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At least 1,567 records · Page 87Linked to original sources
PubMed2006

Prescription of ocular beta-blockers in patients with obstructive pulmonary disease: Does a central electronic medical record make a difference?

OBJECTIVES: Topical beta-blockers are contraindicated in obstructive pulmonary diseases (OPDs). In this study we aimed to evaluate through central or local electronic medical records (EMRs) the prescription patterns for topical ocular beta-blockers for patients with glaucoma and OPD treated by ophthalmologists. METHODS: The study was carried out at the Leumit Health Maintenance Organisation (HMO) in Israel. The physicians at the HMO all work with an EMR, either a central EMR incorporating data from primary-care physicians and consultants, or a local one. The study population included all HMO members who filled at least one prescription for antiglaucoma medications in 2004. The patients were divided into two groups: those with a previous diagnosis of OPD (ICD-9 codes 493) and those with no known diagnosis of OPD. RESULTS: 7481 patients consumed topical antiglaucoma medications during the study period, and 14.5% had a diagnosis of OPD. 798 OPD patients were treated by ophthalmologists, and of the 61.8% who were treated with topical beta-blockers, only 38 received betaxolol. In comparison with glaucoma patients without OPD, OPD patients received fewer beta-blockers (p < 0.001), more selective beta-blockers (p < 0.0001) and less timolol (p < 0.001). Of the OPD patients treated by ophthalmologists with a central EMR, 59.5% received beta-blockers in comparison with 66.4% treated by ophthalmologists with a local EMR (p = 0.06). OPD patients treated by ophthalmologists with a central EMR received more non-beta-blockers in comparison with patients treated by ophthalmologists with a local EMR (p = 0.02). CONCLUSION: Most patients with OPD and glaucoma continued to receive topical beta-blockers, mostly noncardioselective beta-blockers. A central EMR with a comprehensive and highly available medical history reduced the prescription of beta-blockers to OPD patients, but rates remained unacceptably high.

Adrenergic beta-Antagonists↗
PubMed2005

Medicare coverage and reimbursement of outpatient prescription drugs in the US: history, recent changes and outlook for the future.

US Medicare provides health insurance to 41.5 million disabled and elderly Americans. Outpatient coverage, including a limited pharmacy benefit, is provided by Medicare Part B. Even with very restrictive criteria, Part B incurs 8.5 billion US dollars annually for outpatient prescription medications. Prior to passage of the Medicare Prescription Drug and Improvement Modernization Act (MMA) 2003, the Part B pharmacy benefit was criticised for its limited coverage criteria and flawed reimbursement practices. Despite the changes made under the MMA, these two issues continue to be concerns for the Medicare Part B outpatient prescription drug programme because (a) the criteria for selection of drugs for coverage do not necessarily reflect valuable advances in medicine, and the extent to which the new private-sector style 2006 Medicare Part D drug benefit will correct this is unknown; and (b) although pre-MMA average wholesale price-based reimbursement practices were clearly flawed, MMA changes such as use of the average sales price and providing increased reimbursement to physicians for drug administration may or may not be successful, and could lead to new problems. The extent to which the MMA and its associated Part D drug benefit address concerns and advance towards better, more cost-effective healthcare is reviewed and recommendations made.

Ambulatory Care↗
PubMed2005

Are direct to consumer advertisments of prescription drugs educational?: comparing 1992 to 2002.

We investigate the educational value of direct-to-consumer (DTC) prescription drug advertisements from 58 popular magazines published in 1992 and 2002. We find that the number of DTC prescription drug ads increased nine-fold from 1992 to 2002, while the advertisements for other health care products increased only slightly. We examine changes in 1992-2002 DTC prescription drug ads both quantitatively and qualitatively. We find that the educational value as it relates to serious medical conditions decreases over time based on the media logic that the primary purpose of advertisements is to promote consumption, rather than education. We enumerate and describe the media logic tactics employed, and find a statistically significant increase in the number of such tactics per ad in 2002.

