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PubMed1987

Patient compliance in filling prescriptions after discharge from the emergency department.

Frequently, emergency department treatment consists of prescriptions given to a patient at discharge on the assumption that they will be filled promptly and the medications begun as directed. Although the plan depends on the validity of this assumption, many patients may be unable (or unwilling) to fill their prescriptions. This study was undertaken to determine the prevalence of and reasons for noncompliance in filling prescriptions among patients discharged from the emergency department and to determine if differences in compliance exist among various socioeconomic groups. Ninety-six consecutive patients who had been given prescriptions at discharge from the emergency department were contacted by telephone the following day to determine if their prescriptions had been filled and if not, the reasons for not filling them. Patients were stratified by payor classification groups as follows: insured by third-party payor (53 patients), covered by Medicaid (19 patients), noninsured "self-paying", (14 patients), covered by Medicare (four patients), and unknown payor status, (six patients). The percentages in each group who had not filled their prescriptions by follow-up the next day were as follows: insured, 21%; Medicaid, 21%; self-paying, 21%; Medicare, 25%; unknown, 50%. Differences between groups were not significant. The following reasons were given for not having filled prescriptions: insufficient funds, 36%; lack of transportation or assistance, 14%; negligence, 32%; and miscellaneous, 18%. Of the prescriptions not filled, 45% were for analgesics or muscle relaxants, 41% were for antibiotics, and 14% were for miscellaneous medications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Association between non-medical and prescriptive usage of opioids.

Understanding and managing prescription opioid abuse is one of the major challenges in pain management worldwide. The relationships between prescriptive usage of opioids and reported morbidity at the national level, using data from the Drug Abuse Warning Network (DAWN), were examined. When the major prescription opioids were evaluated, the association between prescriptive medical use in kilograms and reported morbidity, as measured by a ratio between the two, was similar for the intermediate-potency opioids (hydrocodone, methadone, oxycodone, and morphine). This rate was much lower for low-potency opioids (codeine, meperidine, pentazocine, and propoxyphene) and much greater for high-potency opioids (hydromorphone and fentanyl). When the drugs were adjusted by potency (relative to morphine), the rates of reported morbidity per kilogram of morphine equivalent opioid in prescriptive usage were similar among the opioids. Using the potency-adjusted total kilograms of opioid in prescriptive use for all the opioids evaluated, there was a statistically significant association (r(2)=0.9791) with the reported morbidity for prescription analgesics as a class, as measured in the DAWN system. These data suggest that non-medical use of opioids is predictable based on potency and extent of prescriptive use.

Analgesics↗
PubMedDate not supplied

Outpatient prescription drug use by children enrolled in five drug benefit plans.

This study examined prescription drug use among ambulatory children younger than 18 years of age enrolled in five drug benefit plans. Data for this study were obtained from the pharmacy benefit manager who administers the drug benefit plans. During the study period of December 29, 1992, through December 28, 1993, 3144 children younger than 18 years of age (34.0% of the total plan enrollment) were enrolled in the five drug benefit plans. A total of 8547 prescription drugs were dispensed to the study population. The mean prescription price was $16.38, and the mean duration of therapy was 11.7 days. The mean prescription price was $1.56 more for boys than for girls. The most frequently dispensed drugs were antibiotics (42.0%), followed by cold preparations (15.9%). The annual prevalence rate of prescription drug use was 59.1 cases per 100 children. The study population-based annual frequency rate was 3.2 prescriptions per child, and the drug user-based annual frequency rate was 5.5 prescriptions per child. The annual expenditures were $51.85 per child and $90.39 per drug users, with the out-of-pocket expenditures being $19.09 and $33.04, respectively. The prevalence rate varied little by sex. However, both frequency and expenditure rates differed by sex and decreased with age. Higher levels of cost sharing per prescription were associated with higher prevalence, frequency, and expenditure rates. Larger cost-sharing differentials between generic and brand name drugs were associated with higher rates of generic drug use but were not always associated with lower expenditure rates.

