Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PRESCRIPTIONS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMed1999

Migraine prescription density and recommendations. Results of the PCAOM Study.

We estimate the extent to which recommendations on the prevention and treatment of migraine issued by professional medical bodies are implemented in medical practice in Germany. Computerized data (MediPlus, IMS Health) were analyzed in 4,636 male and 16,573 female migraineurs from 383 primary care practices 1994 through 1996 (Primary Care of Migraine, PCAOM study). A total of 90,540 drug prescriptions with a documented diagnosis of migraine were issued in 45,669 person-years (1,492 prescriptions [DM 40.99] per person-year to men, 2,109 prescriptions [DM 62.01] per person-year to women). Approximately three of every four prescriptions were incompatible with the recommendations of the German Migraine and Headache Society (DMKG), amounting to extrapolated costs of DM 49 million per year borne by the German statutory health insurance fund for combination migraine preparations. The density of non-DMKG therapies for diagnosed migraine followed a sigmoid curve with increasing patient age, while DMKG-compliant therapies described a bell-shaped curve. Referrals to neurological care specialists were not associated with subsequent primary care focus on recommended therapies. We conclude that medication prescribed for migraine is largely not according to long-standing recommendations by medical societies in Germany.

Adolescent↗
PubMed2002

Prescription duration after drug copay changes in older people: methodological aspects.

OBJECTIVES: Impact assessment of drug benefits policies is a growing field of research that is increasingly relevant to health care planning for older people. Some cost-containment policies are thought to increase noncompliance. This paper examines mechanisms that can produce spurious reductions in drug utilization measures after drug policy changes when relying on pharmacy dispensing data. Reference pricing, a copayment for expensive medications above a fixed limit, for angiotensin-converting enzyme(ACE) inhibitors in older British Columbia residents, is used as a case example. DESIGN: Time series of 36 months of individual claims data. Longitudinal data analysis, adjusting for autoregressive data. SETTING: Pharmacare, the drug benefits program covering all patients aged 65 and older in the province of British Columbia, Canada. PARTICIPANTS: All noninstitutionalized Pharmacare beneficiaries aged 65 and older who used ACE inhibitors between 1995 and 1997 (N = 119,074). INTERVENTION: The introduction of reference drug pricing for ACE inhibitors for patients aged 65 and older. MEASUREMENTS: Timing and quantity of drug use from a claims database. RESULTS: We observed a transitional sharp decline of 110% t a standard error of 30% (P = .02) in the overall utilization rate of all ACE inhibitors after the policy implementation; five months later, utilization rates had increased, but remained under the predicted prepolicy trend. Coinciding with the sharp decrease, we observed a reduction in prescription duration by 31% in patients switching to no-cost drugs. This reduction may be attributed to increased monitoring for intolerance or treatment failure in switchers, which in turn led to a spurious reduction in total drug utilization. We ruled out the extension of medication use over the prescribed duration through reduced daily doses (prescription stretching) by a quantity-adjusted analysis of prescription duration. CONCLUSION: The analysis of prescription duration after drug policy interventions may provide alternative explanations to apparent short-term reductions in drug utilization and adds important insights to time trend analyses of drug utilization data in the evaluation of drug benefit policy changes.

Age Factors↗
PubMed2005

National adherence to evidence-based guidelines for the prescription of nonsteroidal anti-inflammatory drugs.

BACKGROUND & AIMS: Our objective was to assess adherence to evidence-based guidelines by providers of the Department of Veterans Affairs nationwide. METHODS: This was a cross-sectional study among veterans prescribed a nonsteroidal anti-inflammatory drug (NSAID) from January 1, 2002, to December 31, 2002. Prescription data were linked to inpatient and outpatient medical records and death files. The population was characterized as high risk based on the following: age 65 years or older, concurrent corticosteroid or anticoagulant use, history of peptic ulcer, and high average daily dose of NSAIDs. Adherence was defined as the prescription of a traditional NSAID with gastroprotection or a coxib in high-risk NSAID users. Univariate and multivariate analyses assessed the potential predictors of adherence. RESULTS: Three hundred three thousand seven hundred eighty-seven met our definition of high risk. Most (97.3%) were male; 55.6% were white, 9.6% black, and 34.8% of other/unknown race. Age 65 years or older was the largest high-risk subset (87.1%). Overall, only 27.2% of high-risk veterans (n = 82,766) were prescribed an adherent strategy. Among veterans with at least 2 risk factors, adherence was 39.7%; among those with 3 risk factors, adherence was 41.8%. Predictors of adherence included history of upper gastrointestinal events, anticoagulant use, rheumatologic disease, high Deyo comorbidity index score, use of low-dose salicylates, and concurrent corticosteroid use. Predictors of nonadherence included prescriptions > or =90 days and high average daily dose of NSAIDs. CONCLUSIONS: Adherence to evidence-based guidelines for safe prescription of NSAIDs in the Department of Veterans Affairs is low (27.2%). The likelihood of adherence is further decreased if veterans are prescribed NSAIDs for > or=90 days.