Advertising↗
PubMedDate not supplied

[Celecoxib prescription: data from the "Sécurité Sociale" database of the Aquitaine Region, South-Western, France].

OBJECTIVE: The objective of this study was to describe the characteristics of subjects beginning celecoxib treatment and the evolution of treatment over a 6-month period. METHODS: All the subjects (n = 14 323) for whom reimbursement of celecoxib was submitted to the "Sécurité Sociale" d'Aquitaine in December 2000 were included in the study. Their mean age was 61.9 years, and the male/female sex ratio was equal to 0.45. Almost two-thirds of the subjects were previous typical nonsteroidal anti-inflammatory drug users (NSAIDs-typical). RESULTS: Fifteen percent of the subjects had a gastroprotective agent prescribed, either on the same form as celecoxib or during the following 30 days. New reimbursements of celecoxib involved 41% of the subjects. Among the subjects who received a repeat prescription of celecoxib, 41% had used a gastroprotective agent at least once during the 6 months before study inclusion and 44% during the 6 months after inclusion. Among the subjects who did not renew their celecoxib prescription, the respective proportions were 32.2% and 33.7%. DISCUSSION: These results show that celecoxib is mainly prescribed to previous NSAIDs-typical users. The small difference in the prescription of gastroprotective agents between the period preceding and that following the initiation of celecoxib treatment does not indicate an advantage of celecoxib in terms of a lower rate of use of gastroprotective agents.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

General practitioners' attitudes to oestrogen prescription in the menopause: a national survey in Norway.

A questionnaire was mailed to a random sample of approximately 10% of Norwegian general practitioners (GPs) in order to investigate attitudes to the prescription of hormone replacement therapy (HRT) in menopausal women. Nine short case histories were presented, and the GPs indicated their attitude to oestrogen prescription in each case on a five-step scale. Each case history contained four items that were systematically varied so that the effect of each could be investigated by comparing the answers from case to case. 251 GPs (74%) responded to the questionnaire. The answers indicated restrained attitudes towards prescription of HRT. Smoking and a family history of cardiovascular disease were regarded as contraindications. Angina pectoris was considered a contraindication for local oestrogen application in elderly women with urogenital complaints.

Adult↗
PubMed1991

Development of sitting ability, assessment of children with a motor handicap and prescription of appropriate seating systems.

The prescription of appropriate seating for children and young adults with a motor handicap is a complex issue requiring a clear identification of the child's physical ability in all postures. Recent work by Pountney et al. (1990) has shown how the development of lying ability is linked to sitting ability. This emphasises the importance of the total approach to assessment and prescription of seating systems and of not isolating seating needs from other postural considerations. This article summarises the work undertaken in recent years at Chailey Heritage to improve knowledge about prescriptive, adaptive seating for children with a motor handicap. The results are being increasingly applied throughout the United Kingdom.

Biomechanical Phenomena↗
PubMedDate not supplied

Physicians' prescriptions of tranquilizers and tranquilizer abuse.

The abuse of tranquilizers is recognized as a major health problem. A substantial number of qualitative studies have suggested that the prescribing practices of physicians are at least partly responsible for the problem. Yet there is still a need to test this contention statistically. This paper tests the strength of the relationship over time between physicians' prescriptions of tranquilizers and tranquilizer abuse. Data on physicians' prescriptions are based on projections calculated by the National Disease and Therapeutic Index (NDTI). Data on tranquilizer abuse are based on emergency room episodes reported to the Drug Abuse Warning Network (DAWN). The correlation between physicians' tranquilizer prescriptions and tranquilizer abuse is found to be .46 (significant at the .05 level), after controlling for serial correlations in the data.

Adult↗
PubMed2003

[Clinical observation on treatment for postoperative metastasis of gastric cancer by Jianpi Huoxue Jiedu prescription].

