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PubMedDate not supplied

[Are the prescriptions of anticholinesterasic drugs adapted to the associated diseases and/or drugs in the Alzheimer's dementia?].

The aim of this study was to evaluate if the prescriptions of anticholinesterase drugs took into account some diseases and drugs which could interfere with them, in 58 inpatients (82 years old). The anticholinesterase drugs were respectively at admission and discharge: donepezil (n = 27 and 34), galantamine (n = 12 and 19) and rivastigmine (n = 3 and 1). Nineteen patients received a combination of anticholinesterase drug with an anticholinergic drug (muscarinic antipsychotic 15 times). Twelve patients had a medical history which interfered with the anticholinesterase drug: uretroprostatic obstacle, chronic renal failure and auriculo-ventricular block. Thirty-five adverse drug reactions, mainly in digestive track, were recorded in 26 patients. The treatment with anticholinesterase drug was modified only in 18 patients and the combination of anticholinesterase drug and antipsychotic agent was stopped in 5 patients. In conclusion, inappropriated prescriptions of anticholinesterase drugs seem frequent, with a more important prevalence of adverse drug reactions than in prospective studies. These results incite to develop studies of evaluation of prescriptions of anticholinesterase drugs.

Aged↗
PubMed1988

Factors affecting prescription of psychotropic drugs in general practice.

During one week in 1985, 227 general practitioners (GPs) in the county of Aarhus, Denmark, recorded all their prescriptions of psychotropic drugs, amounting to 4,180 prescriptions for 3756 patients. There was great variation in the rate of prescribing among the GPs. The median number of prescribed defined daily doses per 1,000 registered patients per day was 84, and the corresponding median number of prescriptions per 1,000 patients per week was 14. There was a significantly lower rate of prescribing of psychotropic drugs by rural/small town GPs, compared with GPs in major cities (odds ratio, 0.84; 99% confidence limits, 0.77-0.91), after correction for differences in patients' age and sex. There were no differences in rate of prescribing among GPs in relation to size and type of practice, nor to the age and sex of the GP.

Age Factors↗
PubMed1988

An estimation of the prevalence of diabetes mellitus in Norway. A prescription registration study.

A prevalence of 0.9% for drug-treated diabetes mellitus was calculated (male 0.8; female 1.0) for Norway, based upon a survey of 6777 prescriptions of antidiabetic drugs at 61.5% of Norwegian pharmacies during a four-week period in 1984. A male dominance was found below the age of 50 years, gradually shifting towards female dominance among the elderly. These findings are in accordance with a population screening on diabetes mellitus in the county of Nord-Trøndelag, and may indicate that prescription data can be a valuable source in the estimation of sex and age prevalence figures. Compared to screening, prescription studies are more simple to perform and cheaper, and can provide valuable background information in primary health care.

Administration, Oral↗
PubMedDate not supplied

Management of prescription refills in primary care: an Oklahoma Physicians Resource/Research Network (OKPRN) study.

BACKGROUND: Management of prescription refills is a significant challenge for primary care practices, but little information exists on the best way to do it. METHODS: Using the "best practices research" method within a primary care practice-based research network, we delineated steps involved in the process and the most important requirements for each step. We identified potential exemplary practices for each step and conducted practice audits and patient surveys to document actual performance. Methods with the highest performance ratings for the predetermined requirements for the steps were combined into a "best" unified approach. RESULTS: Half of the surveyed practices were satisfied with at least one step in their current refill management process, but only 9% (3 practices) were satisfied with all 5 steps. Practice audits identified acceptable methods for each step. The best combined method involves teaching patients to call the pharmacy first for prescription refills, accepting only fax requests from the pharmacy, allowing a nurse or medical assistant to make most refill decisions, documenting them in the chart immediately, responding back to the pharmacy by fax, and relying on the pharmacy to notify the patient when the refill is ready. Patient satisfaction with this method was reasonably good. The cost per refill was approximately $0.25 excluding overhead associated with office equipment and utilities. CONCLUSIONS: A satisfactory method for managing prescription refills in primary care practices was identified using the best practices research method.

Benchmarking↗
PubMed2002

Knowledge and self-efficacy of community health nurses concerning interactions of prescription medicines with over-the-counter agents and alcohol.