Adolescent↗
PubMed2000

[Externally induced prescriptions, degree of agreement and ... possibility of change in primary care?].

OBJECTIVE: To find whether externally induced prescriptions (EIP) condition attendance through their prevalence, quality, the degree of agreement of the PC doctor and his/her capacity to alter them. DESIGN: Cross-sectional study of use of indication-prescription type medicines. SETTING: Health district. PARTICIPANTS: 2656 prescriptions for 678 patients interviewed. MEASUREMENTS: Each interview recorded: type of visit, age, sex, work situation, existence or otherwise of social problems and/or psychiatric pathology; doctor-patient relationship, pharmaceutical preparations (PP) prescribed and those which the patient remembers he/she is taking, indication, origin, duration, speciality of the prescribing person, agreement of the PC doctor issuing the prescription and the possibility of his/her changing it. For each prescription the following was analysed: therapeutic group, intrinsic value, time it lasts, cost and whether it is a recently marketed PP. MAIN RESULTS: 90% of visits to the doctor end in prescription. 58% of patients remember taking one or more EIP. 72% of the prescriptions analysed were externally caused. They came mostly from the public health system (66%), private medicine (20%) and self-medication (11%). There was no PC agreement with almost half these EIPs, but only 13% could be changed. The EIPs without agreement and without possibility of change were greater in: women, the elderly, people on a pension, psychiatric pathologies and in cases of bad doctor-patient relationship. The EIPs originated in health insurance companies, pharmacies, self-medication, former GPs and private doctors. They were associated with ill-defined signs and symptoms, circulatory diseases and locomotive disease. We found no significant differences in expenditure or use of PP recently put onto the market between self-medication and EIP, though there were in quality. CONCLUSIONS: The current model of prescribing medication causes consultations to be greatly "medicinised" at the expense of EIP. Doctors only alter a small part of the EIPs they don't agree with. Longitudinal studies are needed to monitor patients to find the evolution of EIPs (withdrawal, replacement, dragging on or new external prescription).

Adult↗
PubMed2003

[Study of brands in the prescription of generic drugs at 6 health centers in 2001].

OBJECTIVE: To examine, through the analysis of the prescriptions billed during 2001, the brands of generic medicine prescribed by family doctors at 6 health centres in a primary care area. DESIGN: Descriptive study of medical prescription. SETTING. Primary care health area.Participants/context. 6 health centres: 3 urban and 3 metropolitan. METHOD: Pharmaceutical prescription was analysed through the billing procedures for medical prescriptions, with the help of the administrator for GAIA pharmaceutical provision. 50% of the total generics billed in 2001, involving 7 active principles, were studied. RESULTS: Statistically significant differences in the prescription at the 6 centres were only found in two (omeprazole and ranitidine) of the 7 active principles. There was wide variety in the prescription of the various brands for all active principles. By assessing the involvement of the pharmaceutical industry in health centres, it was found that the smallest and the most metropolitan centres had different patterns of brand prescription. CONCLUSIONS: Determined brands of generic drugs were prescribed more than others. Active information on brands of generic medicines, coming from professional purveyors of information for family doctors, influenced prescription more than passive information. Doctors' lack of information on a brand of generic medicine from a particular laboratory was no obstacle to their being represented just the same on pharmaceutical billing.

Drug Costs↗
PubMed2005

Correlates of prescription drug use during pregnancy.

