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At least 757 records · Page 42Linked to original sources
PubMed2003

[Identification and analysis of errors in prescription, preparation and administration of drugs in intensive care, medicine and surgery at the University Hospital Center of Tours].

OBJECTIVE: Within the framework of a project to establish "the safety of drug use and the prevention of iatrogenic risks", the pharmaceutical team conducted a review on the errors in drug prescription in order to implicate the medical professionals in its development. In collaboration with the medical teams, the pharmacy organised a series of therapeutic surveys aimed at quantifying and qualifying the errors related to the prescription, preparation and administration of medicinal products. METHODS: A prospective survey was conducted in three types of care units (Medicine, surgical intensive care and paediatric vascular surgery) over a 30-day period in each unit. A resident pharmacist studied the preparations and administration of drugs and compared them to the prescriptions and recommendations of in the literature. The investigator also conducted the pharmaceutical analysis of the prescriptions (dose, drug interactions, administration timetable...). The clinical impact of the errors on the patient were scored 0 (none) to 3 (lethal) by a duo composed of an external physician and the resident physician in charge of the study on site. RESULTS: Among the 3,023 drugs prescribed, the error rate was of 0.04 [0.033; 0.047], 44% of which scored 2. The errors in preparation or administration were of 0.134 [0.117; 0.151] among the 1,632 drug administrations observed, 19% of which scored 2. Regarding errors in prescription and administration, no significant difference was revealed between the three units [p > 0.09]. DISCUSSION: This study enhanced the awareness of the nursing and medical staff and the hospital management with regards to the reality of medical errors. Our data were comparable to the results of other studies published elsewhere.

Academic Medical Centers↗
PubMed2003

Highly active antiretroviral therapy: physician experience and enhanced adherence to prescription refill.

OBJECTIVE: To identify patient and physician characteristics that may act as determinants of adherence to prescription refill of triple combination antiretroviral therapy. METHODS: A population-based analysis of antiretroviral therapy-naive HIV-positive men and women in British Columbia, Canada, who initiated triple combination therapy between August 1 1996 and October 31 1998. Study participants were considered adherent if they were actually dispensed antiretrovirals > or = 95% over the first year of therapy. Log-binomial regression was used to identify patient and physician characteristics associated with adherence to prescription refill. RESULTS: Of the 886 individuals eligible for analysis, 495 (56%) were > or = 95% adherent to prescription refill. In multivariate analysis, adherence was positively associated with increased age [adjusted relative rate (ARR) 1.19; 95% CI: 1.07-1.32], having a diagnosis of AIDS (ARR 1.66; 95% CI: 1.29-2.15), being male (ARR 1.79; 95% CI: 1.27-2.53), and with greater experience of the treating physician (ARR 1.27; 95% CI: 1.13-1.42). History of injection drug use was negatively associated with adherence to prescription refill (ARR 0.65; 95% CI: 0.51-0.83), as was increased pill burden (per pill daily) (ARR 0.95; 95% CI: 0.92-0.99). A sub-analysis of 316 patients who provided additional data regarding psychosocial characteristics indicated that adherence was positively associated with physician experience (ARR: 1.28; 95% CI: 1.09-1.51) and being employed (ARR: 1.55; 95% CI: 1.14-2.21), and negatively associated with a history of injection drug use (ARR: 0.61; 95% CI: 0.43-0.85). CONCLUSION: While patient disease stage and personal characteristics may play an important role in patient adherence to prescription refill of complex therapeutic regimens, our findings indicate that HIV-experienced physicians may have greater success in maintaining patients on prescribed therapy.

Adult↗
PubMed2003

Electronic transfer of prescription-related information: comparing views of patients, general practitioners, and pharmacists.

