drug utilization review

..Improper prescription practices will not improve without consumer targeted interventions that educate and empower communities regarding the hazards of inappropriate drug use...

..In particular, antibiotic use was inappropriate in surgical ICUs. Additional interventions such as postgraduate training programmes and elaboration of local guidelines could be beneficial...

..To explore and identify the key determinants influencing the uptake of medicines use reviews (MURs), a new community pharmacy service in England...

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..Plasma levels were used as an indicator of the quality of treatment...

..We investigated the depiction of the patient-pharmacist power relationship within MUR patient information leaflets...

..This paper highlights the importance and interplay of other factors which help explain the inability to capitalise fully on the potential contribution to professional status, which reforms to extend professional roles afford...

..However, each hospital should define and validate its own indicators to describe the local exposures to antibiotics and to study the relationship with resistance...

..Setting. Twelve practices affiliated with 2 managed care organizations (MCOs) in eastern Massachusetts and northwest Washington State. Patients. All enrolled children younger than 6 years old...

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..In several countries, general practitioners (GPs) and pharmacists work closely together to ensure proper use of new drugs in clinical practice...

..Benzodiazepines are commonly prescribed for older people. Inappropriate benzodiazepine prescribing may result in serious adverse effects, including confusion and falls...

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..This will reduce inappropriate use, enhance patient safety by reducing exposure to unnecessary risk, and may stimulate more clinically relevant medicines research...

..Several hospital characteristics were associated with this improvement, but they are weak predictors of hospital-based improvement in the use of beta-blockers...

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..Antipsychotic prescribing often deviates from recommended practice. Nursing staff have considerable discretion to administer large doses of antipsychotics on an 'as required' basis...

..001). Antibiotic treatment in our hospital appears to be substantial and increasing, justifying efforts to improve appropriateness of therapy and improve clinical and financial results...

..In most cases, PNDs involve the peripheral nerves. Treatment of PNDs is likely to use large health care resources. However, little is known about the economic burden of PNDs in Canada...

..To describe a simple method for assessing the quality of drug prescribing...

..However, since some medications are less appropriate for older patients, systems approaches to improving pharmacy care may be an effective way to reduce inappropriate medication use...

..The aim of this study was to assess the prevalence of dispensed anti-asthmatic medications as a proxy of asthma among children and adolescents aged 0-19 years in Norway...

..In view of the current overuse of antimicrobial therapy in often self-limiting acute respiratory tract infections, treatment based on procalcitonin measurement could have important clinical and financial implications...

..In some cases of drug therapy, the available evidence might be sufficient to extend the indications to children without further clinical studies...

..Misdiagnosis, due to the misinterpretation or lack of clinical, microbiological and/or imaging data is thus a major cause of antibiotic misuse. Improvement in the diagnostic process should become part of antibiotic policy...

Retrospective drug utilization review is required of all state Medicaid programs and is performed by most private-sector prescription programs...

..To evaluate anti-asthmatic drug prescriptions in a large Italian paediatric population...

The Omnibus Budget Reconciliation Act of 1990 offered the promise that prospective drug utilization review (pDUR) systems would improve the quality of drug prescribing and patient drug use...

..To analyse strengths and weaknesses of a simple method for assessing the general quality of drug prescribing and to study the acceptance of the method among general practitioners (GPs)...

..To describe trends in utilization and prescribing of statins and other lipid lowering drugs across Europe from data in routine administrative databases...

..The aim of this study was to evaluate DDD changes over time (1982-2000) and to identify possible determinants of these changes...

..The lack of a patient's knowledge about their own medication is precarious...

..To systematically characterize antipsychotic medication coprescribing ('polypharmacy') in a large state hospital system...

..To present and interpret drug prescription patterns, related to various groups of the population in a Swedish county, in order to estimate the prevalence of drug use in different age groups...

..These findings may explain the unprecedented Pharmaceutical Benefits Schedule expenditure on COX-2 inhibitors in Australia...

..We evaluated the adherence to national guidelines for the treatment of asthma in childhood...

..Efforts should be made to scrutinize underevaluated off-label prescribing that compromises patient safety or represents wasteful medication use...

..Prescribing varies considerably between GPs, and a minority of GPs account for a large proportion of new drug prescribing...

..To determine patterns of use of ceftriaxone and cefotaxime (CEFX) in Victorian hospitals and to identify areas for improvement...