Aged↗
PubMed2001

[The indication for heroin prescription - considerations with the historical example of the opiate addicted Swiss author Friedrich Glauser (1896 - 1938)].

Traditional indications for the prescription of opioids to addicts are continuous opioid abuse despite qualified addiction treatment or temporary substitution treatment, if temporarily detoxification is not possible due to external circumstances. These criteria are demonstrated by an historical example, the treatment of the opioid addicted Swiss author Friedrich Glauser (1896-1938). From a modern public health perspective, however, opioid abuse is mainly conceptualised as risk behaviour with aversive consequences for the individual abuser and the public. These consequences should be reduced by prescription of hygienically safe heroin. In this concept, the failure of former addiction treatment is not a necessary condition for heroin prescription. Difficulties in reaching an agreement about indications for heroin prescription are partially results of inherent contradictions between an individual centered traditional medical concept and a public health concept about the goals of opioid addiction treatment.

Adult↗
PubMed1986

Prescription and misuse of benzodiazepines in the Federal Republic of Germany.

Reliable benzodiazepine prescription data are now available for the Federal Republic of Germany by the establishment of GKV-Index. In 1981, 4 benzodiazepines were among the 25 highest ranking drugs in the FRG according to total number of prescriptions. A decline of benzodiazepine prescriptions was observed in 1983 and 1984; two short-acting compounds achieved a higher ranking position. Benzodiazepines make up to about two thirds of all psychotropic drugs prescribed. These data are compared to some figures from Scandinavian countries. In addition, prescription data of 369 outpatients of 42 psychiatrists in private practice in Berlin (West) are presented. Some data on the occurrence of abuse and dependence on benzodiazepines are presented coming from 4 different sources: The spontaneous ADR monitoring of the Medicines Commission of the German Medical Profession; a hospital-based study at the university of Göttingen; a collaborative hospital-based ADR monitoring (AMUP); an outpatient study with psychiatrists in private practice.

Anti-Anxiety Agents↗
PubMed1999

Fetal growth and adverse birth outcomes in women receiving prescriptions for acetaminophen during pregnancy. EuroMap Study Group.

We studied the association between acetaminophen exposure during pregnancy and the prevalence of congenital abnormalities and fetal growth. Our study included 123 women who had received a prescription of acetaminophen during pregnancy and/or 30 days before conception and 13,329 controls who did not receive any prescription at all. We found more malformations among those who received a prescription with an odds ratio of 2.3 (95% CI 1.0-5.4), but the type of malformations did not indicate a causal link. When restricting the study to first time pregnancies, we identified 58 women who received a prescription of acetaminophen during pregnancy and 30 days before conception and 7472 controls. We found no excess risk of malformation [OR = 0.7 (95% CI 0.1-5.5)], and no evidence that acetaminophen should influence fetal growth.

Abnormalities, Drug-Induced↗
PubMed1977

Watching the monitors: "PAID" prescriptions, fiscal intermediaries and drug-utilization review.

Prescription monitoring evolved from the need of drug firms to obtain marketing information. Today, extensive monitoring is also done by fiscal intermediaries who administer prepaid drug benefit plans, both private and governmental, particularly Medicaid. The most important such agent is PAID Prescriptions. Under various contracts, PAID monitors physician, pharmacy, and patient behavior related to prescriptions and uses review processes that evaluate certain kinds of behavior for appropriateness. The criteria of appropriateness are essentially those that save money. PAID negotiates a program fee with the insurer (public or private) and applies constraints so that prescription and administrative costs do not overrun that fee. PAID and other monitors have contemplated expansion into the realm of defining and encouraging appropriate prescribing under the concept of "drugutilization review." The actual practices of PAID, particularly the background of fiscal enforcement, may impede the development of an actual drug-utilization review process.

Blue Cross Blue Shield Insurance Plans↗
PubMed2002

Promotion of prescription drugs to consumers.