OBJECTIVE: To study the effect of Jianpi Huoxue Jiedu (JPHXJD) prescription on prevention of the postoperative metastasis of gastric cancer and to observe the changes of immunity and whole blood viscosity after treatment. METHODS: JPHXJD prescription and chemotherapy were administered to the treated group for 12 successive months, while only chemotherapy was given to the control group. RESULTS: The effective rate of anti-metastasis in the treated group was obviously better than that in the control group. In the aspects of enhancing Karnofsky scores, reducing whole blood viscosity and improving immunity after treatment, the treated group was better than the control group (P<0.05). CONCLUSION: JPHXJD prescription combined with chemotherapy shows apparent effect on anti-metastasis. It can improve the quality of life of the patients, lower the whole blood viscosity and improve the immunity function.

Adult↗
PubMed2004

Health beliefs and prescription medication compliance among diagnosed hypertension clinic attenders in a rural South African Hospital.

This study examines the relationship between health beliefs and the use of both prescribed medication and alternative healing agents among at least one year diagnosed hypertensives attending an hypertension out-patient clinic in a rural South African hospital. The sample included 33 men and 67 women, in the age range of 31 to 81 years, (M=60.7 years, SD=9.8 years). Main outcome measures included causative beliefs, health beliefs, and quality of the health care provider patient interaction. From the 100 patients studied 35% were not compliant with prescription medication. Most patients (almost 80%) had taken something else for their high blood pressure apart from prescription medication, especially those who had been non-compliant with prescription medication. Most popular were the use of home remedies and faith healing, followed by traditional healing and over-the-counter drugs. Non-compliant behaviour was associated with the use of alternative healing agents, the belief of curability of hypertension by traditional and faith healers, perceived benefits and barriers of antihypertensive medication and some items of the quality of the practitioner-patient relationship such as not explaining medical problems. Results are discussed in view of improving culturally sensitive compliance behaviour among hypertensive patients.

Adult↗
PubMedDate not supplied

Consumers' attitudes and behavior toward prescription drug advertising.

OBJECTIVE: To explore how consumers' characteristics interact with direct-to-consumer advertising (DTCA) to influence 2 behaviors: information seeking and asking for prescription. METHOD: A secondary data analysis was conducted using a subset of 1,102 consumers who responded to a 1998 national survey conducted by Prevention magazine. RESULTS: Being afflicted with chronic conditions and having positive attitudes toward DTCA were associated with the consumers' willingness to talk with doctors about the advertised drugs. Consumers who asked for prescriptions tended to agree that DTCA made prescription drugs appear harmless and helped them make their own decision. CONCLUSION: DTCA appears to have an influence on consumers' behavior.

Adolescent↗
PubMed1998

Standardized hemodialysis prescriptions promote inadequate treatment in patients with large body mass.

BACKGROUND: Although a relation between the adequacy of hemodialysis and mortality has been established, hemodialysis prescription is rarely individualized precisely in adults with end-stage renal disease in the United States. OBJECTIVE: To test whether persons who receive standardized hemodialysis prescriptions have an increased risk for inadequate hemodialysis with increasing body mass. DESIGN: Cross-sectional study. SETTING: Four ambulatory hemodialysis facilities in Brooklyn, New York. PATIENTS: 214 patients receiving hemodialysis. Patients were sorted by body weight into quartiles (groups 1 through 4, in ascending order). MEASUREMENTS: Urea reduction ratio (percentage reduction in blood urea nitrogen concentration after a hemodialysis session), prescribed length of hemodialysis, and body weight quartile at the start of the study. Urea reduction ratio was measured at the start of the study and at weeks 4, 8, and 12, and a mean value was calculated for each patient. Inadequate hemodialysis was defined by a urea reduction ratio of 65% or less. RESULTS: Women had a higher mean urea reduction ratio (72% +/- 6%) than men (67.6% +/- 7%) (P < 0.001). The urea reduction ratio was inversely related to body weight (r = -0.47; P = 0.001). It was greater in group 1 (74% +/- 5.2%) than in group 2 (70% +/- 5.7%), group 3 (68% +/- 5.8%), or group 4 (66% +/- 8.4%) (P < 0.05). Logistic regression done with a urea reduction ratio of 65% or less as the outcome variable showed that the odds of receiving inadequate hemodialysis were increased 3.5-fold in men (95% CI, 1.53-fold to 8-fold; P = 0.003), 10-fold in group 3 (CI, 2.1-fold to 50.3-fold; P = 0.003), and 13-fold in group 4 (CI, 2.6-fold to 61.6-fold; P = 0.001). CONCLUSIONS: Standardized hemodialysis prescriptions result in inadequate hemodialysis in many patients who weigh more than 68.2 kg.

