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PubMed1991

[A study on components and compound prescription of huangqin decoction].

The results obtained from the pharmacological experiments have preliminarily demonstrated that the compound prescription is better than its individual component drug in the range and potency of pharmacological activities. In the prescription Radix Scutellariae plays a principal role in pharmacological effects. Radix Scutellariae and Radix Paeoniae Alba can potentiate each other. Radix Glycyrrhizae and Fructus Jujubae in the compound prescription also exhibit biological activities to some extent. The relieving effect of the prescription for spasm and pain may result from the synergistic interaction between Radix Paeoniae Alba and Radix Glycyrrhiza, and the heat clearing and diarrhea stopping action is due to the biological activity of Radix Scutellariae.

Animals↗
PubMed1990

Comparison of frequency response and aided speech-recognition performance for hearing aids selected by three different prescriptive methods.

The gain and the speech-recognition performance obtained for behind-the-ear (BTE) hearing aids selected by different prescriptive methods was compared. The three prescriptive methods examined were the NAL-revised method, the Memphis State or COX method, and the POGO-II procedure. Twelve subjects had hearing aids and earmolds selected to match the prescription made by each method. Once selected, the instruments were fine tuned to match the obtained gain to that prescribed and then speech recognition was assessed. Subjects listened to the CUNY Nonsense Syllable Test (NST) in quiet and in noise. Results indicated that, although the prescribed frequency responses differed significantly among methods, there were no differences among the three prescriptive methods in obtained frequency responses or aided speech-recognition performance.

Adult↗
PubMed1989

[Clinical and experimental study on the prescription of jianpi yipi].

According to "Spleen-Stomach" theory, the effect of Jianpi Yiqi prescription (JPYQ) was observed clinically and studied experimentally. 168 cases manifested as Spleen-Qi ( ) deficiency including chronic gastritis and peptic ulcer (84 cases), chronic glomerulonephritis (44 cases) and vomitus gravidarum-edema of pregnancy (40 cases) were treated with JPYQ. Estimation were made based on their clinical conditions. Serum gastrin, serum cholyglycine, blood acetylcholine and cholinesterase, blood 5-HT and histamine were measured before and after treatment. The overall effective rate was 92.9% in gastritis and peptic ulcer group, 86.3% in nephritis group and 100% in pregnancy group respectively. A marked increase of serum glycocholic acid level was shown in gastritis and peptic ulcer and vomitus gravidarum groups. That was considered as the result of the secretion of cholic acid by this prescription. Clinical improvement was also obtained in nephritis group accompanying disappearance of albuminuria in 36.4%. Blood level of 5-HT and histamine lowered to some extent and tended to be normal. Besides, this prescription markedly inhibited electric stimulated excitement on isolated longitudinal muscle strip of guinea pig's ileum. The mechanism could be the inhibition of release of acetylcholine from Auerbach's plexus by this prescription.

Adult↗
PubMedDate not supplied

Prescription drug liability: the learned intermediary and informed consent.

Prescription drugs are the most often used therapy in health care. Because they are dangerous and sometimes cause severe side effects, it is important for drug manufacturers, health care providers, and patients to understand their responsibilities regarding prescription drug liability. The learned intermediary doctrine, exacting a duty from the drug manufacturer to warn the doctor of prescription drug properties, is discussed. The doctrine of informed consent is reviewed as a cause of action where a doctor fails to inform a patient of prescription drug properties. Application of the medical community and patient-centered standards as they relate to informed consent cases is made.

Communication↗
PubMed1989

[Effects of quingre-lidan prescription on bacteria in the bile of patients with biliary diseases].