BACKGROUND: Spending on prescription drugs is the fastest growing component of the health care budget. There is public concern about the possibility that direct-to-consumer advertising of prescription drugs will result in inappropriate prescribing and higher costs of care. Guidelines issued in 1997 by the Food and Drug Administration (FDA) regarding advertising to consumers through electronic media are considered by some to be responsible for unleashing a flood of direct-to-consumer advertising. METHODS: Using data on spending for promotional purposes and sales of prescription drugs, we examined industrywide trends for various types of promotion. We also tracked the relation between promotional efforts and sales over time. Finally, we documented the variation in direct-to-consumer advertising among and within five therapeutic classes of drugs and compared the variation in the intensity of such advertising with variation in the intensity of promotion to health care professionals. RESULTS: Annual spending on direct-to-consumer advertising for prescription drugs tripled between 1996 and 2000, when it reached nearly $2.5 billion. Despite this increase, such advertising accounts for only 15 percent of the money spent on drug promotion and is highly concentrated on a subgroup of products. Within a therapeutic class, there is marked variation in the intensity of direct-to-consumer advertising, and the amount of such advertising for specific products fluctuates over time. The initial surge in direct-to-consumer advertising preceded the 1997 FDA guidelines that clarified the rules for electronic direct-to-consumer advertising, and thus the 1997 guidelines may not have been the most important reason for the overall increase. CONCLUSIONS: Although the use of direct-to-consumer advertising has grown disproportionately to other forms of promotion, it continues to account for a small proportion of total promotional efforts. Nevertheless, physicians must assist patients in evaluating health-related information obtained through direct advertising.

Advertising↗
PubMed2002

Drug prescribing in public primary care centres. Results from prescription studies 1988-1997 in the county of Halland, Sweden.

OBJECTIVE: To present the prescribing patterns of general practitioners (GPs) at public primary care centres (PPCCs) in Halland, a county in the south-west of Sweden. GP share of the total prescribing of different drug groups 1988-1997 is presented, as well as changes in patterns. DESIGN: A descriptive prescription study performed 3 months each year in 10 consecutive years. SETTING: Medical service and pharmacies in Halland. SUBJECTS: Prescriptions from about 100 GPs of PPCCs and 550 physicians of various other specialties. MAIN OUTCOME MEASURES: Percentages and absolute numbers of GPs prescribing. RESULTS: GPs prescribed 45% and 51% of the prescriptions from physicians in 1988 and 1997, respectively, while the cost shares were 40% and 42%. An increase in prescriptions was seen both in relative and in absolute numbers (from 117414 in 3 months in 1988 to 161012 in 1995). The increase in cost per DDD (defined daily dose) during the study period was 47% for GPs and 72% for other doctors. CONCLUSIONS: GP prescribing increased in both absolute and relative numbers, while the cost increase per DDD was moderate compared to other physicians.

Disease↗
PubMed2005

Influence of self-registration on audit participants and their non-participating colleagues. A retrospective study of medical records concerning prescription patterns.

OBJECTIVE: To compare participants and non-participants early in the process of an audit on treatment of respiratory tract infections (RTIs) and to analyse any effect of the actual self-registration on the prescription of antibiotics in both groups. DESIGN: All 80 general practitioners (GPs) at 14 health centres were invited to audit their use of antibiotics and 45 agreed to participate. There were both participants and non-participants at all centres. Data were collected retrospectively from the electronic patient records of all visits for RTI during five periods including the self-registration period. Comparisons were made over time within and between the groups. SETTING: Primary health care in Blekinge county, Southern Sweden. SUBJECTS: 80 GPs: 45 participants and 35 non-participants. MAIN OUTCOME MEASURE: Proportion of patients with RTI who received antibiotics. RESULTS: At the start, the difference in prescription frequency between participants and non-participants was six percentage points (RR = 0.92; 95% CI = 0.87-0.97), and at the end seven percentage points (0.88; 0.81-0.95). The proportion of RTIs treated with antibiotics fell for both groups, (0.86; 0.80-0.92 and 0.90; 0.83-0.97, respectively). CONCLUSIONS: GPs who chose to take part in the audit had a different prescription pattern from the non-participants right from the start. Both groups reduced their prescription of antibiotics during the study period. Either the registration had no effect on the participants or it had an effect on both the participants and the non-participants.

Anti-Bacterial Agents↗
PubMed1998

Drug prescribing for children in general practice. A report from the Møre & Romsdal Prescription Study.

To investigate general practitioners' drug prescribing patterns for children (0-12 y), an observational, cross-sectional study was conducted in Western Norway. Seven thousand, two hundred and twenty-nine GP-patient contacts during which 5222 drugs were prescribed, were included for analysis. The highest prescribing rates were for boys < 2 y (82.1 prescriptions per 100 contacts). Two-thirds of all prescriptions were for drugs in main groups respiratory system or systemic anti-infectives. The 20 most commonly prescribed agents comprised 75% of all prescriptions. The 20 most frequently recorded diagnoses for prescribing comprised 81% of all. Phenoxymethylpenicillin was the most frequently prescribed antibiotic for otitis, tonsillitis and sinusitis, while erythromycin was used most often for bronchitis and pneumonia. Antibiotics were prescribed in more than 8/10 contacts for tonsillitis, sinusitis, acute bronchitis and pneumonia, and in two-thirds of all contacts for urinary tract infections. Sixty-five percent of the antibiotic prescriptions for urinary tract infections were for co-trimoxazole.

