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 955 records · Page 53Linked to original sources
PubMed1987

Reliability of women's histories of climacteric oestrogen treatment assessed by prescription forms.

A questionnaire study conducted in a cohort of women who had been prescribed oestrogen treatment for climacteric symptoms provided a unique opportunity to assess the concordance between their histories of oestrogen use and the exposure data derived from the prescription forms that had been collected for recruitment of the cohort. The questionnaire information, which was gathered within three years after the registration of prescription forms, was found to be highly concordant with the prescription data with respect to name of brand (85%), dosage (88%), treatment schedule--cyclic versus continuous--(88%), total duration of drug intake (months of treatment; correlation coefficient 0.98) and time of start of medication (correct month in 85%). A method for estimating the true exposure on the basis of prescription data--taking into account non-compliance and non-registered forms--was developed and found to be reproducible. It was concluded that information on climacteric oestrogen intake could be reliably obtained through a questionnaire within a period of less than three years after the exposure.

Adult↗
PubMed2001

Detection of non-prescription heroin markers in urine with liquid chromatography-atmospheric pressure chemical ionization mass spectrometry.

The planned introduction of a prescription heroin program in Germany created a need for differentiation between non-prescription and prescribed diamorphine use. The following substances were chosen as markers of non-prescription heroin: acetylcodeine (AC); its metabolites codeine (C) and codeine 6-glucuronide (C6G); papaverine (P); and noscapine (N). Typical heroin markers diamorphine (DAM) and its metabolites monoacetylmorphine (MAM) and morphine (M) were also determined. The drugs were extracted from urine samples with solid-phase extraction (C18) using standard 200-mg columns and 96-well microplates (100 mg). The extracts were examined with liquid chromatography-atmospheric pressure chemical ionization mass spectrometry (positive ionization) in two isocratic systems. Selected ion monitoring procedures were applied for protonated molecular masses and characteristic fragments of drugs involved. The limits of detection were in the range of 0.5-1 ng/mL urine. The occurrence of selected heroin markers was investigated in 25 urine samples collected from heroin abusers (road traffic offenders and overdosed patients). C6G was found in all samples, C in 24 samples, N in 22 samples, MAM in 16 samples, P in 14 samples, DAM in 12 samples, and AC in 4 samples. The appearance of these compounds in urine reflects their pharmacokinetic properties and the composition of non-prescription heroin.

Adult↗
PubMed2004

A syringe prescription program to prevent infectious disease and improve health of injection drug users.

Injection drug users (IDUs) are at increased risk for many health problems, including acquisition of human immunodeficiency virus (HIV) and hepatitis B and C. These risks are compounded by barriers in obtaining legal, sterile syringes and in accessing necessary medical care. In 1999, we established the first-ever syringe prescription program in Providence, Rhode Island, to provide legal access to sterile syringes, reduce HIV risk behaviors, and encourage entry into medical care. Physicians provided free medical care, counseling, disease testing, vaccination, community referrals, and prescriptions for sterile syringes for patients who were not ready to stop injecting. We recruited 327 actively injecting people. Enrolled participants had limited stable contact with the health care system at baseline; 45% were homeless, 59% were uninsured, and 63% did not have a primary care physician. Many reported high-risk injection behaviors such as sharing syringes (43% in the last 30 days), reusing syringes (median of eight times), and obtaining syringes from unreliable sources (80%). This program demonstrates the feasibility, acceptability, and unique features of syringe prescription for IDUs. The fact that drug use is acknowledged allows an open and frank discussion of risk behaviors and other issues often not disclosed to physicians. The syringe prescription program in Providence represents a promising and innovative approach to disease prevention and treatment for IDUs.

Adult↗
PubMedDate not supplied

Graduating medical students' exercise prescription competence as perceived by deans and directors of medical education in the United States: implications for Healthy People 2010.

