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At least 91 records · Page 5Linked to original sources

Planning stereotactic surgery using the graphic prescription and explicit prescription MRI programs.

A method is described for planning stereotactic approaches to central nervous system lesions utilizing specialized programs contained within the GE sigma Magnetic Resonance Imaging scanner software. The graphic prescription program creates oblique scans relative to a localizer scan made in any standard orthogonal plane and the explicit prescription program creates slices perpendicular to any two chosen points. Using these programs to advantage, one can create an oblique coronal scan that contains the entry point, the approach tract and the target plus a series of cross sectional oblique scans perpendicular to and progressing along the approach track to the target. These scans can then be employed to modify a proposed approach so as to avoid blood vessels and other vital structures.

Brain↗

A comparative study of current Medicaid prescription reimbursement (MAC/EAC) (maximum allowable cost/estimated acquisition cost) with prescription reimbursement based on a competitive market.

Many pharmacists have suggested that the current Maximum Allowable Cost/Estimated Acquisition Cost (MAC/EAC) program has departed from its intended purpose of generating savings by taking full but fair advantage of the competitive marketplace. The objective of this study was to compare Medicaid prescription reimbursement under current MAC/EAC regulations with prescription reimbursement based on a competitive market. Data representing the top selling single source and multiple source drug products for nine states were analyzed. Results indicated that the current MAC/EAC system of Medicaid reimbursement produced a small savings when compared to reimbursement based on a competitive market.

Costs and Cost Analysis↗

Distribution of blood derivatives by registered blood establishments that qualify as health care entities; Prescription Drug Marketing Act of 1987; Prescription Drug Amendments of 1992; delay of applicability date. Final rule; delay of applicability date.

The Food and Drug Administration (FDA) is further delaying, until December 1, 2008, the applicability date of a certain requirement of a final rule published in the Federal Register of December 3, 1999 (64 FR 67720) (the final rule). The final rule implements the Prescription Drug Marketing Act of 1987 (PDMA), as modified by the Prescription Drug Amendments of 1992 (PDA), and the Food and Drug Administration Modernization Act of 1997 (the Modernization Act). The provisions of the final rule became effective on December 4, 2000, except for certain provisions whose effective or applicability dates were delayed in five subsequent Federal Register notices, until December 1, 2006. The provision with the delayed applicability date would prohibit wholesale distribution of blood derivatives by registered blood establishments that meet the definition of a "health care entity." In the Federal Register of February 1, 2006 (71 FR 5200), FDA published a proposed rule specific to the distribution of blood derivatives by registered blood establishments that qualify as health care entities (the proposed rule). The proposed rule would amend certain limited provisions of the final rule to allow certain registered blood establishments that qualify as health care entities to distribute blood derivatives. In response to the proposed rule, FDA received substantive comments. As explained in the SUPPLEMENTARY INFORMATION section of this document, further delaying the applicability of Sec. 203.3(q) (21 CFR 203.3(q)) to the wholesale distribution of blood derivatives by health care entities is necessary to give the agency additional time to address comments on the proposed rule, consider whether regulatory changes are appropriate, and, if so, to initiate such changes.

Biological Products↗

[Hearing aid prescription in ENT practice. II. Forms of hearing aid construction and prescription of bilateral hearing aids].

The fundamental constructional types of hearing aids are box or pocket hearing aids, behind-the-ear devices and in-the-ear devices. Other special forms include hearing aid spectacles. The indications for prescription of the various constructional types are described with consideration of their advantages and disadvantages, supplemented by a comment on the legal aspects of prescription of in-the-ear aids. In binaural deafness, provision of hearing aids for both ears is to be regarded as the normal approach with careful observation of the limits of the indications. The advantages of hearing in both ears compared with monaural hearing, and the contra-indications to binaural provision of hearing aids are described in detail. The legal basis of binaural hearing aid provision is explained.

Auditory Threshold↗

Matching prescription claims with medication data for nursing home residents: implications for prescriber feedback, drug utilisation studies and selection of prescription claims database.