Adult↗
PubMedDate not supplied

Prescription of hearing aids: a rationale.

A rationale is presented for a hearing aid prescription. Once the choice of ear(s) to be fitted is determined and whether air or bone conduction fitting is appropriate, output and gain-frequency response characteristics are prescribed on the basis of audiometric test data. The specific prescription data for ouptut are based on uncomfortable loudness levels, and gain-frequency response data are based on a formula that was determined by imposing typical speech parameters over a given hearing loss. A hearing aid prescription is not only intended to predict amplification needs but, just as important, it also provides a method for testing the results of those predictions.

Audiometry↗
PubMed1991

Employer-sponsored prescription drug benefits.

In summary, between 1979 and 1989, prescription drug costs increased by 151 percent, the rate of growth second only to the costs of hospital room and board. While expenditures on prescription drugs in the United States account for only 3 percent of all medical expenses, there is great interest in prescription drug coverage.

Data Collection↗
PubMed1999

The optimal approach to peritoneal dialysis prescription in children.

OBJECTIVE: To describe the optimal approach to peritoneal dialysis (PD) prescription in children. DESIGN: Review of the available literature. RESULTS: Unlike the situation in adults, the main method used for PD in children is automated peritoneal dialysis (APD). The prone position, while resting, permits the dialysis prescription to use a higher fill volume (IPV), as in continuous ambulatory peritoneal dialysis (CAPD), and is also probably more effective than PD in an upright position. However, because APD is limited to 10 hours, the dialytic effectiveness of nocturnal APD should avoid two potential risks: (1) use of too high an IPV per exchange, inducing lymphatic reabsorption, a factor in unsuitable water and sodium balance [Fischbach M. Peritoneal dialysis prescription for neonates. Perit Dial Int. 1996; 16(Suppl):S52-4]; and (2) use of too short a dwell time per exchange, limiting the purification of creatinine and phosphate despite an apparently adequate urea purification (Malhotra C, Murota GH, Tzamaloukas AH. Creatinine clearance and urea clearance in PD: What to do in case of discrepancy. Perit Dial Int. 1997; 17:532-5).

Biological Transport↗
PubMed1999

Effect of insurance on prescription drug use by ESRD beneficiaries.

In this article the author reviews the prescription drug coverage policy in the Medicare End Stage Renal Disease (ESRD) program and examines the relationship between secondary insurance status and the number of medications prescribed for dialysis patients who had Medicare as their primary payer. Negative binomial models were used to examine this relationship. Findings in this study indicate that the number of secondary payers has a significant impact on the number of prescription drugs received by Medicare ESRD patients. Further research is needed to determine whether Medicare beneficiaries without secondary insurance are obtaining fewer prescriptions than needed or if those with greater coverage are obtaining more than needed.

Adult↗
PubMed1999

Influence of prescription patterns in general practice on anti-microbial resistance in Norway.