OBJECTIVES: This study examined perceptions of deans and directors of medical education at 128 allopathic schools of medicine in the US about the importance of physical activity and exercise topics, and their perceptions about the competence of graduating medical students to perform six fundamental skills related to exercise prescription. Healthy People 2010 recommends that clinicians counsel all patients about regular physical activity. However, in previous studies physicians identified lack of training as a barrier to physical activity counseling, and they questioned their own ability to advise patients properly. METHODS: Using the 17-item Exercise and Physical Activity Competence Questionnaire, data were collected from 72 of 128 medical schools, for a response rate of 56%. RESULTS: While 58% of respondents indicated their typical graduate was competent in conducting a patient evaluation for the purpose of approving that patient to begin an exercise program, only 10% said their students could design an exercise prescription. Only 6% of respondents reported that their school provided a core course addressing the American College of Sports Medicine Guidelines for Exercise Testing and Prescription. CONCLUSIONS: Findings suggest a need for more undergraduate medical training in physical activity and exercise prescription.

Adult↗
PubMed2003

Preparing CNSs for prescriptive authority: Winona State University Model Course.

Medical-surgical clinical nurse specialists (CNSs) have always been involved in treating disease-based and nondisease-based health problems. Recently, expanding state nurse practice acts have allowed medical-surgical CNSs to add pharmacologic agents to their arsenal of advanced practice interventions to best manage their patients' complex healthcare needs. This article discusses the history of prescriptive authority for medical-surgical CNSs, describes a new university program for preparing CNSs for prescriptive authority, summarizes interview responses of 4 students who have completed the university program, and highlights implications for practice and education. The university program includes coursework and clinical training and integrates distance-education strategies to reach students with diverse geographic and scheduling challenges. Themes from the 4 student interviews are positive and support CNSs having prescriptive authority. Facilitators and barriers to actualizing CNS prescriptive authority, implications for educational programs, and issues surrounding distance-education and clinical training are highlighted.

Adult↗
PubMed2003

Antipsychotic prescribing patterns in Germany: a retrospective analysis using a large outpatient prescription database.

Data of prescribing practices for antipsychotics are of great interest with respect to quality of care. Consequently, we analysed all prescriptions under the statutory health insurance redeemed at pharmacies in Southern Germany between July 1999 and December 2001. The database covers prescriptions for approximately 25 million people. Up to 6% of the population were prescribed an antipsychotic at least once during the study period. Most prescriptions were for conventional antipsychotics and written by non-specialists. Patients receiving second generation antipsychotics were more likely to receive continuous antipsychotic therapy. For a large proportion of patients, antipsychotic polypharmacy, as well as comedication for somatic illnesses, were observed. In particular, drugs for the treatment of cardiovascular and metabolic disorders were frequently co-prescribed. Physicians should consider patients' cardiovascular and metabolic risk profile when making treatment choices. The data suggest that the majority of antipsychotics are used for the treatment of disorders other than schizophrenia. It is important to raise awareness among non-specialists about the indications, efficacy and side-effects of the antipsychotics because these physicians account for the majority of antipsychotic prescriptions.

Adolescent↗
PubMed1991

Assessing the appropriateness of the prescription of psychiatric medications in prison.

Although critics have argued that psychiatric medications in correctional settings are often prescribed in a clinically irrational manner, without adequate diagnostic criteria, and for the purposes of coercive control rather than treatment, there has been no systematic research in an attempt to validate these claims. The present study examines the influence of inmate clinical and social characteristics, as well as prison setting factors, on the prescription of psychiatric medication to New York State prison inmates. Study findings show that clinical characteristics predominate in the psychiatric medication prescription process. Specifically, psychiatric impairments, measured in terms of levels of depression, manifest symptomatology, agitation, and prior psychiatric hospitalization were found to be highly significant predictors of drug prescription. This finding suggests clinically appropriate use. Some researchers have suggested that the influence of patient social characteristics on psychiatric treatment is greatest when patient symptomatology is less severe. The conditional effect of inmate social characteristics on drug prescription was examined by levels of inmate impairment, and differences were found. The decision to prescribe medication for mildly impaired inmates appears to be influenced by social factors. However, when an inmate's behavior is unquestionably bizarre or disruptive, social status characteristics are less likely to influence physicians' clinical judgments.

