March 2018. British Medical Journal Publishing Group, 2018. http://dx.doi.org/10.1136/bmjspcare-2018-aspabstracts.100.

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Kamat, Nagesh, Shiran Shetty, Sumit Bhatia y Anurag Shetty. "IDDF2019-ABS-0324 Appropriateness of prescribing proton pump inhibitor in a tertiary care superspeciality hospital in india". En International Digestive Disease Forum (IDDF) 2019, Hong Kong, 8–9 June 2019. BMJ Publishing Group Ltd and British Society of Gastroenterology, 2019. http://dx.doi.org/10.1136/gutjnl-2019-iddfabstracts.232.

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Rudoler, David, Agnes Grudniewicz, Nichole Austin, Sara Allin, Richard Glazier, Elisabeth Martin, Caroline Sirois y Erin Strumpf. "Did the Implementation of Team-Based Primary Care Models in Ontario and Quebec, Canada, Impact Appropriate Prescribing?" En NAPCRG 50th Annual Meeting — Abstracts of Completed Research 2022. American Academy of Family Physicians, 2023. http://dx.doi.org/10.1370/afm.21.s1.3643.

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Romero, L. Yunquera, A. Henares Lopez, D. Furones Araujo, MJ Morales Lara y I. Marquez-Gomez. "4CPS-063 Appropriateness of antibiotic prescribing in urinary tract infections in the emergency department of a tertiary hospital". En Abstract Book, 23rd EAHP Congress, 21st–23rd March 2018, Gothenburg, Sweden. British Medical Journal Publishing Group, 2018. http://dx.doi.org/10.1136/ejhpharm-2018-eahpconf.154.

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Fujii, Tomoharu, Terutaka Fujioka, Chris Ablitt, Julian Speck y Brian Cane. "Development of Risk-Based Maintenance Software for Gas Turbines". En ASME Turbo Expo 2007: Power for Land, Sea, and Air. ASMEDC, 2007. http://dx.doi.org/10.1115/gt2007-27054.

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Risk-based maintenance software has been developed to perform risk-based maintenance and inspection planning on gas turbine hot gas path components. The software allows the user to easily prepare a risk matrix, plotting every active damage mechanism for each hot gas path component. Based on the result of the risk assessments the components can be ranked, allowing inspection plans to be focused and prioritized and aiding the user to identify the most appropriate and effective risk mitigating activity within the software. Risk assessments are performed on a component-by-component basis, with the software’s scope including all combustor and turbine hot gas path components. The software also contains comprehensive help documents to aid the user in identifying and assessing peculiar damage mechanisms and prescribing the most effective inspection methods for gas turbines.

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Saravanan, Pratima, Charity Hipple, Jingxin Wang, Christopher McComb y Jessica Menold. "Decision-Making in the Prescription of Orthotics and Prosthetics for Partial-Foot Amputees". En ASME 2019 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/detc2019-97470.

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Abstract Prosthetists face a daunting number of decisions that directly affect an amputee’s ability to walk and indirectly affect the overall quality of life of that amputee. In addition, the lack of resources in low-income countries provides a barrier to receive care after an amputation, and approximately 80% of amputees in low-income countries lack appropriate prosthetic care. In this research, we are motivated to understand what factors affect the decision-making strategies of prosthetists and podiatrists when prescribing prosthetics and orthotics to partial foot amputees. This work establishes a decision-making framework as a step towards automated methods that may reduce the complexities and decision-making burden of prosthetic prescription, ultimately increasing the efficiency of prosthetic prescription in low-resourced areas. A decision-making model is proposed based on an extensive literature review of over 100 papers. The proposed model is compared to qualitative data regarding decision-making strategies during prosthetic or orthotic prescription collected from nine prosthetists, surgeons, and other healthcare professionals directly involved in amputee care. Changes to the proposed model are described and future work exploring the role of automated methods to support decision-making in the context of prosthetics is discussed.

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Yadav, Amulya, Roopali Singh, Nikolas Siapoutis, Anamika Barman-Adhikari y Yu Liang. "Optimal and Non-Discriminative Rehabilitation Program Design for Opioid Addiction Among Homeless Youth". En Twenty-Ninth International Joint Conference on Artificial Intelligence and Seventeenth Pacific Rim International Conference on Artificial Intelligence {IJCAI-PRICAI-20}. California: International Joint Conferences on Artificial Intelligence Organization, 2020. http://dx.doi.org/10.24963/ijcai.2020/605.

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This paper presents CORTA, a software agent that designs personalized rehabilitation programs for homeless youth suffering from opioid addiction. Many rehabilitation centers treat opioid addiction in homeless youth by prescribing rehabilitation programs that are tailored to the underlying causes of addiction. To date, rehabilitation centers have relied on ad-hoc assessments and unprincipled heuristics to deliver rehabilitation programs to homeless youth suffering from opioid addiction, which greatly undermines the effectiveness of the delivered programs. CORTA addresses these challenges via three novel contributions. First, CORTA utilizes a first-of-its-kind real-world dataset collected from ~1400 homeless youth to build causal inference models which predict the likelihood of opioid addiction among these youth. Second, utilizing counterfactual predictions generated by our causal inference models, CORTA solves novel optimization formulations to assign appropriate rehabilitation programs to the correct set of homeless youth in order to minimize the expected number of homeless youth suffering from opioid addiction. Third, we provide a rigorous experimental analysis of CORTA along different dimensions, e.g., importance of causal modeling, importance of optimization, and impact of incorporating fairness considerations, etc. Our simulation results show that CORTA outperforms baselines by ~110% in minimizing the number of homeless youth suffering from opioid addiction.

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