BACKGROUND: The National Health Service (NHS) intends to introduce a system of electronic transfer of prescription-related information between general practitioners (GPs) and community pharmacies. The NHS Plan describes how this will be achieved. AIM: To gather opinions of patients, GPs, and community pharmacists on the development of a system of electronic transfer of prescription-related information between GPs and community pharmacies. DESIGN OF STUDY: Survey combining interviews, focus groups, and postal questionnaires. SETTING: General practitioners, opinion leaders, computing experts, pharmacists, and patients. Eight hundred members of the public, 200 GPs, and 200 community pharmacists, all living in Scotland. METHOD: Content-setting interviews and focus groups were conducted with purposive samples of relevant groups. Postal questionnaires were developed and sent to random samples of members of the public selected from the electoral roll, GPs, and community pharmacists. RESULTS: The corrected postal response rates were: 69% (patients); 74% (GPs); and 74% (community pharmacists). All three groups were generally supportive of electronic transfer of prescription-related information. Different aspects appealed to each group: patients anticipated improved convenience; GPs, better repeat prescribing; and pharmacists, an enhanced professional role. Security of patient-identifiable information was the main concern. All groups acknowledged potential benefits of a full primary care information system, but GPs and patients had reservations about allowing community pharmacists to access parts of the medical record that did not concern medication. CONCLUSION: Electronic transfer of prescription-related information is likely to be acceptable to all users, but concerns about patient confidentiality and an extended role for pharmacists in prescription management need to be addressed.

Attitude of Health Personnel↗
PubMedDate not supplied

[Intention of purchasing generic prescription drugs on the part of consumers in Asturias, Spain].

BACKGROUND: Ascertaining how consumers perceive the risk related to the use of generic prescription drugs and those factors which have the greatest impact on the intention to request a generic drug from the prescribing physician and/or the pharmacist for the purpose of determining any possible barriers or hindrances to the acceptance of generics and to gather information to aid healthcare managers in their decision-making processes. METHODS: Study on prescription drug use revolving around the degree to which patients are willing to request an EFG. In this quantitative transversal study, a total of 542 individuals were individually surveyed upon exiting a healthcare center or pharmacy in Asturias. A scale for measuring the perceived risk involved in the purchase of a prescription drug including 15 attributes grouped into five aspects was included in the questionnaire. Information was also gathered regarding the intention of using generic prescription drugs and on the demographic and socioeconomic characteristics of those surveyed. For the analysis of the results, a factorial confirmational analysis, multiple regression and univariate analysis were used. The data was processed using the EQS and SPSS statistics programs. RESULTS: Mean perception of the risk (scales 1-7): functional: 2.75; physical: 2.68: financial: 2.19; psychological: 1.99; social: 1.42. Factors having a bearing on the intention of requesting generic prescription drugs from their physician: psychological risk (p = 0.000). On requesting the same from their pharmacist: psychological risk (p = 0.000) and social risk (p = 0.020). CONCLUSIONS: The agents interested in the development on the EFG market should target their communication efforts on putting the functional and financial aspects of the manufacturer's specialties and generic specialties on the same level, but should not leave out psychological and social aspects of the consumers' purchasing behavior.

Consumer Behavior↗
PubMedDate not supplied

[Assessment of prescription in discharge reports at a university hospital].

OBJECTIVE: To determine and analyze drug prescription at hospital discharge, mainly regarding generic drug use, use of novel but irrelevant therapeutic agents and use of low therapeutic value drugs (LTVD). MATERIAL AND METHODS: In a retrospective study 195 discharge reports from 11 different departments in a 450-bed general hospital were analyzed for a monthly period. An Access database allowed us to record the number of prescriptions, each drugs therapeutic group according to the Anatomical Therapeutic Chemical (ATC) Classification System, prescribed drugs for which generics are available, prescribed C-group drugs, LTVD drugs, etc. RESULTS: Following an analysis of results, only 6.17% of all drugs were prescribed according to their generic name, when this would have been possible in 22.8%. If only the most efficient agents had been prescribed, savings would have amounted to 589.3 Euros. In all, 1.28% of prescribed drugs were LTVD, and 1.15% had irrelevant therapeutic value. CONCLUSION: Although specialized medical prescription represents a minimum of total prescriptions in a healthcare area, measures intended to improve quality will have a positive impact on primary care prescriptions. These measures include information to physicians on more efficient preparations, plus the design of a Pharmacotherapeutic Guide to unify pharmacologic criteria in the Area.

Drug Prescriptions↗
PubMed2004

[It's possible to influence prescriptions patterns by producer-independent information].