Adult↗
PubMed1996

A review of prescriptive authority for nurse practitioners.

Nurse practitioners in many states continue to struggle to gain prescriptive authority. Independent prescriptive authority holds in a small number of states. In states that grant prescriptive privileges, nurse practitioners battle strict regulations and mandatory supervision by a physician. The article reviews prescriptive authority for practitioners, interpretation of legislation, barriers to prescribing practice, and current trends.

Drug Prescriptions↗
PubMed1987

A segmentational analysis of prescription drug information seeking.

Drug information-seeking proclivities were examined using data from a telephone survey of 835 individuals who had obtained new outpatient prescriptions within the previous 4 weeks. Factor analytic and clustering techniques were used to segment patients based on the source and nature of drug information received in conjunction with the prescription. A four-cluster solution appeared to represent the most stable, distinct, yet homogeneous solution for the data. The groups were named "physician reliant" (40%), "pharmacist reliant" (19%), "questioners" (7%), and "uniformed" (34%). The four groups were compared for demographic, situational, and attitudinal differences. The physician-reliant group appeared most satisfied with the direct counseling of the doctor. Although this group may have sought additional information, the information appeared to reinforce the physician's directions. The pharmacist-reliant group often obtained prescriptions at independent pharmacies and tended not to rely on magazines or reference books for additional information. The questioners were often taking multiple medications. This group tended to seek out reference information from nonprofessional sources and reported several barriers to seeking information from professionals. The uninformed group was the oldest, tended to receive little information, and was more likely than the other groups to agree that one need not ask questions if one trusts the doctor. Different types of patient education programs were recommended as appropriate for each of the four groups. Motivational messages directed to the uninformed segment appeared to be the largest unmet need in patient-oriented prescription drug education.

Adult↗
PubMed1989

Behavioral prescription writing in smoking cessation counseling: a new use for a familiar tool.

Tobacco use, a self-inflicted epidemic, causes more than 390,000 deaths in the United States each year. Smoking is a habit perpetuated by both physiologic and psychosocial mechanisms. Physician use of behavioral prescriptions is a practical, familiar, and efficient method for achieving smoking cessation. Physicians should ask patients if they want to quit smoking, take a smoking history, motivate patients to quit by personalizing risks, set a quit date, and then follow the behavioral prescription. Behavioral prescription involves writing prescriptions based on a plan that leads the patient through five successive weeks of behavioral modification, culminating in complete cessation of cigarette use. Physician time involved is minimal, since the approach requires only two meetings in person--one at an initial patient visit, and a second at a follow-up appointment.

Adult↗
PubMed2003

Effect of tiered prescription copayments on the use of preferred brand medications.

BACKGROUND AND OBJECTIVE: Health plans are increasingly using more open drug formularies that offer differential prescription copayments as an incentive to enrollees to use brands that plans prefer. How much this financial incentive affects use of preferred brands has not been widely reported. The aim of this study was to estimate the effect of tiered copayments on the choice between preferred and nonpreferred brand medications. MATERIALS AND METHODS: Longitudinal logistic regression analyses of pharmacy claims from 1998 and 1999 comparing concurrent groups that were or were not exposed to tiered copayments. SUBJECTS: Enrollees in four independent physician practice association model health plans who had pharmacy claims for angiotensin converting enzyme inhibitors (ACEI), proton pump inhibitors (PPI), or hydroxymethylglutaryl coenzyme A reductase inhibitors (STATINS). OUTCOME MEASURE: Change in the percentage of prescription claims that were for preferred brands. MAIN RESULTS: Regression adjusted estimates of the average net increase in the percentage use of preferred brands of ACEI, PPI and STATIN from first quarter 1998 to third quarter 1999 attributed to tiered prescription copayments were 13.3 (P = 0.001), 8.9 (P = 0.03), and 6.0 (P <0.001) percentage points, respectively. CONCLUSIONS: Tiered prescription copayments were associated with a significant shift from nonpreferred to preferred brand medications. This type of financial incentive can help purchasers providing open access drug benefits by steering use of medications toward lower cost brands. The clinical effects of changes in medication use brought about differential copayments warrant further investigation.