Knowledge and self-efficacy concerning interactions of prescription medications with over-the-counter (OTC) agents were assessed in community health nurses. Three convenience samples of community nurses were recruited to complete the instruments. The first was a sample of 20 experienced nurses working for a local visiting nurse agency (VNARNs). The second was a sample of 20 bachelor of science in nursing (BSN) students (graduate nurses [GNs]) completing their final nursing rotation with the VNARNs. The third was a sample of 31 nurses enrolled in a graduate program training nurses for advanced practice (APRNs). There were no significant differences in overall mean self-efficacy scores among the groups of community health nurses. The mean scores indicated moderate self-efficacy about prescription-OTC interactions. Post-hoc analyses determined VNARNs had significantly greater knowledge scores than APRNs. Overall mean self-efficacy was not correlated with mean knowledge scores. Inspection of the knowledge item responses revealed nine general misconceptions about OTC medications held by many community nurses in the sample. The data can guide the development of continuing education programs about prescription-OTC interactions aimed at community health nurses.

Alcoholic Beverages↗
PubMed2006

Prescription drug re-importation: a balanced look.

The rising cost of prescription drugs has decreased access for some older adults to purchase needed medications. For this reason, some older adults are purchasing prescriptions from foreign and Internet mail-order sites. There are two main concerns related to drug re-importation--price and safety. Therefore, should the federal government allow the re-importation of prescription drugs with Food and Drug Administration (FDA) safeguards? This article presents some of the facts about this issue including the history, chronology, and stakeholders for and against drug re-importation. Implications of drug re-importation to older adults, nurses, and public health policy are given.

Aged↗
PubMed2003

National survey on prescription of cardiovascular drugs among outpatients with coronary artery disease in Switzerland.

BACKGROUND: Secondary prevention of coronary artery disease markedly reduces cardiovascular mortality and non-fatal endpoints. Outpatient care of subjects with coronary artery disease has been assessed in several European countries, but no current data is available for Switzerland. METHODS: A random sample of office-based physicians across Switzerland recorded current drug prescription of outpatients with coronary artery disease in the years 2000/2001 by means of a mail questionnaire. We assessed treatment frequencies according to different patient characteristics. RESULTS: 565 patients were included (mean age 68 +/- 11 years, 75% male). There was no evidence for differences in drug utilisation among the regions. Drug prescription rates for antithrombotic agents, beta-blockers, ACE-inhibitors/angiotensin receptor blockers and lipid lowering drugs were 91%, 58%, 50% and 63% respectively. Lower treatment rates were observed among patients >70 years and in those without a history of myocardial infarction or coronary revascularisation. Forty-nine percent of the patients had a blood pressure >140/>90, and 60% had lipid readings above the intervention cut-off according to the Swiss recommendations. Among those without a history of myocardial infarction or coronary revascularisation, the respective figures were 60% and 80%. CONCLUSIONS: Compared to former surveys evidence based drug prescription has improved in Switzerland. Despite this, therapeutic goals for cholesterol levels and blood pressure are not being reached in a large proportion of patients. A high risk group for under use of evidence based drugs are patients without a history of myocardial infarction or coronary revascularisation.

Adrenergic beta-Antagonists↗
PubMed1976

Some notes on prescriptions.

Two separate surveys of prescriptions and prescription habits have been performed. In a survey in one pharmacy in Tamworth, 16 out of 750 prescriptions had to be returned to the doctor for correction. The most common problem was illegible handwriting. Another survey to determine the competence of script writing amongst 12 interns at Tamworth Base Hospital revealed a certain lack in their basic training.

Abbreviations as Topic↗
PubMedDate not supplied

Non-prescription medicines: prescribing legislation.

This article discusses developments in prescribing legislation in relation to non-prescription medicines. The three supply categories are outlined: prescription only, general sale list, and pharmacy medicines. Changes in legislation towards increased availability of medicines that do not require prescription are covered and the implications for at-risk groups are discussed. A table of minor ailments and their principal treatments is provided.

Complementary Therapies↗
PubMed1999

[Drug prescription in internal medicine: an analysis of the influencing factors].