Following the publication of a metaanalysis over effectiveness and tolerability of triptanes for acute treatment of migraine we investigated whether a short oral information by clinical pharmacologists, describing the rationale for prescribing a certain triptane, combined with memory cards could influence the prescription by general practitioners. The primary care units, which had received the information, showed a significantly better adherence to prescription of the recommended triptane than units that had not received such information. The desired influence on prescription was, however, transient and not statistically significant for more than three months following the prescription. The finding underlines the need for repeated information when effects on prescription habits are wanted.

Community Health Centers↗
PubMed2002

Prevention of prescription errors by computerized, on-line, individual patient related surveillance of drug order entry.

Computerized prescription of drugs is expected to reduce the number of many preventable drug ordering errors. In the present study we evaluated the usefullness of a computerized drug order entry (CDOE) system in reducing prescription errors. A department of internal medicine using a comprehensive CDOE, which included also patient-related drug-laboratory, drug-disease and drug-allergy on-line surveillance was compared to a similar department in which drug orders were handwritten. CDOE reduced prescription errors to 25-35%. The causes of errors remained similar, and most errors, on both departments, were associated with abnormal renal function and electrolyte balance. Residual errors remaining on the CDOE-using department were due to handwriting on the typed order, failure to feed patients' diseases, and system failures. The use of CDOE was associated with a significant reduction in mean hospital stay and in the number of changes performed in the prescription. The findings of this study both quantity the impact of comprehensive CDOE on prescription errors and delineate the causes for remaining errors.

Drug Prescriptions↗
PubMed2005

[Methods and modes about the theory of traditional Chinese prescription composition].

Theory and mode about compatibility of prescription are the key element for studies on complex prescription in traditional Chinese medicine. In this article, we reviewed the sources, methods and thoughtway about theory of prescription composition, and concluded the current researches about components compatibility. Through introducing the researches about compatibility of effective components, we advanced that components compatibility would be one of the new modes of compound prescription of Chinese medicine. The researches and foundation about the new modes of compound prescription of Chinese medicine would do active influence either in making modern Chinese medicine or in increasing clinical curative effect.

Diagnosis, Differential↗
PubMed2005

One pill, many prices: variation in prescription drug prices in selected government programs.

This paper updates a June 2002 National Health Policy Forum Issue Brief, "Average Wholesale Price for Prescription Drugs: Is There a More Appropriate Pricing Mechanism?" Since the release of that paper, Congress enacted the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, which created a new, comprehensive outpatient prescription drug benefit and reduced Medicare's reliance on the average wholesale price (AWP) in paying for prescription drugs. This paper discusses the continued use of AWP as well as other pricing benchmarks that pertain to prescription drugs. It explains the relevance of these pricing mechanisms to different government programs and sets forth some of the issues that have arisen in their use. The paper also contains a glossary of commonly used drug pricing terms, as well as an appendix that lists state Medicaid drug payment formulas.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2005

Physician perspectives on a pilot prescription monitoring program.

In 2003, during implementation of a pilot electronic prescription monitoring program in southwest Virginia, a survey was mailed to 672 physicians to learn about their knowledge of and attitudes toward the program and its impact on their opioid prescribing behaviors. A total of 275 surveys were returned yielding a response rate of 41%. Less than one-half had previously heard about the prescription monitoring program. Nearly 60% believed their prescribing behaviors were being monitored more closely as a result of the program; of these, 23% reported that this had a negative impact on their ability to help patients manage their pain. Sixty-eight percent reported that the prescription monitoring program was useful for monitoring patients' prescription histories and decreasing doctor shopping; however, only 11% had requested information from the prescription monitoring program database, primarily due to access barriers. Recommendations include education to increase physician awareness of and utilization of the program and to address their concerns about scrutiny of practice and collection of relevant data that examines the impact of the program on diversion, abuse, and quality of patient care for persons in pain.

Attitude of Health Personnel↗
PubMed2005

Prescription pattern for treatment of hemorrhoids under the universal coverage policy of Thailand.