Aged↗
PubMed1993

Effect of value-added utilities on prescription refill compliance and Medicaid health care expenditures--a study of patients with non-insulin-dependent diabetes mellitus.

An estimated 20 million Americans suffer from diabetes. Patients with non-insulin-dependent diabetes mellitus (NIDDM) comprise approximately 90% of the diabetic population. An estimated 10-30% of patients with NIDDM withdraw from their prescribed regimen within 1 year of diagnosis, and of the remainder, nearly 20% administer insufficient medication to facilitate an adequate reduction in blood glucose. A randomized trial was undertaken to discern the effect of pharmacy-based value-added utilities on prescription-refill compliance with sulfonylurea therapy and health service utilization. The subjects were 258 Medicaid beneficiaries from the state of South Carolina, previously untreated for NIDDM, prescribed 5 mg of the second-generation sulfonylurea glyburide twice daily, and monitored with regard to prescription-refill compliance and health service utilization for 1 year. Subjects provided informed consent and were randomly assigned to one of four experimental groups: (i) the control cohort received standard pharmaceutical care with each dispensing of glyburide; (ii) the second cohort received standard pharmaceutical care and was mailed a medication-refill reminder 10 days prior to each sequential refill date; (iii) the third cohort received standard pharmaceutical care and was provided unit-of-use packaging with each prescription-refill request; (iv) the fourth cohort received standard pharmaceutical care, mailed medication-refill reminders, and unit-of-use packaging. Analysis of variance (ANOVA) procedures revealed that patients receiving mailed prescription-refill reminders, unit-of-use packaging, or a combination of both interventions achieved a significant (P < or = 0.05) increase in the Medication Possession Ratio (MPR) for sulfonylurea therapy relative to controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus, Type 2↗
PubMed2006

Home delivery of dietary products in inherited metabolic disorders reduces prescription and dispensing errors.

UNLABELLED: In the UK, for patients with inherited metabolic disorders (IMD) the traditional system for acquiring essential dietary products [patient prompted prescriptions generated by a medical general practitioner (GP) and dispensed by a chemist] is problematic. OBJECTIVE: To investigate the efficacy of a home delivery service (HDS) for essential dietary products (EDP) (i.e. protein substitutes, milk replacements, energy and vitamin and mineral supplements) for subjects with IMD, particularly examining any prescription and dispensing errors, metabolic control and consumer satisfaction. METHODS: A prospective, controlled, home delivery trial for EDP was conducted in patients with IMD for 12 months. Sixty-two patients with IMD [50 with phenylketonuria (PKU); 12 with other IMD: aged 6 months-30 years] were recruited. Thirty subjects used a monthly HDS (Homeward: Nutricia) to receive EDP, 32 remained on the traditional system. Each month, the HDS checked home stock levels of EDP, obtained their prescriptions directly from GP's, and then delivered them to the subjects' homes. An independent researcher completed monthly telephone interviews with patients/parents about any EDP prescription errors or delay in receipt. RESULTS: Incorrect protein substitute was dispensed once by the HDS compared with nine subjects who had 12 errors in the control group (P = 0.01); incorrect flavours of protein substitute were dispensed to the home delivery group once compared with eight subjects getting 11 errors via the chemist (P = 0.03). The HDS delayed delivery of protein substitute for one subject on three occasions compared with 39 occasions in 16 subjects via the chemist (P = 0.001). In patients with PKU, plasma phenylalanine control deteriorated in the control group (P < 0.05) but not in the HDS group. CONCLUSIONS: The long-term use of a HDS for EDP in IMD is safer, effective and more reliable than conventional systems.