After giving Quingre-Lidan Prescription to the patients with biliary diseases, the authors observed the changes of bacteria in their bile employing anaerobic and aerobic culture techniques. The results suggested that among the bile specimens from 38 patients (hepatolithiasis in 32 and biliary duct tumour in 6), the anaerobes were detected in 68.4%, aerobes in 84.2%. The mean number of the isolated bacteria from those specimens was 3.3 species. Having taken the prescription for 3-14 days (mean 6.5 days), 33 cases among them received an operation for biliary diseases (hepatolithiasis in 32, biliary duct tumour in 1). The positive rate of anaerobes and aerobes in the bile was 42.4%, 97.0% respectively. The mean of bacteria was 2.5 species. The statistical analysis showed that the positive rate of anaerobic bacteria and the mean of bacteria all had significance before and after patients taking the prescription. The above observation explored the mechanism of Qingre-Lidan Prescription used for biliary infections in microbiology.

Adolescent↗
PubMed1988

Exercise prescription in medical practice.

The goal of exercise prescription is to advise and motivate an individual to attain the maximum health benefits of exercise for a given indication with minimum risk and other "costs". Numerous data indicate both perceived demand and medically determined need of such service for healthy as well as for sick people. The knowledge of the effects of exercise and its behavioral basis is sufficient for individual prescription for fitness maintenance and improvement. Safe and effective exercise as self-conducted activity or as formal rehabilitation can be prescribed also for large numbers of high risk and sick persons for fitness and to counteract the harmful effects of disease. The most problematic area is exercise prescription for disease prevention. Where ischaemic heart disease is concerned, the analysis of the published information suggests that regular exercise of moderate intensity and amount is an effective and feasible preventive measure, and its prescription is an appropriate medical service.

Adult↗
PubMed1981

Control of antibiotic therapy in pediatric patients. I. A computer system to collect and analyze antibiotic prescriptions in hospitals.

A computer system to record and analyze antibiotic prescriptions in hospitalized children is described. This system is especially organized in order to obtain simultaneously a quantitative evaluation of antibiotic use and a qualitative analysis of the process by which the physician makes his decision for therapy. The practical employment of this program has been demonstrated by analyzing 765 prescriptions given in nine different pediatric hospital wards. Many errors of prescription have been demonstrated: antibiotic therapy was based on the clinical impression alone in 31.5% of the prescriptions, antibiotic choice was rational in 20.1% and the posology prescribed complied with the usually applied schemes in 22.4%. Finally, the physician's attitude regarding laboratory monitoring of side effects was adequate in 52.8% before treatment and 33.4% during antibiotic treatment.

Aging↗
PubMed1994

[Unit of compliance with chronic prescriptions: a study of frequency of attendance].

OBJECTIVE: To analyse frequency of attendance at a Unit of Compliance with Chronic Prescriptions (UCCP) within a Health Centre (HC). DESIGN: A prospective study with a six-year follow-up period 1986-1992. SETTING: The study was carried out at the Florida HC, Alicante, which covers an urban population of about 20,000 inhabitants. PATIENTS AND OTHER PARTICIPANTS: The population under study were those patients who needed pharmacological treatment for a period longer than three months. The criteria of evaluation were: attendances and prescriptions dispensed at the UCCP, patient attendances avoided and time saved in medical consultations. MEASUREMENTS AND MAIN RESULTS: In 1986 there were 8,512 attendances at the UCCP (13.53% of the Centre's total attendance of 62,889), rising in 1992 to 12,884 (20.43% of the Centre's total of 63,078). In 1986 there were 18,000 prescriptions dispensed at the UCCP (16.38% of the Centre's total of 109,900) and in 1992, 41,500 (25.94% of the Centre's total of 160,000). The amount of time for medical consultations saved in the different years of the study ranged between 155 hours in 1986 and 536 in 1992. The index of prescriptions per attendance at the UCCP went up from 2.11 in 1986 to 3.22 in 1992. The index of attendances per patient and year was 12.09 in 1986 and 7.82 in 1992. CONCLUSIONS: A centralized unit for compliance with chronic treatments lessens the frequency of attendance for medical consultations, improves the patient's access renewed treatment and leads to a considerable saving in care time.