The Universal Coverage Policy (UCP) or "30 Baht Scheme" was launched in Thailand in 2001. The policy caused a cutback in the budgets of all public hospitals and health service centers. Traditional medicine was then viewed as an alternative to save costs. This study examines whether this had any influence on hemorrhoid treatment prescription patterns, ratio of traditional/modern medicine, or the cost of hemorrhoid treatment after the UCP was implemented at a community hospital. The traditional medicine prescribed was Petch Sang Kart and the modern alternative was Proctosedyl. All hemorrhoid prescriptions at a community hospital from October 2000 to January 2003 were surveyed. Segmented Regression Analysis was applied to evaluate prescription trends, the ratios between the types of medicine, and the hemorrhoid treatment cost. A total of 256 prescriptions were analyzed. The average number of traditional medicine prescriptions per month were more than modern medicine (41 versus 16). During the study period, the trend of modern medicine use and the treatment cost was decreased (p < 0.01). The ratio of traditional/modern medicine increased 0.2 times (p = 0.02).

Adolescent↗
PubMed2006

Prescription pattern at primary health care centres in Lagos State.

Health care received in health facilities depends on adequate consultation, correct prescription and dispensing with relevant information given to the patient. These are some of the indicators for rational drug use. The objective of the study was to determine the pattern of prescription among prescribers in twenty Primary Health Care Centers of Lagos State using some of these indicators used in investigating health facilities by the World Health Organisation and International Network for Rational Use of Drugs. The study was carried out using multi-stage random sampling in selecting the Primary Health Care Centers from each of the twenty Local Government Areas of Lagos State. Both prospective and retrospective data were collected and analysed using Epi-Info version 6. The results showed that there was polypharmacy, misuse of antibiotics and injections. There was no statistically significant difference between the retrospective and prospective indicators of mean drugs prescribed per encounter, percentage antibiotics prescribed and percentage of generic prescription. It was concluded that there was irrational prescription pattern in all the selected health facilities as evidenced by poly-pharmacy, misuse of antibiotics and low generic prescriptions. There is need for educational intervention to improve the prescribing habits of health professionals in these health facilities.

Anti-Bacterial Agents↗
PubMed1991

Change in the established prescribing habits of general practitioners: an analysis of initial prescriptions in general practice.

The aim of this study was to describe the types of drugs prescribed by general practitioners in a sample of initial (rather than repeat) prescriptions, the additions and deletions made to a doctor's repertory and the factors influencing these changes. The method used here enabled repeat prescriptions to be excluded as these are an inaccurate reflection of the current habits of the prescriber. A total of 201 (74%) of the principal general practitioners in the Grampian region participated. Data were obtained by substituting special prescription pads containing duplicate forms which allowed additional data to be recorded at the time of prescribing, including perceived influences that had resulted in changes from established choices of drug therapy. A sample of 100 forms were collected on seven occasions from each doctor over a one year sample period. Prescribers on average selected a preparation that they had only started to use within the last 12 months (that is newly adopted to their repertory) in 5.4% of initial prescriptions. These changes mostly involved antibiotics and analgesics and were occasioned mainly by the influence of the 'limited list' regulations, pharmaceutical company representatives and hospital specialists. We conclude that general practitioners were not unduly influenced by commercial sources of information, and that their prescribing habits were stable and conservative. The paper presents a case for the separate analysis of initial and repeat prescriptions as an essential step in producing more informative data on prescribing.

Drug Prescriptions↗
PubMed1991

[Surveillance of adverse reactions of drugs and monitoring of drug prescriptions as routine in hospital activities].

Since January 1988 is taking place a multicentre experience on pharmaco-epidemiology named ARIES (Adverse Reaction Identification Evaluation System), with two primary aims: surveillance of drug adverse reactions and monitoring of medical prescriptions. At present 5 departments of internal medicine are involved in the study. The factual cooperation of the departmental doctors depends on the evaluation of benefits and costs of the study. The benefits for doctor are: (a) the possibility of contributing to the research in a field which has not been systematically investigated in a hospital setting; b) the acquisition of skill in monitoring adverse reactions: to facilitate doctors cooperation an algorithm has been developed to select the events to be entered into the system; c) the possibility of evaluating and improving the prescription habits. At present, data on 9,000 patients and 60,000 prescriptions are available. As an example of utilization study, we report a research on antibiotics prescribed for bronchopneumonia in two departments involved in the ARIES project. The remarkable differences in the prescription settings lead to some rethinking on the strategies of such different prescription choices. In each department, the contribution of doctors is integrated by a monitor, entering additional information on drugs and patients into the system. Thanks to the cooperation of doctors and contribution of monitors, the pharmaco-epidemiology research may become a "normal" component of the hospital activities, thus allowing to systematically retrieve and process some basic knowledges, which are not routinely used, derived from the daily activity of the departmental doctor.