Adolescent↗
PubMed2000

Impact of increasing the re-supply interval on the seasonality of subsidised prescription use in Australia.

OBJECTIVE: To evaluate the impact of increasing the minimum re-supply period for prescriptions on the Pharmaceutical Benefits Scheme (PBS) in November 1994. The intervention was designed to reduce the stockpiling of medicines used for chronic medical conditions under the PBS safety net. METHODS: Interrupted times series regression analyses were performed on 114 months of PBS drug utilisation data from January 1991 to June 2000. These analyses assessed whether there had been a significant interaction between the onset of the intervention in November 1994 and the extreme levels of drug utilisation in the months of December (peak utilisation) and January (lowest utilisation) respectively. Both serial and 12-month lag autocorrelations were controlled for. RESULTS: The onset of the intervention was associated with a significant reduction in the December peak in drug utilisation; after the introduction of the policy there were 1,150,196 fewer prescriptions on average for that month (95% CI 708,333-1,592,059). There was, however, no significant change in the low level of utilisation in January. The effect of the policy appears to be decreasing across successive post-intervention years, though the odds of a prescription being dispensed in December remained significantly lower in 1999 compared to each of the pre-intervention years (11% vs. 14%). CONCLUSION: Analysis of the impact of increasing the re-supply period for PBS prescriptions showed that the magnitude of peak utilisation in December had been markedly reduced by the policy, though this effect appears to be decreasing over time. Continued monitoring and policy review is warranted in order to ensure that the initial effect of the intervention be maintained.

Australia↗
PubMed2006

Benzodiazepines prescription in Dakar: a study about prescribing habits and knowledge in general practitioners, neurologists and psychiatrists.

Benzodiazepines are relatively well-tolerated medicines but can induce serious problems of addiction and that is why their use is regulated. However, in developing countries like Senegal, these products are used without clear indications on their prescription, their dispensation or their use. This work focuses on the prescription of these medicines with a view to make recommendations for their rational use. Benzodiazepine prescription was studied with psychiatrists or neurologists and generalists in 2003. Specialist doctors work in two Dakar university hospitals and generalists in the 11 health centres in Dakar. We did a survey by direct interview with 29 of 35 specialists and 23 of 25 generalists. All doctors were interviewed in their office. The questionnaire focused on benzodiazepine indications, their pharmacological properties, benzodiazepines prescribed in first intention against a given disease and the level of training in benzodiazepines by doctors. Comparisons between specialists and generalists were made by chi-square test. Benzodiazepines were essentially used for anxiety, insomnia and epilepsy. With these diseases, the most benzodiazepines prescribed are prazepam against anxiety and insomnia and diazepam against epilepsy. About 10% of doctors do not know that there is a limitation for the period of benzodiazepine use. The principal reasons of drugs choice are knowledge of the drugs, habit and low side effects of drugs. All generalists (100%) said that their training on benzodiazepines is poor vs. 62.1% of specialists, and doctors suggest seminars, journals adhesions and conferences to complete their training in this field. There are not many differences between specialists and generalists except the fact that specialists prefer prazepam in first intention in the insomnia treatment where generalists choose bromazepam. In addition, our survey showed that specialists' training in benzodiazepines is better than that of generalists. Overall, benzodiazepine prescription poses problems particularly in training, and national authorities must take urgent measures for rational use of these drugs.

Anxiety↗
PubMedDate not supplied

Seniors with chronic health conditions and prescription drugs: benefits, wealth, and health.