PURPOSE: To evaluate the extent of prescription drug use and the use of category D or X drugs during pregnancy and examine the maternal characteristics associated with use. METHODS: Medical record and survey data from an observational cohort of pregnant women from 2001 to 2003 (n=1626) were analyzed to examine the use of prescription drugs and the use of category D or X drugs. RESULTS: A majority of these pregnant women were prescribed a prescription drug (56%), and 4% of women were prescribed a category D or X drug. The most common classes of medications prescribed were antibiotics (62%), analgesics (18%), asthma medications (18%), and antiemetics (17%). After adjustment for sociodemographic and clinical characteristics, African American women were more likely to use a prescription drug than white women. Lower levels of educational attainment were also associated with greater use of prescription drugs compared with women who had graduated from college. Women with a chronic health condition, gestational diabetes, a prenatal hospitalization, a history of infertility, or symptoms of acid reflux were also more likely to use a prescription drug than women without these conditions. Nulliparous women and women who were married or living with a partner were less likely to use category D or X drugs during pregnancy than women without these characteristics. Women with a history of infertility and those with a chronic health condition were more likely to use a category D or X drugs during pregnancy than those without these conditions. CONCLUSIONS: The common use of prescription drugs during pregnancy supports the importance of expanding the evidence about the risks and benefits of prescription drug use during pregnancy and suggests the need for systems to safeguard prescribing practices for women of reproductive age.

Adult↗
PubMed2004

What happened to the prescriptions? A single, short, standardized telephone call may increase compliance.

BACKGROUND: Patients' compliance with prescribed prescriptions and doctors' advice is a prerequisite for successful treatment. Compliance is estimated to be <or=50% in the treatment of hypertension. Thus, it is important to find simple methods to increase compliance. OBJECTIVES: Our aim was to estimate the extent to which patients visit the pharmacy and redeem prescribed items after seeing a GP, and to assess if a phone call 1 week later improves compliance. METHODS: A total of 399 patients attending a primary health care centre receiving prescriptions were randomized to active intervention receiving a short standardized follow-up telephone call or to standard intervention receiving no telephone call. The doctors' prescriptions were later compared with the dispensed drugs at the pharmacies. RESULTS: A majority of the patients (90%) redeemed prescriptions. Women redeemed prescriptions to a greater extent than men, both in the control group (P = 0.023) and in the intervention group (P = 0.0003). A telephone call 1 week later increased the proportion of patients that redeemed their prescriptions (P = 0.023). Further analysis showed that only women were affected by the telephone call. Twenty percent of the prescriptions were drugs for cardiovascular diseases (CVDs). The proportion of dispensed drugs for CVD was only 66%, compared with 88% for all other drugs (P = 0.001). CONCLUSION: A single, short, standardized telephone call increases women's compliance. Women also redeem prescriptions more often than men irrespective of a telephone call. The compliance and treatment of CVD are not acceptable, and seem to be lower for men than women.

Cardiovascular Agents↗
PubMed1999

Multiple prescriptions of antibiotics for children aged 0 to 5 years in relation to type of antibiotic.

The risk of receiving more than one prescription within an antibiotic course was examined for all children aged 0 to 5 years in a Danish county during 1997. We identified 29,307 prescriptions of systemic antibiotics for 16,245 children in a prescription database. Ten per cent of the prescriptions were followed by a new prescription within 10 days. In children who received two prescriptions (n = 3993), 19% redeemed the prescriptions within the same course. When the child was prescribed penicillin V, compared with broad-spectrum penicillin, the odds ratio of receiving a repeat prescription within 1-2 days was 2.9 (95% CI 2.5-3.4) and within 3-10 days 1.3 (95% CI 1.2-1.5).

Anti-Bacterial Agents↗
PubMed2004

Defined daily doses of antimicrobials reflect antimicrobial prescriptions in ambulatory care.