BACKGROUND: The amount and quality of drugs prescribed after hospitalization in Internal Medicine and the factors which influence them have been rarely evaluated in Spain. MATERIAL AND METHODS: We study prospectively drugs prescribed in patients hospitalized in Internal Medicine analyzing amount of drugs before admission (BAD), on discharge (DD), end drugs after temporal drugs were removed (ED), drugs prescribed as chronic treatment (CTD), symptomatic drugs (SD), acute-use drugs (AUD) and low therapeutic utility drugs (LTUD). We also evaluated the sort of drugs and the factors implicated in increase or decrease of prescription volume. RESULTS: Two hundred and eighty-five patients were evaluated [164 males, 121 females, mean age 68.08 (SD 15.27)]. They had mean BAD 3.42(SD 2.67)7 DD 3.92 (SD 2.36) (p < 0.001) and ED 3.65 (SD 2.30) (No differences with BAD). The amount of drugs were higher in patients 65 years old and elder (p < 0.001). LTUD were decreased from 62(22%) patients on admission to 21 (7%) on discharge (p < 0.001). Compounded drugs were reduced from 36 (13%) patients to 17 (6%) (p < 0.05). Age older 65, length of stay greater 7 days, need for intravenous administration of drugs, comorbidities and complications during hospitalization all caused increase in prescription volume on discharge. Logistic-regression analysis showed that CTD and AUD were the main causes of increase of drugs while BAD and LTUD were protective. Drugs reduced in higher proportion were mucolytics (p < 0.005) drugs to treat plant-based hyperplasia benign of prostate (p < 0.05), brain vasodilators (p < 0.001) and peripheral vasodilators (p < 0.01). CONCLUSIONS: Hospitalization in Internal Medicine results in an increase of prescription volume though it is short-term. The higher number of drugs is accumulated in elderly. Factors implicated in increasing are length of stay, need for intravascular access, complications during inpatient, drugs to treat acute diseases and chronic use drugs. Low therapeutic utility drugs are used before admission in outpatients.

Aged↗
PubMed1999

[Chronic prescription of drugs for geriatric patients at an urban health center].

OBJECTIVE: To find the chronic prescription of medication in older people, associated variables and its quality. DESIGN: Observation, descriptive-crossover study. SETTING: Urban health district. PATIENTS: Sample stratified in age and sex groups of 385 people of 65 and over registered at the health centre and not in institutions. MEASUREMENTS AND MAIN RESULTS: Social and demographic data, self-perception of health and functional capacity were obtained through interview; and pathology and medication records, from the clinical records and authorized medication cards. 349 people, average age 73 (SD +/- 6.5), were interviewed. There were 210 women and 139 men. 12% perceived their health as bad/very bad. Barthel's index and the Lawton scale were disturbed in 13.8% and 30.4%, respectively. 93% suffered some chronic pathology (average 2.7). 81.4% habitually took medication (average 3.1). The most commonly consumed drugs belonged to the cardiovascular (32%), nervous system (21%) and digestive apparatus and metabolism (17%) groups. For the first group, the main drugs were ACEIs and diuretics; for the second, analgesics and neuroleptics; for the third, antacid and antiulcer drugs. 86% had high intrinsic value, the most prescribed drugs of those with low intrinsic value belonged to the antivaricose, cerebral and peripheral vasotherapy, and urological drugs groups. Multiple medications was related significantly to having more than two chronic pathologies (OR = 7.89, 95% CI 4.40-14.15) and self-perception of worse health (OR = 2.51, 95% CI 1.13-5.59). CONCLUSION: The elderly persons with a greater number of pathologies and perception of worse health took more medication. We thought that our quality of prescription was acceptable, although we should review the indications for neuroleptics and reduce prescription for medication of low therapeutic value.

Age Factors↗
PubMed1991

Prescriptions; requirements clarification--Drug Enforcement Administration (DEA). Final rule.

This final rule amends 21 CFR 1306.05 and 1306.13 to clarify the requirements of prescriptions for controlled substances, and to extend the partial filling of Schedule II prescriptions to patients in hospice or home-care that have a medical diagnosis documenting a terminal illness. The proposal regarding the use of medication order sheets for filling prescriptions for patients in Long Term Care Facilities under the provisions of 21 CFR 1306.11 is not adopted at this time and will be the subject of a separate proposed Federal Register announcement which will allow a period for additional comments.

Drug Prescriptions↗
PubMed1992

What does the Consumer Price Index for prescription drugs really measure?

This article examines the conceptually desirable attributes of a fully quality-adjusted prescription drug price index. It provides an understanding of how the Consumer Price Index for prescription drugs and medical supplies treats quality changes in prescription drugs and, in particular, quality changes associated with the introduction of new drugs.

Abstracting and Indexing↗
PubMed1993

Patient counseling detects prescription errors.

