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At least 145 records · Page 8Linked to original sources

Physicians' choice in using Internet and fax for patient recruitment and follow-up in a randomized controlled trial.

OBJECTIVE: To examine the physicians' preference between Web and fax-based remote data entry (RDE) system for an ongoing randomized controlled trial (RCT) in Japan. METHODS: We conducted a survey among all the collaborating physicians (n = 512) of the CASE-J (Candesartan Antihypertensive Survival Evaluation in Japan) trial, who have been recruiting patients and sending follow-up data using the Web or a fax-based RDE system. The survey instrument assessed physicians' choice between Web and fax-based RDE systems, their practice pattern, and attitudes towards these two modalities. RESULTS: A total of 448 (87.5%) responses were received. The proportions of physicians who used Web, fax, and the combination of these two were 45.9%, 33.3% and 20.8%, respectively. Multivariate logistic regression analyses revealed that physicians 55 years or younger [odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.1-3.3] and regular users of computers (OR = 4.2, 95% CI = 2.1-8.2) were more likely to use the Web-based RDE system. CONCLUSIONS: This information would be useful in designing an RCT with a Web-based RDE system in Japan and abroad.

Adult↗

Reducing waste of intravenous solutions.

A program to minimize the waste of i.v. drug solutions is outlined, and the results of audits to determine the effectiveness of the program are presented. The program for reducing i.v. solution waste at a 500-bed acute-care center involves measures to compound admixtures for individual shifts, recycle solutions, remove unused solutions from nursing units, use a standardized administration schedule and automatic stop orders, standardize total parenteral nutrient (TPN) solutions, use commercially prepared products when possible, verify telephone orders, and prepare labile products just before use. From January 1987 to January 1990, six 30-day audits were performed to determine the number of i.v. admixtures discarded. The audits showed the hospital's average rate of waste to be 3.27%, well below other published values. The medical and surgical intensive-care units, pediatrics wards, and general medicine units accounted for most of the waste, which was largely attributable to dosage changes and stat-type drugs ordered but never used. Poor communication between the pharmacy and the nursing units also contributed to sterile product waste. Although the audits showed that waste was already at a low level, they pointed out areas for further improvement. A computer linkup that gives physicians the formulas for i.v. solutions is being set up, the list of standardized TPN solution formulas is being expanded to include condition-specific solutions, and clinical pharmacists are establishing better communication with the nursing units. By using several methods to reduce the waste of i.v. solutions, a pharmacy department has limited the rate of waste to only 3.27%.

Appointments and Schedules↗

[Pilot study for the surveillance of adverse reactions to herbal preparations and dietary supplements].

Use of herbal medicine is increasing in Italy. Herbal preparations are generally used as self-medication, often in the wrong belief that "natural" can be equated with "harmless". Whereas use of these products has been associated with serious adverse events, due to the quality of the raw materials used, to interactions with synthetic drugs or to their use in particular conditions, such as pregnancy or lactation. To monitor herbal preparation use in the population is necessary in order to point out possible adverse reactions. This was the objective of this pilot study, together with the urgency to inform health personnel and patients on the correct use of these products. After this experience we strongly believe that a system to assess the safety of herbal preparations is needed.

Abortion, Spontaneous↗

Medicare program; e-prescribing and the prescription drug program. Final rule.

This final rule adopts standards for an electronic prescription drug program under Title I of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). These standards will be the foundation standards or the first set of final uniform standards for an electronic prescription drug program under the MMA, and represent the first step in our incremental approach to adopting final foundation standards that are consistent with the MMA objectives of patient safety, quality of care, and efficiencies and cost savings in the delivery of care.

Drug Prescriptions↗

The Nighthawks.

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After-Hours Care↗

Assessment of a fax document for transfer of medication information to family physicians and community pharmacists caring for hemodialysis outpatients.

BACKGROUND: Studies have clearly identified the outpatient dialysis population as one that is at high risk for drug-related problems. The objective of this study was to evaluate whether a fax document was useful for community pharmacies and family physicians to notify these health care providers that their patient was receiving hemodialysis, to update medication and allergy records, provide dosing information on antibiotics and drugs to avoid, facilitate communication from the hemodialysis unit, and to decide if this was a worthwhile project to continue on an on-going basis. METHODS: Fax documents were sent to community pharmacists and family physicians of 70 hemodialysis patients from two different hemodialysis satellite units. The fax document consisted of a brief cover letter with contact numbers, a copy of the patient's medication and allergy list, a table of appropriate antibiotic doses and medications to avoid in dialysis, and a survey to evaluate this project's usefulness. Fisher's exact test was used to determine whether there were any significant differences between the family physician and community pharmacist responses. RESULTS: The survey response rate was 37%. Ninety-five per cent (20/21) of family physicians and 81% (22/27) of community pharmacists who responded to the survey would use the medication profile to update their records. Ninety-five per cent of family physicians and 93% of community pharmacies thought the fax document was an improvement in communication from the dialysis unit. Ninety per cent of family physicians and 85% of community pharmacies thought that the fax document was a worthwhile project for the dialysis unit to continue. No significant differences were found between family physician and community pharmacist responses. CONCLUSIONS: Implementation of a fax document for the transfer of medication information to family physicians and community pharmacists caring for hemodialysis patients aids in updating medication and allergy profiles, improves communication fom the dialysis unit and is considered a worthwhile project to continue on an ongoing basis.

Ambulatory Care↗