BACKGROUND: Data on actual antimicrobial prescriptions are rarely made available and the World Health Organization (WHO) recommends using the number of defined daily doses (DDDs) as a measurement unit for inter-country comparisons of antimicrobial use in outpatients. However, because antimicrobials are given for limited periods of time and the DDDs may not represent the doses used in practice, this measurement unit has been blamed for poorly reflecting the number of antimicrobial prescriptions in outpatients. METHODS: For 11 out of 15 European countries, data on national outpatient sales of antimicrobials and on antimicrobial prescriptions to outpatients in 1997 were purchased from the Institute for Medical Statistics (IMS) Health. For two additional countries, i.e. Sweden and Denmark, similar data were obtained from the National Corporation of Swedish Pharmacies and the Danish Medicines Agency, respectively. The relationships between the number of DDDs and the number of prescriptions, on the one hand, and the antimicrobial use density (DDD per 1000 inhabitant-days) and the prescription rate (prescriptions per 1000 inhabitants), on the other hand, were assessed with the two-tailed Spearman coefficient for non-parametric correlations. RESULTS: The number of DDDs, as defined by the WHO, and the number of prescriptions of antimicrobials to outpatients in European countries in 1997 were strongly correlated. Similarly, the antimicrobial use density and the prescription rate in these countries were strongly correlated. These relationships were found for total systemic antimicrobials and for all major antimicrobial classes. CONCLUSION: Our results confirm the relevance of the number of DDDs per 1000 inhabitant-days as a measurement unit to compare outpatient antimicrobial use among countries or regions.

Ambulatory Care↗
PubMed1998

Pharmacists' attitudes about pharmacy sale of needles/syringes and needle exchange programs in a city without needle/syringe prescription laws.

We assessed pharmacists' practices for needle and syringe (NS) sales and their attitudes toward a needle exchange program through a telephone survey of 75 randomly selected pharmacies in Baltimore, Maryland, where possession of drug paraphernalia is illegal but where NS can be purchased without a prescription. Pharmacists' (n=46) procedures for NS sales included asking for picture identification (54%), requiring a prescription (34%), or requiring a diabetic identification (DID, 34%) for NS purchase; multiple responses were allowed. The median number of prescription and nonprescription NS sold per month was 950. Most (86.6%) pharmacists reported selling NS without prescriptions at their discretion. Pharmacists sold a median of 16 nonprescription NS per month. Pharmacists who required prescriptions or DID (56.5%) sold nonprescription NS significantly less often than those who did not require prescriptions or DID (p=.007). Most pharmacists (87%) were aware of the needle exchange program, 78.3% supported the program, and 67.4% supported selling nonprescription NS in pharmacies. Although there was no difference in anticipated effects of needle exchange or in support for needle exchange between pharmacists who did or did not require prescriptions, DID, or both, pharmacists who did require these items were significantly less likely to support pharmacy sales of nonprescription NS than pharmacists with less restrictive sales policies (p=.04). Although most pharmacists surveyed supported access to sterile NS by injection drug users through a needle exchange program, there was a diversity of approaches to nonprescription NS sales among pharmacists in a city that does not require prescriptions for access to sterile NS. Most supported nonpharmacy needle exchange programs, and more than one half limited injection drug users' access to NS through restrictive sales practices. To reduce injection drug users' exposure to HIV, pharmacists should be educated about HIV prevention and injection drug use and be included in development of HIV prevention programs, including legal pharmacy NS sales.

Attitude of Health Personnel↗
PubMed2005

The influence of the structure and culture of medical group practices on prescription drug errors.

BACKGROUND: This project was designed to identify the magnitude of prescription drug errors in medical group practices and to explore the influence of the practice structure and culture on those error rates. Seventy-eight practices serving an upper Midwest managed care (Care Plus) plan during 2001 were included in the study. METHODS: Using Care Plus claims data, prescription drug error rates were calculated at the enrollee level and then were aggregated to the group practice that each enrollee selected to provide and manage their care. Practice structure and culture data were obtained from surveys of the practices. Data were analyzed using multivariate regression. RESULTS: Both the culture and the structure of these group practices appear to influence prescription drug error rates. Seeing more patients per clinic hour, more prescriptions per patient, and being cared for in a rural clinic were all strongly associated with more errors. Conversely, having a case manager program is strongly related to fewer errors in all of our analyses. The culture of the practices clearly influences error rates, but the findings are mixed. Practices with cohesive cultures have lower error rates but, contrary to our hypothesis, cultures that value physician autonomy and individuality also have lower error rates than those with a more organizational orientation. Our study supports the contention that there are a substantial number of prescription drug errors in the ambulatory care sector. Even by the strictest definition, there were about 13 errors per 100 prescriptions for Care Plus patients in these group practices during 2001. CONCLUSIONS: Our study demonstrates that the structure of medical group practices influences prescription drug error rates. In some cases, this appears to be a direct relationship, such as the effects of having a case manager program on fewer drug errors, but in other cases the effect appears to be indirect through the improvement of drug prescribing practices. An important aspect of this study is that it provides insights into the relationships of the structure and culture of medical group practices and prescription drug errors and provides direction for future research. Research focused on the factors influencing the high error rates in rural areas and how the interaction of practice structural and cultural attributes influence error rates would add important insights into our findings. For medical practice directors, our data show that they should focus on patient care coordination to reduce errors.