Medication errors are part of almost every pharmacist's professional life. They are a consequence of the behavioral habits developed by pharmacists to fill prescriptions efficiently. Outpatient prescription errors at an Indian Health Service pharmacy were reviewed. Mistakes detected after pharmacists had signed off on prescription accuracy were recorded. The errors were separated into two groups: 1) those detected during patient counseling, and 2) those reported after patients left the pharmacy. Patient counseling was the intervening event between the pharmacist's accuracy check and the patient's departure from pharmacy. The review of errors showed that of 323 reported mistakes, 286 (89%) were detected during patient counseling and subsequently corrected. Patient counseling appears to be a valuable tool for intercepting medication errors before they leave the pharmacy. The interactive environment created during the patient encounter probably improves concentration and allows previously overlooked mistakes to be noticed. Pharmacists should be encouraged to develop error detection strategies that are a natural part of the counseling process.

Arizona↗
PubMed1995

Medicare program; Medicare coverage of prescription drugs used in immunosuppressive therapy--HCFA. Final rule.

This final rule amends the regulations to provide Medicare coverage for prescription drugs used in immunosuppressive therapy furnished to an individual who receives an organ transplant for which Medicare payment is made. This rule reflects the enactment of section 1861(s)(2)(J) of the Social Security Act that provides Medicare coverage for prescription drugs used in immunosuppressive therapy for a period of up to 1 year from the date of discharge from an inpatient hospital stay during which the Medicare-covered organ or tissue transplant was performed. This final rule also implements section 13565 of the Omnibus Budget Reconciliation Act of 1993 (Public Law 103-66) and section 160 of the Social Security Act Amendments of 1994 (Public Law 103-432) that, beginning January 1, 1995, expand Medicare coverage for prescription drugs used in immunosuppressive therapy from 1 year to a phased-in period of 3 years from the date of discharge from a hospital stay during which the Medicare-covered organ or tissue transplant was performed.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1995

Prescription guidelines in OPADE: what are they, how are they used?

Many computerised drug prescription systems have been developed, but they are rarely used in clinical practice; among the reasons are their lack of integration with the functioning of medical institutions and the lack of consideration of general and local clinical practice rules. We present in this paper how OPADE, a computerised drug prescription system does answer this shortcoming by introducing prescription guidelines called Prescribing Principles. We argue that introduction of these Prescribing Principles will not only allow for integration of the computer in medical practice but will also introduce a positive feed back loop in the prescribing process.

Artificial Intelligence↗
PubMed1999

[Antibiotic prescription in acute respiratory infections in adults: its variability and appropriateness in 10 Spanish hospitals].

OBJECTIVE: To report the variability in antibiotic prescribing habits for patients diagnosed of non-specified acute respiratory infections (ARI) (according to the International Classification of Diseases 9MC) at Emergency Departments of ten Spanish hospitals, and to evaluate the appropriateness of antimicrobial prescription for such patients, after specifically elaborating some reference patterns for appropriate antimicrobial use. DESIGN: Descriptive study of variability in clinical practice by means of a prospective series of cases. Study of appropriateness by means of elaborating reference standards for appropriate use and comparison with the data from the descriptive study with such standards. DURATION: six months. SETTING: Emergency Department in ten Spanish hospitals from different autonomic communities: Andalucía, Islas Canarias, Castilla-León, Cataluña, Galicia, Madrid, Murcia and Valencia for a 6-month period. PATIENTS: Patients with the diagnosis of community ARI attended at emergency departments. SAMPLE SIZE: 903 cases. INTERVENTIONS: Collection of cases in a unified database with the following variables: age, sex, ARI type, diagnosis of comorbidity, prescribed antimicrobial, hospital admission and type of prescriber. A panel of experts was commissioned to elaborate the gold standards for the appropriate use of antibiotics or the lack of indication for the different locations of ARI. RESULTS: The adjusted proportion of the inappropriate prescription for the group with laryngo-tracheal-influenza-rhinopharyngitis-multiple ARI or non specified infections was 67.9%. CONCLUSIONS: Concerning antibiotic prescription, significant inter-center variability and relevant heterogeneity were observed.

Acute Disease↗
PubMed1980

Food and Drug Administration--Prescription drug products; patient package inserts requirements. Final rule.

The Food and Drug Administration [FDA] adopts final regulations establishing requirements and procedures for the preparation and distribution of patient package inserts for prescription drugs for human use. The package inserts will inform the patient about the drug product. This action is intended to promote the safe and effective use of prescription drug products by patients and to ensure that patients have the opportunity to be informed of the benefits and risks involved in the use of prescription drug products. The agency intends to apply the regulations to 10 drugs or drug classes during an initial implementation program. Further evaluation of the costs and benefits of the program will guide the agency in deciding whether to extend, revise, or defer these requirements.

Drug Labeling↗