Medication data retrieved from Australian Repatriation Pharmaceutical Benefits Scheme (RPBS) claims for 44 veterans residing in nursing homes and Pharmaceutical Benefits Scheme (PBS) claims for 898 nursing home residents were compared with medication data from nursing home records to determine the optimal time interval for retrieving claims data and its validity. Optimal matching was achieved using 12 weeks of RPBS claims data, with 60% of medications in the RPBS claims located in nursing home administration records, and 78% of medications administered to nursing home residents identified in RPBS claims. In comparison, 48% of medications administered to nursing home residents could be found in 12 weeks of PBS data, and 56% of medications present in PBS claims could be matched with nursing home administration records. RPBS claims data was superior to PBS, due to the larger number of scheduled items available to veterans and the veteran's file number, which acts as a unique identifier. These findings should be taken into account when using prescription claims data for medication histories, prescriber feedback, drug utilisation, intervention or epidemiological studies.

Databases, Factual↗

Impact of prescription card service and mail-order drug programs on employers' prescription drug costs.

A study indicates that prescription card service and mail-order drug programs cost employers more money than a traditional indemnity offering because of the significant increase both in the number of claimants and in the paid charges per claimant. Focusing attention only on cost, however, may hamper the overall quality of care delivered under a health benefits program.

Drug Prescriptions↗

[How many prescription drugs does a general practitioner handle? A prescription database study].

INTRODUCTION: General practitioners must know of treatments for a broad range of diseases, but it may be difficult to keep abreast of the effects and adverse reactions of a large spectrum of drugs, and a good quality of prescribing implies the use of a limited number of analogue products. The aims were to investigate the number of different drugs prescribed per practice and to analyse the influence of practice characteristics on this number. MATERIAL AND METHODS: The study comprised 173 general practices (99 single and 74 group practices in the County of Funen, Denmark. All prescription registered on the Odense Pharmaco-epidemiological Database (OPED) were analysed. The main outcome measure was the number of different drugs prescribed per dispensing unit. RESULTS: The number of different drugs prescribed per dispensing unit varied almost fourfold (range: 102 to 381) and four practice characteristics were able to predict 74% of this variation. Practices with several doctors, a high number of patients listed per doctor, a high percentage of elderly patients, and a heavy workload showed the highest number of different drugs prescribed. CONCLUSION: There is almost a fourfold variation in the number of different drugs used in general practice, and three-quarters of this variation is associated with factors related to the practice.

Databases, Factual↗

[General practitioners' training in psychiatry and prescription of psychotropic drugs. 2. Attitudes of physicians to training in psychotherapy and the extent of their prescriptions].

The object of this investigation was to describe and analyse differences in psychiatric training and attitudes to and employment of psychotropic drugs among general practitioners with and without training in psychotherapy, respectively. The investigation was carried out as a multicentre questionnaire investigation in the County of Aarhus with participation of 192 out of 215 (89%) doctors who were invited. Thirty-nine of the participating general practitioners (20%) had participated in a supervised course in psychoanalytically orientated psychotherapy. Doctors who were trained in psychotherapy had more rarely had appointments in psychiatric departments than other doctors. Doctors trained in psychotherapy prescribed fewer benzodiazepines than other doctors (p less than 0.05) and there was psychotherapy chose psychotherapy more frequently (p = 0.02) and more rarely tendency to a lower total prescription of psychotropic drugs. Doctors trained in a psychotropic drugs (p = 0.004) than doctors without this training as treatment for patients with psychosocial conflicts and they more rarely chose psychotropic drugs to supplement psychotherapy (p less than 0.0001). It is concluded that one of the ways of reducing the massive use of psychotropic drugs in Denmark is to improve general practitioners' training in psychotherapy.

Anti-Anxiety Agents↗

[Drug prescription in myocardial postinfarction: results of the EPPI (étude de prescription postinfarctus). A French cooperative study].

An enquiry into the prescribing behaviour in patients discharged from hospital after myocardial infarction was performed in 36 hospital departments in France and included 528 patients. Each patient was prescribed an average of 3.6 drugs. The most commonly prescribed drug was Aspirin (63.3%) followed by the calcium antagonists (61.7%) long acting nitrate derivatives (49.5%) and betablockers (41.5%). These results suggest that many post-infarction prescriptions disregard recently acquired scientific knowledge.

Adrenergic beta-Antagonists↗

Effect of a cancer chemotherapy prescription form on prescription completeness.