Culture↗
PubMed2004

Analgesic prescription patterns among hemodialysis patients in the DOPPS: potential for underprescription.

BACKGROUND: Dialysis patients require special consideration regarding analgesics, given their altered pharmacokinetic and pharmacodynamic profiles and increased potential for adverse reactions. METHODS: Analgesic prescription patterns were investigated using data from the Dialysis Outcomes and Practice Patterns Study (DOPPS), with 3749 patients in 142 United States facilities studied between May 1996 and September 2001. RESULTS: The proportion of patients prescribed any analgesic decreased from 30.2% to 24.3%; narcotic prescriptions decreased from 18.0% to 14.9%. The most commonly prescribed narcotics were propoxyphene/acetaminophen combinations (47.2%). Combinations containing acetaminophen were prescribed concurrently for 84.1% of patients on narcotics. About one half of prescriptions for narcotics, acetaminophen, and cyclooxygenase-2 (COX-2) agents were for 12 months or more; one half of prescriptions for nonsteroidal anti-inflammatory drugs (NSAIDs) were for 8 months or more. The proportion of patients prescribed analgesics varied by facility (mean +/- SD = 27.9%+/- 18.9% for all analgesics, range 0% to 89.3%). Analgesic prescription was more likely among the elderly, women, and patients with cardiovascular disease (other than coronary artery disease or congestive heart failure), lung and psychiatric disease, cancer (other than skin), and recurrent cellulitis. Patients prescribed laxatives were almost twice as likely to be on a narcotic (odds ratio = 1.95, P < 0.0001). Analgesic prescription did not correlate with loss of residual renal function or hospitalization for a gastrointestinal disorder. Three-quarters of patients reporting moderate to very severe pain were not prescribed analgesics. Furthermore, 74% of patients with pain that interfered with work had no analgesic prescription. CONCLUSION: Dialysis patients and providers may benefit from both refinement of existing guidelines and a renewed understanding regarding appropriate prescription of analgesics.

Acetaminophen↗
PubMed2005

A computer method for validating traditional Chinese medicine herbal prescriptions.

Traditional Chinese medicine (TCM) has been widely practiced and is considered as an alternative to conventional medicine. TCM herbal prescriptions contain a mixture of herbs that collectively exert therapeutic actions and modulating effects. Traditionally defined herbal properties, related to the pharmacodynamic, pharmacokinetic and toxicological, as well as physicochemical properties of their principal ingredients, have been used as the basis for formulating TCM multi-herb prescriptions. These properties are used in this work to develop a computer program for predicting whether a multi-herb recipe is a valid TCM prescription. This program is based on a statistical learning method, support vector machine (SVM), and it is trained by using 575 well-known TCM prescriptions and 1961 non-TCM recipes generated by random combination of TCM herbs. Testing results by using 72 well-known TCM prescriptions and 5039 non-TCM recipes showed that 73.6% of the TCM prescriptions and 99.9% of non-TCM recipes are correctly classified by this system. A further test by using 48 TCM prescriptions published in recent years found that 68.7% of these are correctly classified. These accuracies are comparable to those of SVM classification of other biological systems. Our study indicates the potential of SVM for facilitating the analysis of TCM prescriptions.