Chronic Disease↗
PubMed1993

[6 pages of medical prescriptions in the Glagolitic Psalter 3/N of the Sinai Closter].

Between the pages 141 und 142 of the Sinai Glagolitic Psalter 3/N there are three sheets of smaller size, containing twenty-two medical prescriptions (Folio 141 a-c). The order of prescriptions is different to the classifications of the famous ancient medical authors. Apart from general prescriptions, the text is also containing three prescriptions for women, children and horses' disease. Mediterranean plants, animal products, one sort of magic and minerals are listed as remedies. There is no exact information as to dose and way of preparing. Following linguistical characteristics, the text can be dated between beginning of the 12th and beginning of the 13th century. Contents are a philological analysis of the text, and a comparison of ancient medical and botanical texts.

Adult↗
PubMedDate not supplied

[Prescription of diphosphonates in ambulatory oncology. A study of the health insurance medical services].

OBJECTIVES: As requested by the Health Ministry, the Agricultural (Mutualité Sociale Agricole) and Independant Professions (Assurance Maladie des Professions Indépendantes) Health Insurances carried out a survey to analyse the use of second generation oral biphosphonates. METHODS: The data, from 3,414 prescriptions, gathered over the twelve months from May '93, showed that clodronate is prescribed mainly for breast cancer (35%), prostate cancer (23%), multiple myeloma (19%) and carcinoma of the lung (7%). The other prescriptions (16%) were either related to various malignant diseases (18 types encountered) or non-malignant diseases (mainly osteoporosis, but also Paget's disease of bone and hyperparathyroidism). The initial prescriber was most often a cancerologist (49%) but also quite frequently (17%) a general practitioner. The treatment was prescribed for an average of 41 days. 1600 mg daily was the most frequent dose (79%). However, in non-authorised indications, especially osteoporosis, the dose was lower, generally 800 mg a day. Altogether 14% non-authorised indications were linked either to non-metastatic malignant diseases (for the prevention of metastases) or with osteo-condensing type metastases (prostate cancer: 43%) or non-malignant diseases (osteoporosis, Paget's disease of bone, hyperparathyroidism, chronic renal insufficiency, sympathetic algodystrophy, bedbound decalcification, etc.). The prescription for these cases was motivated by the expected beneficial effect on bone mineralisation. Such treatment authorised was more often initiated by a general practitioner (23%) than a specialist (12%). CONCLUSION: These data raise the problem of limiting the possibility of prescribing second generation biphosphonates as initial treatment to a specialist. They also reaffirm the need to have precise guidelines in the field of medical prescription controls.

Aged↗
PubMed1996

[Impact of an informative feedback process on drug prescription].

OBJECTIVE: To evaluate the impact of the face-to-face interview and feed-back on the prescribing habits of doctors interviewed. DESIGN: Controlled intervention study. SETTING: Primary Care area (PCA) of Alt Penedès-Garraf. PARTICIPANTS: 16 general practitioners (GP). The intervention group (IG) consisted of 8 GPs from the county of Garraf; the control group (CG), of 8 from the Alt Penedès. INTERVENTIONS: The target doctors were identified by quantitative analysis of GP prescription in the PCA in 1993. In June 1994, there was a face-to-face interview with the IG doctors. There was no intervention on the CG. MEASUREMENTS AND MAIN RESULTS: No statistically significant differences were found, for the overall prescription turnover or expenditure generated by the prescriptions, between the two groups in the pre-intervention period (p > 0.05). Drugs expenditure decreased in the IG versus an increase in the CG. Comparison of the monthly accumulated increase revealed containment of drugs expenditure during the 9 months after the interview in the IG against the growth in the CG. In addition the number of units of medicine of doubtful efficacy (UDE) and unwarranted combinations of medicine to combat infection (UCMI) prescribed per doctor went down in the IG, but went up in the CG. CONCLUSIONS: The results show a containment in the growth of drug expenditure and a decrease in UDE and UCMI prescription by GPs in the IG as against the CG. The decreasing effectiveness over time of the one-off intervention suggests that there should be regular interventions to ensure a long-term effect.