Chi-Square Distribution↗
PubMed2004

Usage of antifungal drugs for therapy of genital Candida infections, purchased as over-the-counter products or by prescription: 2. Factors that may have influenced the marked changes in sales volumes during the 1990s.

BACKGROUND: The epidemiology of vulvovaginal candidiasis (VVC) and such recurrent infections (RVVC) has been difficult to study as the majority of episodes of these conditions are self-treated by the women affected. In Sweden, all pharmacies are owned by the state and all prescriptions and over-the-counter (OTC) products, such as antifungals, are registered in a database, which offers unique possibilities to study the epidemiology of VVC/RVVC. OBJECTIVES: To analyze all prescriptions and OTC products purchased for therapy of VVC/RVVC and to establish reasons for any observed variation in the sales figures. METHODS: Sales figures in the Swedish county of Skåne of antifungal drugs for therapy of VVC/RVVC were analyzed by the aid of the 'ACS' database of the National Corporation of Swedish Pharmacies for the years 1990--1999. The size of the female population in the county is approximately half a million. RESULTS: The study showed that 93% of all antifungal drugs for VVC/RVVC were sold as OTC products. An increase in sales of the drugs occurred until mid- 1993/94, followed by a decrease until end of the study period in 1999. Demographic factors (e.g. the number of female inhabitants in the county, pharmacies and health-care units), the pregnancy rate and pharmacy-dependent factors (such as the introduction of shelves for self-selection of antifungal products) did not explain the observed variations in sales. Distinct short-term variations in the number of prescriptions of fluconazole and itraconazole could be explained by drugs company sales campaigns and logistics factors in drug distribution. The sales volumes in the 33 municipalities in the county correlated with the density of the population, which was not the case for the total number of prescriptions made in the county during the 1990s. The variation in antifungal drug sales was similar to that of hormonal intrauterine devices, but this was not the case for oral contraceptives. The total Swedish usage of antibiotics showed a similar variation to that of the antifungal drugs analyzed. CONCLUSION: The study stresses the limited impact on the treatment of VVC/RVVC by the medical community. Behavior-related factors in the female population are the most likely explanation for the marked variations found in the usage of drugs for the two conditions.

Adolescent↗
PubMedDate not supplied

Riskier than we think? The relationship between risk statement completeness and perceptions of direct to consumer advertised prescription drugs.

Direct to consumer (DTC) prescription drug advertising is one of the fastest growing categories of advertising. Expenditures have increased from about $25 million in 1992 to nearly $2 billion in 1999. Given strong evidence of consumer-driven demand for advertised prescription drugs, research was conducted to assess the extent to which DTC prescription drug advertising provides consumers with the information they need to make an informed evaluation of an advertised drug's relative benefits and risks. Two studies explored the relationship between the completeness of the statement describing drug-associated side effects (the "risk statement") and consumers' perceptions of a drug's safety and appeal. The research manipulated risk statement completeness with regard to the incidence levels of side effects mentioned in the statement (which in turn affected the number of side effects mentioned) and the presence or absence of a numeric indicator of side effect incidence. The research strongly suggests a direct relationship between risk statement completeness and consumers' perceptions of drug safety and appeal. Consumers rate the safety and appeal of drugs described with an incomplete risk statement significantly more positively than comparable drugs described with a more complete risk statement. Implications of the research for the regulation and presentation of DTC prescription drug advertising and advertiser communication practices are discussed.

Adult↗
PubMed2005

Pharmaceutical insurance and the demand for prescription pharmaceuticals in Västerbotten, Sweden.

AIMS: The aim of this paper is to analyze the impact of pharmaceutical insurance on the demand for prescription pharmaceuticals in the county of Västerbotten, Sweden. As the patients do not bear the full marginal costs of the pharmaceuticals they consume when pharmaceutical insurance systems are present, this could induce patients to over-consume pharmaceutical treatments. METHODS: Data covering all prescription pharmaceuticals sold in the county of Västerbotten, Sweden during the year 2001 have been provided by the local county council. Data include information concerning the gender and age of the patient, the number of defined daily doses, total cost, and the patient's co-payment for the prescription. The hypothesis that patients will consume more (or perhaps more expensive) pharmaceuticals when there is pharmaceutical insurance is tested by means of regression analysis. RESULTS: The results show that both the quantities dispensed and the price of the pharmaceuticals consumed increase when the pharmaceutical insurance system pays part of the total cost of the pharmaceuticals consumed. CONCLUSIONS: The findings suggest that introducing a small patient co-payment for all prescriptions should be an effective measure to decrease pharmaceutical consumption.