Chemistry, Pharmaceutical↗
PubMed2006

The availability of web sites offering to sell opioid medications without prescriptions.

OBJECTIVE: This study was designed to determine the availability of web sites offering to sell opioid medications without prescriptions. METHOD: Forty-seven Internet searches were conducted with a variety of opioid medication terms, including "codeine," "no prescription Vicodin," and "OxyContin." Two independent raters examined the links generated in each search and resolved any coding disagreements. The resulting links were coded as "no prescription web sites" (NPWs) if they offered to sell opioid medications without prescriptions. RESULTS: In searches with terms such as "no prescription codeine" and "Vicodin," over 50% of the links obtained were coded as "NPWs." The proportion of links yielding NPWs was greater when the phrase "no prescription" was added to the opioid term. More than 300 opioid NPWs were identified and entered into a database. CONCLUSIONS: Three national drug-use monitoring studies have cited significant increases in prescription opioid use over the past 5 years, particularly among young people. The emergence of NPWs introduces a new vector for unregulated access to opioids. Research is needed to determine the effect of NPWs on prescription opioid use initiation, misuse, and dependence.

Acetaminophen↗
PubMedDate not supplied

[Drug prescription for hospitalized pediatric patients: how can the quality be evaluated?].

BACKGROUND: Pediatric patients called "therapeutic orphans" are usually excluded from clinical trials for development of new drugs, which, sometimes, are used empirically. This study evaluates the prescriptions for pediatric inpatients, and proposes criteria for evaluation of the quality of the prescriptions. METHODS: The hospital pharmacist determined the prevalence of drug prescription in five pediatric wards. One day collection of all prescriptions for pediatric inpatients was performed in March, April, May and June 1999, and the data were jointly analyzed. Six criteria were proposed for quality evaluation of the drug prescriptions. The drugs were classified according to the ATC classification index. RESULTS: The prescriptions of a total of 322 patients were collected in the four collection days. The three most common diagnoses were: pneumonia 40.4%, meningitis and meningococcemia 6%, diarrhea and dehydration 6%. The three most prescribed therapeutic classes were: nervous system (N ) 109%, general antiinfectives for systemic use ( J ) 81.9% and respiratory system ( R ) 69,0%. The three most prescribed drugs were: metamizole 88.3%, fenoterol 30.7% and penicillin G 25.0%. The quality evaluation showed 1. an excessive use of the intravenous route, 2. appropriate dose schedule for drugs with narrow therapeutic index, 3. no therapeutic duplication, 4. prescription of unapproved and off-label drugs, 5. frequent potential adverse drug interactions, and 6. prescription of drugs not in the therapeutic formulary of the hospital. CONCLUSION: Very simple measures can improve the quality of the health care of pediatric inpatients as inclusion of adequate drug presentations in the hospital formulary, and a careful evaluation of the need of the intravenous route. This study also shows the hospital pharmacists acting as part of the multidisciplinary health care team.

Adolescent↗
PubMed1997

[Trends in the prescriptions for antihypertensive drugs in elderly patients].