Drug Prescriptions↗
PubMed1991

[Generic prescription].

On the basis of increased interest by the Danish public, not only popularly but also professionally, for generic prescription, a review of the subject is presented. In USA, in particular, pronounced opposition to generic prescription exists from the medical profession and from the drug industry. It is considered that the incitement to develop an original product is weakened. It is feared that marketed "synonymous" product are not always synonymous. Investigation have been carried out to show that generic prescription can function to the satisfaction of everyone and parcticularly the consumers' satisfaction (up to 83% of the patients express satisfaction with arrangement in a Danish investigation). In addition, the system results in an immediate saving (approximately 7%), if it functions. However, at its best, the system functions in only half of the cases in the majority of places, in USA most frequently only in 10% and in England in 36%. The professional groups constitute the greatest obstacle. Doctors, in particular, show great doubts about the advisability of the system. If the system is to function at all, pharmacologists and doctors must be motivated to employ the system correctly. Education is necessary in order to avoid generic prescription involving considerable unpaid extra work for the pharmacist and the doctor. It is essential that the Danish Board of Health can guarantee that synonymous preparations on the market are, in fact, synonymous. Finally, decisions about the extent to which synonymous preparations may be dispensed must lie in the hands of the prescribing doctor who is responsible for the prescription.

Decision Making↗
PubMed1990

[A drug prescription study in chronic pathology at a primary care center].

To evaluate the characteristics of the drug used for the therapy of chronic diseases, 1588 prescriptions from a sample of 549 continued drug prescription forms were evaluated. Every patient had a mean number of 2.9 drugs, 2.14 diagnoses and 1.41 drugs per diagnosis. The patients over 65 years had a higher number of drugs and diagnoses. A smaller number of diagnoses but a higher number of drugs per diagnoses was found for males. The drug subgroups with higher prescription rates were cardiac drugs (12.3%), diuretics (11.2%) and analgesics (9.9%). The most common diagnoses were hypertension and osteoarthritis, with 17.6% and 13.6% of prescriptions, respectively. A high rate of patients receiving vasodilators (12%) and benzodiazepines (14.7%) was found. The usefulness of the continued prescription forms for the control of chronic treatments is emphasized.

Age Factors↗
PubMed1990

[Prospective evaluation of modalities of ceftazidime prescription].

Between November 1987 and October 1988, we have prospectively studied 101 hospital prescriptions of ceftazidime, a third generation cephalosporine, including all the health care departements of St Joseph hospital. A standard questionnaire was used to collect the date: dosage, length, and conditions of prescriptions. We observed that this antibiotic is correctly prescribed concerning dosage, length of prescription, and is adapted to bacteriological findings. The striking results were a high proportion of empirical prescriptions (48%) comparing to less than 10% 6 months before the beninning of this study. 75% of these empirical prescriptions being later on confirmed by bacteriological exams.

Aged↗
PubMed1990

Prescription drug abuse. Patient, physician, and cultural responsibilities.

The abuse of prescription drugs is one facet of America's drug problem that is particularly complex because access to prescription drugs must be maintained for some purposes and contained for others. The American Medical Association has sponsored two national conferences to grapple with the confluence of the medical access to prescription drugs and a national drug abuse control policy. One result has been a classification of misprescribing physicians that blames physicians for prescription drug abuse. The conceptualization and public policy response to prescription drug abuse have been largely shaped by the emotional response to the epidemic of crack cocaine and other nonprescription drug abuse. A new perspective is needed--one that accommodates the evolving role of physicians in society, the life-style choices that physicians enable in their patients, and the respective responsibilities of both physicians and patients in physician-patient transactions.

Crime↗