..These findings suggest that the quality of health care--as related to drug use, patient safety and treatment cost--is lower with dispensing doctors than with non-dispensing doctors...

..The aim of this trial is to compare a ProCT-guided antibiotic therapy with a standard approach based on evidence-based guidelines for patients with ARTI in primary care...

..The aim of this study was to critically evaluate recent journal articles which fit the Medline definition for Drug Utilization Review (DUR) and which also cover multiple healthcare sites.

..4%) and 8428 men (35.6%). The study population for drug utilization review consisted of those cohort members who were admitted into hospitals during the period January 1993 through ..

..CONCLUSIONS: It is evident that inappropriate drug prescribing is very common in Korea; thus, a great deal of attention is urgently needed in the country with respect to proper prescribing and supportive interventions...

..This study was designed to identify the disease conditions for which IVIG was being prescribed in academic hospitals during this period, and to explore the effects that IVIG shortages had on prescribing patterns...

..Identifying the fastest growing categories of drugs, where drugs are grouped into clinically relevant classes and subclasses, can help policymakers decide where to focus their cost containment efforts...

..Many employers and health plans have adopted 3-tier formularies in an attempt to control costs for these and other drugs...

..CONCLUSION: This study demonstrates the discrepancies that remain between recommendations and practical care in the treatment of acute diarrhea in children. Private French pediatricians often prescribe drugs...

..The purpose of this study was to assess the affect a PA restriction had on the utilization patterns of cefuroxime tablets in a managed care organization (MCO) in Israel...

..We investigated trends in antibiotic use by U.S. children, from 1996 to 2001, a period that followed the launch of national campaigns to promote the appropriate use of antibiotics...

..001). This multidisciplinary consultative approach thus reduced antibiotic costs, contributed to infection control, and improved the quality of antibiotic prescription...

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..We sought information about the cost-related underuse of medications-which medications are underused, by whom, and how often...

..7%); the diagnosis was included in about two-thirds. The prescriber's handwriting was illegible in 64.3% of prescriptions. Measures to improve the situation are suggested...

..A nationwide, primary care-based prescription audit in infants to determine the prescribing pattern and prescribing errors of topical corticosteroid preparations in Bahrain...

..This study aimed to evaluate the impact of the HPI funding, which at the time had been in place for nearly 2 years, on pharmacy activities in this area...

..Next, after a 5 month interval, a second intervention, i.e. an AD approach, addressed suboptimal prescribing of ciprofloxacin and co-amoxiclav. Segmented regression analysis was used to analyse the interrupted time-series data...

..DISCUSSION: This study supplies data that can improve our understanding of factors associated with the extramedical use of prescription pain relievers among 2 distinct stages of use...

..Drug information services including side effects and drug interactions for professionals and consumers at the hospital is highly desirable...

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..To quantify clinical inappropriateness of antibiotic prescription and its costs in primary health care...

..The resulting list of drugs to avoid was added to the 2006 Health Plan Employer Data and Information Set (HEDIS) to measure the quality of prescribing for the elderly...

..This analysis, using data based on Computerised Physician Order Entry (CPOE), was performed to evaluate prescription patterns, to analyse possible over-prescribing of drugs and to assess the compliance with therapy-guidelines...

..To control these expenses, many state Medicaid programs have implemented prior-authorization requirements before coxibs can be prescribed. We evaluated the effect of such programs on the use of coxibs by Medicaid beneficiaries...

..The level of agreement seems to be affected by combination therapy and the immune status of the patient...

..CONCLUSIONS: In conjunction with the support and advice of the pharmacy and microbiology departments, the use of a gentamicin monitoring form can improve the quality of intravenous gentamicin use in the hospital setting...

..The objective of this study was to examine inappropriate drug combinations among privately insured patients with HIV disease...

..Additional studies are needed to determine the impact of PIRx on this NH population...

..CONCLUSION: This study shows that the implementation of guidelines needs to be improved in clinical practice...

..55% of the 110 prescriptions evaluated were unnecessary or inappropriate. Ward and combination therapies were significantly associated with misuse...

..Continuing education of prescribers and healthcare providers, monitoring, supervision, public education would be beneficial...

..8 million adult Americans, particularly those aged >65 years, and has been described as a "new epidemic" due to the high annual incidence of the disease (an estimated 550,000 new cases per year)...