Communication↗
PubMed1997

Variations and trends in the prescription of initial second line therapy for patients with rheumatoid arthritis.

OBJECTIVE: To evaluate practice variation and time trends in the initial prescription of second line drugs for the treatment of rheumatoid arthritis (RA) by a group of selected rheumatologists. METHODS: We retrospectively reviewed medical charts of all patients with a diagnosis of RA, initially seen between January 1, 1985, and June 30, 1994, by rheumatologists from a tertiary center and a rheumatology referral clinic in Edmonton. RESULTS: 1427 patients initially seen between 1985 and 1994 were included in the study. Of these, 1244 (87%) received a second line drug, 71% within 1.5 years after the disease onset. Overall, antimalarials and parenteral gold were the most frequently prescribed. Statistically significant trends were observed for the years under study. From 1985 to 1987, the most frequently prescribed initial second line drug was parenteral gold, between 1988 to 1990, sulfasalazine, and after 1991, antimalarials. Methotrexate was rarely used as a first choice. Marked variability was observed among rheumatologists in the use of initial second line drugs. In general, year of prescription and prescribing rheumatologist were significantly associated with the selection of all second line drugs but methotrexate. In addition, disease duration and residence (urban or rural) were associated with the selection of antimalarials and parenteral gold. CONCLUSION: Most patients were treated early with second line drugs. Initial prescription patterns varied among rheumatologists. These patterns have changed over the last 10 years. An increasing trend in the use of antimalarials was noted, and unlike prescription patterns in the US, methotrexate was rarely used as the first second line drug.

Antimalarials↗
PubMed2002

Compliance among pharmacies in California with a prescription-drug discount program for Medicare beneficiaries.

BACKGROUND: Several states have developed prescription-drug discount programs for Medicare beneficiaries. In California, Senate Bill 393, enacted in 1999, requires pharmacies participating in the state Medicaid program (Medi-Cal) to charge customers who present a Medicare card amounts based on Medi-Cal rates. Because Medicare beneficiaries may not be accustomed to presenting their Medicare cards at pharmacies, we assessed the compliance of pharmacies with Senate Bill 393. METHODS: Fifteen Medicare beneficiaries who received special training and acted as "standardized patients" visited a random sample of pharmacies in the San Francisco Bay area and Los Angeles County in April and May 2001. According to a script, they asked for the prices of three commonly prescribed drugs: rofecoxib, sertraline, and atorvastatin. The script enabled us to determine whether and when, during their interactions with pharmacists or salespeople, the discounts specified in Senate Bill 393 were offered. Pharmacies at which the appropriate discounts were offered were considered compliant. RESULTS: The patients completed visits to 494 pharmacies. Seventy-five percent of the pharmacies complied with the prescription-drug discount program; at only 45 percent, however, was the discount offered before it was specifically requested. The discount was offered at 91 percent of pharmacies that were part of a chain, as compared with 58 percent of independent pharmacies (P<0.001). Compliance was higher in the San Francisco Bay area than in Los Angeles County (84 percent vs. 72 percent, P=0.004) and was higher in high-income than low-income neighborhoods (81 percent vs. 69 percent, P=0.002). A Medicare beneficiary taking all three drugs would have saved an average of $55.70 per month as compared with retail prices (a savings of 20 percent). CONCLUSIONS: Discounts required under California's prescription-drug discount program for Medicare beneficiaries offer substantial savings. Many patients, however, especially those who use independent pharmacies or who live in low-income neighborhoods, may not receive the discounts.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1984

Prescription pricing across Canada (Part II).

The first of a two part article entitled "Prescription Pricing Across Canada" appeared in the June issue of CPJ. The article was prompted by recent press reports of a prescription drug study commissioned by the Saskatchewan government, and the consequent attention-getting headlines. The first article dealt with the Western provinces. The second part discusses prescription pricing in Ontario, Québec, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland, and the Northwest Territories.