Adolescent↗
PubMed2004

Gender and other factors associated with the nonmedical use of abusable prescription drugs.

Although there is extensive research on gender differences in the use of alcohol and illicit substances, few studies have examined gender differences in nonmedical prescription drug use, Using data from the 1991 National Household Survey on Drug Abuse (NHSDA), based on a sample of 3185 persons, logistic regression analysis is employed to determine how gender and other factors affect the likelihood of past-year nonmedical prescription drug use. Analysis revealed that women are significantly more likely than men to use any prescription drug, and that this gender difference is primarily driven by women's increased risk for narcotic analgesic and minor tranquilizer nonmedical use. Other factors, such as race, age, health status, and other substance use, also are significant predictors of nonmedical use. Findings from this study will enable researchers, policy makers, and providers to have a greater understanding of nonmedical drug use patterns and support greater gender sensitivity in the prevention, education, and treatment of nonmedical prescription drug use.

Adolescent↗
PubMed1998

Prescription of neuroleptics for children and adolescents in Italy.

The objective of this study was to describe the use of neuroleptics among children and adolescents in the province of Rome. Subjects 5 to 19 years of age who received neuroleptic prescriptions within the National Health Service between 1986 and 1991 were identified. Prevalence and incidence of use were estimated. The yearly prevalence of use during the study period ranged from 1.3 to 1.7 per 1000 inhabitants. The incidence during 1989 was 1.1 per 1000, with a marked increase with age. Haloperidol was the drug most frequently prescribed; 59.2% of the subjects received only one prescription during the year. Among subjects with more than one prescription, 42.3% received neuroleptics in combination. The observed pattern of use suggests that in current practice neuroleptics are also used for the treatment of nonpsychotic conditions. The analysis of data derived from a prescription monitoring system may provide an important contribution to the description of neuroleptic use among children and adolescents.

Adolescent↗
PubMed2004

Prescription-filling rates for key medications in Veterans Affairs patients after coronary artery bypass grafting.

PURPOSE: The six-month prescription-filling rates for key secondary-prevention drugs in Department of Veterans Affairs (VA) patients who had undergone coronary artery bypass grafting (CABG) were studied. METHODS: Patient records for elective CABG from April 2000 through March 2002 (divided into four six-month periods) were analyzed. The study population included 8925 CABG-only patients surviving to hospital discharge. For each six-month period and in aggregate, the primary study endpoint was the six-month prescription-filling rate. RESULTS: Across the four six-month periods, prescription-filling rates increased for all categories of medications studied. There were modest progressive increases for lipid-lowering agents, statins, -blockers, angiotensin-converting-enzyme Inhibitors, and angiotensin-receptor blockers. The antithrombotic-filling rate averaged 88.5%. Filling rates for aspirin were much higher than for aspirin alternatives. CONCLUSION: Prescription-filling rates for post-CABG medications in VA facilities were generally high and suggested compliance with guidelines for the prevention of cardiovascular events.

Adrenergic beta-Antagonists↗
PubMed2003

Total and out-of-pocket expenditures for prescription drugs among older persons.

PURPOSE: The burden of prescription drug costs on Medicare beneficiaries has become a critical policy issue in improving the Medicare program, yet few studies have provided detailed and current information on that burden. The present study estimates total and out-of-pocket expenditures for prescription drugs and the burden of these costs in relation to income among the elderly population. We also compare spending and burden across major subgroups of the elderly population, as defined by socioeconomic and health characteristics, and we distinguish the impact of these factors by using multivariate models. DESIGN AND METHODS: The study uses nationally representative data on Medicare beneficiaries from the 1997 Medicare Current Beneficiary Survey Cost and Use files. The study estimates out-of-pocket prescription drug spending and burden through ordinary least square, median, and logistic regression models with corrections for the complex survey design. RESULTS: Our results show that in 1997, nearly 8% of the older population, more than 2.3 million people, spent greater than 10% of their income on prescription drugs. Despite pharmacy coverage, out-of-pocket cost burden fell most heavily on women and those with chronic health conditions. Burden was also higher among those with self-purchased supplemental coverage. IMPLICATIONS: The impact of Medicare reform proposals on these subgroups has to be carefully evaluated.

Age Distribution↗