We compared trends in the prescription of antihypertensive drugs in elderly patients with those in middle-aged patients. We analyzed prescriptions given to 141 patients with hypertension who were 65 years old or older (mean age, 73 years) and to 511 patients with hypertension who were 64 years old or younger (mean age, 59 years). The numbers of drugs prescribed did not differ between the elderly and the non-elderly patients. In both groups, about 50% of patients were given prescriptions for one antihypertensive drug, about 40% were given prescriptions for two drugs, and about 10% were given prescriptions for three drugs. Calcium antagonists were the agents most commonly prescribed as monotherapy (51.4% and 56.4% in the non-elderly and elderly respectively; n.s.); followed by beta-blockers (32.2% and 25.6%; n.s.). Diuretics were prescribed less often to non-elderly patients than to elderly patients (5.1% and 10.0%; p < 0.01). When prescriptions for more than one antihypertensive agent were included in the analysis, calcium antagonists were still the most commonly prescribed agents (63.8% and 66.4%; n.s.), followed by the beta-blockers (53.3% and 66.4%; p < 0.05). Diuretics were less commonly prescribed to non-elderly patients (13.5% and 21.3%; p < 0.005), while ACE inhibitors (19.0% and 11.6%; p < 0.005) and beta-blockers (52.3% and 44.0; p < 0.05) were more commonly prescribed to non-elderly patients. When we classified the data according to the time of the first visit, we found that patients whose first visit was earlier were more likely to have been given a prescription for a diuretics, whether they were elderly or non-elderly. Calcium antagonists were the most commonly prescribed agents in all time periods studied, followed by beta-blockers. Comparison of our results with those of a similar study done at our clinic in 1990 showed that the use of calcium antagonist monotherapy doubled in both groups (non-elderly: 26.4% in 1990 to 51.4% in 1995, p < 0.001; elderly: 29.5% in 1990 to 56.4% in 1995, p < 0.001) and that the use of diuretics declined markedly (non-elderly; 20.3% to 5.1%, p < 0.001; elderly: 30.2% to 10.0%, p < 0.001). A similar trend was seen when prescriptions for more than one antihypertensive drug were included in the analysis.

Aged↗
PubMed2006

Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: Results of the National Epidemiologic Survey on Alcohol and Related Conditions.

OBJECTIVE: To present national data on the prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders for sedatives, tranquilizers, opioids, and amphetamines. METHOD: Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a face-to-face nationally representative survey of 43,093 adults conducted during 2001 and 2002. RESULTS: Lifetime prevalences of nonmedical use of sedatives, tranquilizers, opioids, and amphetamines were 4.1%, 3.4%, 4.7%, and 4.7%, respectively. Corresponding rates of abuse and/or dependence on these substances were 1.1%, 1.0%, 1.4%, and 2.0%. The odds of nonmedical prescription drug use and drug use disorders were generally greater among men, Native Americans, young and middle-aged, those who were widowed/ separated/divorced or never married, and those residing in the West. Abuse/dependence liability was greatest for amphetamines, and nonmedical prescription drug use disorders were highly comorbid with other Axis I and II disorders. The majority of individuals with non-medical prescription drug use disorders never received treatment. CONCLUSIONS: Nonmedical prescription drug use and disorders are pervasive in the U.S. population and highly comorbid with other psychiatric disorders. Native Americans had significantly greater rates of nonmedical prescription drug use and drug use disorders, highlighting the need for culturally-sensitive prevention and intervention programs. Unprecedented comorbidity between nonmedical prescription drug use disorders and between nonmedical prescription drug use disorders and illicit drug use disorders suggests that the typical individual abusing or dependent on these drugs obtained them illegally, rather than through a physician. Amphetamines had the greatest abuse/dependence liability, and recent increases in the potency of illegally manufactured amphetamines may portend an epidemic in the youngest NESARC cohort.

Adult↗
PubMed1991

An evaluative study of unclaimed prescriptions.

Effects of implementation of an integrated hospital computer system have greatly increased the outpatient prescription non-compliance rate. The provider's electronic order entry initiates the prescription process resulting in receipt of the prescription order in the pharmacy without the intervention of the patient. A demographic study by clinic of origin and type of medications contributing to the increase in compliance failure is presented. Within a defined range of dates, the number of unclaimed prescriptions for each clinic is reported per total of unclaimed prescriptions for that period. Then, the number of unclaimed prescriptions per clinic is evaluated in light of the total number of prescriptions generated by that clinic. Finally, types of medications in the unclaimed prescriptions are broken down into American Hospital Formulary Service drug categories for data on the most commonly unclaimed type of medications. Conclusions are made on the correlation between compliance failure, clinic type and drug category.

Clinical Pharmacy Information Systems↗