Canada↗
PubMedDate not supplied

Contraceptive prescription: physician beliefs, attitudes and socio-demographic characteristics.

Physicians are important gatekeepers of women's access to effective methods of contraception. An understanding of physician behaviour in this domain is therefore important. This cross-sectional survey examined physician beliefs, attitudes, intentions and behaviour with respect to contraceptive prescription. Physician gender was associated with attitudes to diaphragm prescription, while year of medical graduation was associated with attitude to IUCD prescription. Age and gender in turn were related to differing perceptions of methods pertaining to efficacy, adverse effects, women for whom the methods were suitable and possible impacts on the physician. Regional differences in prescribing of these methods may be due to variations in physician age and gender.

Adult↗
PubMedDate not supplied

[Prescriptions, access, and expenses on drugs among users of health services in Mexico].

OBJECTIVE: To analyze the medical prescription, drug access and drug expenditure by patients based on the National Health Survey in Mexico, 1994. MATERIAL AND METHODS: A descriptive analysis of drug access and expenditure was undertaken and predictive factors for medical prescription were identified by logistic regression for 3,324 patients. RESULTS: 78% of the patients received drug prescriptions. 92% of the Social Security patients and 35% of the Ministry of Health patients received drugs free of charge (p = 0.000). The region with the highest poverty index received the least amount of drugs free of charge. Regarding drug expenditure of patients who purchased drugs, median expenditure was 40.00 pesos (12.50 USD). Private health service patients spent significantly more than public health service patients. CONCLUSIONS: Drug access and drug expenditure are linked to socioeconomic factors and to the institutions attended by patients. The Mexican health system faces, among others, the challenge of increasing the equity of access to medical drugs.

Drug Prescriptions↗
PubMed2006

Adherence to black box warnings for prescription medications in outpatients.

BACKGROUND: Few data are available regarding the prevalence of potentially dangerous drug-drug, drug-laboratory, and drug-disease interactions among outpatients. Our objectives were to determine how frequently clinicians prescribe drugs in violation of black box warnings for these issues and to determine how frequently such prescribing results in harm. METHODS: In an observational study of 51 outpatient practices using an electronic health record, we measured the frequency with which patients received prescriptions in violation of black box warnings for drug-drug, drug-laboratory, and/or drug-disease interactions. We performed medical record reviews in a sample of patients to detect adverse drug events. Multivariate analysis was conducted to assess the relationship of prescribing in violation of black box warnings to patient and clinician characteristics, adjusting for potential confounders and clustering. RESULTS: Of 324 548 outpatients who received a medication in 2002, 2354 (0.7%) received a prescription in violation of a black box warning. After adjustment, receipt of medication in violation of a black box warning was more likely when patients were 75 years or older or female. The number of medications taken, the number of medical problems, and the site of care were also associated with violations. Less than 1% of patients who received a drug in violation of a black box warning had an adverse drug event as a result. CONCLUSIONS: About 7 in 1000 outpatients received a prescription violating a black box warning. Few incidents resulted in detectable harm.

Adolescent↗
PubMedDate not supplied

Patient charges and the utilisation of NHS prescription medicines: some estimates using a cointegration procedure.

Since the inception of the NHS, user charges have been present for prescription medication. However since 1968 there has been a steady increase in this charge, particularly notable during the 1980s. The main justification for user charges is their revenue raising potential, and a recent government report has backed the use of user charges for prescription drugs. Whilst there is extensive evidence of the impact of user charges on utilisation of health care in the US, few studies exist in the UK. An accurate estimation of the price elasticity of utilisation is necessary if the full consequences of user charges are to be examined. This paper uses a cointegration estimation technique to estimate the price elasticity for prescription drug utilisation in the UK.

Drug Utilization↗