BACKGROUND: The global pandemic of antibiotic resistance is causing considerable concern, and a major reason for the growing world-wide resistance problem is the overuse of anti-infective drugs, especially the use of broad spectrum antibiotics. This is still a relatively minor problem in most of the Nordic countries where the consumption of antibiotics is less than half of that reported from southern Europe and the United States of America (USA). AIM: To describe the resistance pattern among common respiratory tract pathogens in Norwegian general practice, the national consumption of antibiotics, and GPs' prescription patterns for respiratory tract infections. To offer some suggestions as to why Norway has maintained a favourable situation regarding resistant microbes during the past 10 years. METHODS: An analysis of the prescription patterns in Norwegian general practice. RESULTS: There is a low total prescription volume of antibiotics compared with other countries. Penicillin V is the most commonly used antibiotic for the most common airway diseases in general practice in Norway. CONCLUSION: Although there is a low prevalence of antibiotic resistance in Norway, there is still a great potential for reducing the unnecessary antibiotic prescribing for the most common respiratory illnesses.

Anti-Bacterial Agents↗
PubMedDate not supplied

[FARMAC: a program designed for monitoring the prescription of antimicrobials in hospitals].

INTRODUCTION: The use of computer programs for monitoring the prescription of antimicrobial agents in hospitals is of paramount importance in the incorporation of electronic databases developed and analyzed by several hospital committees, including the following: infection control; pharmacy; morbidity and mortality; and quality assurance committees, as well as other key areas or departments such as pathology, pharmacy, microbiology, radiology, or hospital administration. OBJECTIVE: To describe the development and use of an "information system" employed for monitoring the prescription of antimicrobial agents in hospitalized patients. MATERIAL AND METHODS: A printed format was developed in order for physicians to ask for authorization for the use of restricted antimicrobial agents (i.e. third-generation cephalosporins and other newly introduced beta lactams, fluoroquinolones, antifungals, antivirals, etc). A computer program, "FARMAC", was designed using the Dbase IV program. FARMAC contemplates the presentation on a screen of a main menu allowing for the use of several options: admissions; antibiotic changes; consultations; discharges; hospital transfers; reports, and distribution. The reports are generated from the menu and appear on the screen or are printed in representative tables and figures. Generally speaking, the system processes information on the use of antimicrobial agents, files information, allows for consultation, of the information and generates reports quickly and efficiently. RESULTS: The presentations were defined on screen, taking into account the space needed in order to avoid an inadequate distribution of the messages, therefore obtaining an optimal image. A database was created defining the necessary fields for storing information with reference to patients and usage patterns of restricted antimicrobial agents. DISCUSSION: The development of an information and surveillance system on the prescription of antibiotics allows for consulting updated information, making the data analysis easier for decision making. Its use will allow for surveying tendencies and usage patterns of controlled and non-controlled antimicrobial agents.

Anti-Infective Agents↗
PubMed2001

[Prescription of thyroid function tests in adults as a function of clinical circumstances and of patient management].

A group of experts composed of clinicians and biologists in 7 University Hospitals in the Aquitaine and Paris regions working within the framework of the Coordination Committee for Clinical Evaluation and Quality in Aquitaine (CCECQA) have developed prescription guidelines for thyroid function tests to be performed in adults. The goal was to determine strategies for prescribing thyroid hormones (T3 and T4) and thyroid stimulating hormone (TSH) to screen for thyroid function disorders and follow thyroid function. The resulting recommendations were based on a review of the literature and a consensus among the experts. The first part of the guidelines concern recommended prescriptions in different clinical situations (early diagnosis of hypothyroidism, early diagnosis of hyperthyroidism, follow-up of anti-thyroid drug treatments, follow-up of levothyroxin replacement therapy, institution and follow-up of treatments susceptible of inducing dysthyroidism, pregnancy and post-partum dysthyroidism, palpation of a thyroid nodule). The second part of the guidelines are devoted to prescriptions according to the therapeutic setting (emergency care, psychiatric care, geriatric care).

Adult↗