OBJECTIVES: The objectives of this study were to examine the relationship between prescription benefit status and access to medications among Medicare beneficiaries with hypertension, congestive heart failure, coronary artery disease, and diabetes and to determine how income, wealth, and health status influence this relationship. METHODS: We analyzed survey and administrative data for 4492 Medicare + Choice enrollees aged 67 and above enrolled in a predominantly group-model health maintenance organization in 2000. Outcome measures included difficulty affording medications, methods of coping with medication costs including obtaining medicines from another country, using free samples, and stretching out medications to make them last longer. Independent variables included prescription benefit status, income, wealth measures, health status, and out-of-pocket prescription drug spending. RESULTS: Lacking a prescription benefit was independently associated with difficulty affording medications (25% of those without a benefit vs. 17% with a benefit) and coping methods such as stretching out medications. Lower income, lower assets, and worse health status also independently predicted greater difficulty as measured by these outcomes; there was no effect modification between these factors and benefit status. Relative to national figures, out-of-pocket spending in this setting was quite low, with only 0.2 and 13% of those with and without a benefit, respectively, spending over 100 dollars per month. Higher out-of-pocket spending predicted greater difficulty affording medications but not stretching out medications. CONCLUSIONS: Efforts to improve medication accessibility for older Americans with chronic conditions need to address not only insurance coverage but also barriers related to socioeconomic status and health status.

Aged↗
PubMed1999

Risk of a new benzodiazepine prescription in relation to recent hospitalization.

OBJECTIVE: To determine if recent hospital admission was associated with new outpatient prescribing of benzodiazepines among community-dwelling older people. DESIGN: Nested case-control study using administrative data sets of the provincial health insurance board. SETTING: Province of Quebec. PARTICIPANTS: Cases were 4127 community-dwelling older people who were newly dispensed a benzodiazepine during an 8-month period in 1990. Controls were 16,486 community-dwelling older people who were dispensed any drug (except a benzodiazepine) on the same day as the case-defining index prescription. EXPOSURE AND OUTCOME MEASURES: Admission to an acute care hospital within a 30-day period before a new dispensing of a benzodiazepine. Other variables measured were patient age, gender, number of ambulatory physician visits, healthcare region, Chronic Disease Score (CDS), and use of drugs for depression and psychosis. RESULTS: Cases were more than three times as likely as controls to have been hospitalized in the 30-day period before the index date (adjusted odds ratio (OR) 3.09; 95% CI, 2.78-3.45). The use of prescription drugs for physical health problems modified this association in that cases who used more medication were also more likely to receive a new benzodiazepine prescription following a recent hospital admission (adjusted OR 4.09; 95% CI, 3.59-4.65 when the CDS was equal to 5 vs adjusted OR 1.96; 95% CI, 1.66-2.31 when the CDS was equal to 0). CONCLUSIONS: Recent hospitalization confers an increased risk of a new outpatient benzodiazepine prescription among community-dwelling older people in Quebec. Those who use more medication, and who may be more vulnerable to drug-related adverse events, are more likely to be newly dispensed a benzodiazepine following a recent, acute-care hospital admission.

Aged↗
PubMed1993

Antipsychotic drug prescription in general practice in Italy.

Prescribing patterns of neuroleptic drugs in a population of about 3,700,000 inhabitants were analysed using all individual prescriptions delivered by the Italian National Health Service during 4 years (1986-1989). Data contained in a regional prescription database were analysed using an outpatient drug monitoring system (VIDEOFAR). The proportion of subjects receiving neuroleptics was about 1.3% of the entire population. During 1989, 20.2% of 52,716 observed subjects received multiple neuroleptic therapy. Haloperidol, the most frequently prescribed antipsychotic, was dispensed to 21.3% of the individuals as the only neuroleptic treatment. Consumption sharply increased with age and about 60% of patients receiving a prescription were women. Nonetheless, among the heavy users in the younger ages, the male-to-female ratio is significantly greater than one. Although the principal indications for neuroleptics are subacute or chronic clinical conditions, a surprisingly high proportion of subjects (ranging from 48% to 76% depending on the type of neuroleptic) received only one single prescription during 1989.

Age Factors↗