Completeness of physicians' orders for cancer chemotherapy was compared before and after implementation of a preprinted form for these orders. When an oncology pharmacy service (OPS) in which pharmacy prepared all drugs for cancer chemotherapy was implemented in 1985 at an 879-bed teaching hospital, the pharmacists began educational sessions for house-staff physicians on writing orders for cancer chemotherapy. Pharmacists assessed the effectiveness of these sessions by comparing completeness of orders written before implementation of the OPS with orders during a four-week period starting two months after implementation. Orders were checked for nine components: patient's diagnosis, height, weight, and body surface area and drug regimen, dose, dosage, frequency, and route. Inclusion of the same components was assessed after implementation of a form that physicians were required to use for prescribing all antineoplastic agents. During the baseline period, orders for 143 patients were evaluated. Only two prescription components, dose and route, were present is more than 90% of the orders. Educational intervention led to some improvement in order completeness, but only dose and route appeared in at least 90% of the 87 orders evaluated. The components necessary to verify physicians' calculations for body surface area and dose--height, weight, and dosage--were absent in 29 of the orders, and a pharmacist spent 420 minutes clarifying them. After the order form was implemented, orders for 77 patients were reviewed. Compliance exceeded 90% for eight of the nine components, and 12 medication errors were prevented by the form. A pharmacist spent 70 minutes clarifying five orders.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Agents↗

Relationships between prescription and non-prescription drug use in an elderly population.

This paper explores, at an epidemiological level, the relationship between categories of over-the-counter (OTC) and prescribed (Rx) drugs in a community-resident elderly population. A total of 2818, randomly selected, older adults were interviewed at home about their use of prescribed and non-prescribed medication and other health-related factors. For comparative purposes OTC drugs were classified into 16 therapeutic groups-identical to those used by other researchers; prescribed drugs were classified into 45 British National Formulary (BNF) therapeutic sub-categories. Analyses revealed significant association between certain BNF categories and OTC categories, which may have a clinical explanation. These include a 3-fold increase (P<0.01) of OTC laxative use by those prescribed an antidepressant, and a 4-fold increase (P<0.001) in OTC antacid use among those prescribed oral corticosteroids. Our findings may indicate an attempt by older people to control side effects of prescription medicines with OTC preparations. This study, in part, supports the call by the Royal College of Physicians for further research to determine the effect of interactions (be they pharmacological, behavioural or otherwise) between OTC and prescribed medicines.

Journal Article↗

Prescription of antibiotics and prescribers' characteristics. A study into prescription of antibiotics in upper respiratory tract infections in general practice.

There is a growing concern about rational prescribing of antibiotics. That is why a secondary analysis of prescribing antibiotics in upper respiratory tract infections has been conducted by means of a nationwide study of morbidity and interventions in The Netherlands. The mean percentage of antibiotic prescriptions varied from about 20% for acute otitis media and acute upper respiratory tract infections to about 70% for sinusitis and tonsillitis. Only attitude--toward prescribing antibiotics in sore throat--and years of settlement were important predictor variables. The other characteristics studied--type of practice, list size, frequency of use of Het Farmacotherapeutisch Kompas, containing national pharmacotherapeutical guidelines, and urbanization level were not. The importance of attitude, however, was less for general practitioners who went into practice after 1975. This means that the influence of a personal characteristic as attitude might have become less influential since the introduction of vocational training for general practice.

Acute Disease↗

[A research on chemical dynamic changes and drug efficacy of shengmaisan compound prescription: chemical researches on shengmaisan prescription(II)].

The content changes of 5-hydroxymethyl-2-furaldehyde(5-HMF), a new compound reported in the previous paper, in eight prescriptions of different composition were further determined by HPLC with a view to find the chemical dynamic changes and compatibility of medicines. The contents of 5-HMF in different combinations of Radix Ophiopogonis and Fructus Schisandrae, different boiling times and boiling frequency were examined. The results indicated that 5-HMF was produced in the boiling process of Radix Ophiopogonis and Fructus Schisandra combined. The contents of 5-HMF would increase with the increase of Radix Ophiopogonis amount, reaching the highest value after 1.5 h boiling and two times of boiling.

Drug Combinations↗