..Exenatide was approved by the US Food and Drug Administration (FDA) in April 2005 as adjunctive therapy to metformin or a sulfonylurea for the treatment of type 2 diabetes mellitus (DM)...

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..Multifaceted interventions have proved effective in changing suboptimal prescribing practices. Educational interventions are needed to address self-medication and adherence...

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..We used these formative results as input to the design of health center and community interventions to encourage more appropriate prescribing for URI among adults...

..There is increasing evidence that clinical guidelines can lead to improvements in clinical care. However, they are not self-implementing. Outreach visits may improve prescribing behaviour...

..Anomalies were noted in prescribing. Improvement was noted in certain parameters compared to previous studies. The educational initiatives should be strengthened. Managerial interventions can be considered. Further studies are required...

..The author also discusses pharmacy benefit managers, as well as various utilization management strategies like benefit plan design and the use of formularies...

..Future research is necessary to measure and test other methods for tackling this major public health problem facing older people...

..Prescribing of potentially harmful medications has not been well documented in hospitals...

..Prescribing practices in Las Palmas are based on scientific data, probably because of the continuing education courses on antibiotherapy that began in 2003...

..Physicians' prescribing practices in India are influenced by socioeconomic factors and the pharmaceutical industry's marketing techniques that include giving incentives to physicians to prescribe certain drugs...

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..To investigate whether a Medication Report can reduce the number of medication errors when elderly patients are discharged from hospital...

..This study examined antimicrobial prescribing patterns for adults and children with bronchitis or upper respiratory infections (URIs) before and after release of nationally disseminated pediatric practice recommendations...

..We evaluated whether prescribers wait until after the prior-approval period to order restricted antimicrobial therapy that is in conflict with guidelines or unnecessary...

..However, certain indications were associated with a significant level of partial or noncompliance. A training program should be developed to improve adherence to prescribing guidelines...

..Step therapy for angiotensin receptor blockers (ARBs) requiring prior use of angiotensin-converting enzyme inhibitors (ACEIs) is a common cost-containment intervention in managed care...

..In our hospital, the value of the data far exceeded the cost of processing and analysis...

..Identification of early predictors of medication nonpersistence may allow timely adherence-promoting interventions and potentially reduce the risk of negative health outcomes...

..Further savings could be realized if lowest available prices were used nationwide. Concentrating on specific agents may be a productive way to address the unrealized savings...

..09]. DISCUSSION: This study enhanced the awareness of the nursing and medical staff and the hospital management with regards to the reality of medical errors. Our data were comparable to the results of other studies published elsewhere...

..CONCLUSIONS: Communication modality correlates with changes in antidiabetes medications prescribed by physicians and may be an effective tool to facilitate inpatient glycemic control...

..integrate, test, deploy and disseminate tools and training materials in five key areas: drug formularies, drug utilization review, lab-pharmacy linkages, N-of-1 trials and pharmacoeconomics...

..SBIRT in the ED for drug misuse has the potential for reaching people during a "teachable moment" during an ED visit that might be related to drug misuse. ..

..The ultimate goal of these analyses will be to (1) develop a computerized pharmacy-based drug utilization review program to identify, in a timely manner, those patients at a high risk of an asthma exacerbation, as well ..

..Systematic efforts such as drug utilization review programs and computerized physician order entry that seek to improve medication use depend entirely upon ..

..Systematic efforts such as drug utilization review programs and computerized physician order entry that seek to improve medication use depend entirely upon ..

..The findings of this research will provide important lessons for clinicians, researchers, insurers, policy-makers, patients, and all those with an interest in improving the use of prescription drugs. ..

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..5. To develop a "tool-kit" resources that include developed intervention products for use by nonphysician providers in other ambulatory settings (e.g. pharmacists in community pharmacy settings). ..

..The evaluation has been structured based on the RE-AIM framework for effectiveness trials. ..

..We will estimate a combination of two-part random-effects models for longitudinal data, latent class random-effects models, logistic regression models, Poisson regression models, and hazard models to address these aims. ..

..Huskamp the training, mentoring, time and resources to develop the skills that will put her in a position to lead independent research on the economics of pharmaceutical treatment for mental illnesses. ..

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..We will estimate a combination of two-part random-effects models for longitudinal data, latent class random-effects models, logistic regression models, Poisson regression models, and hazard models to address these aims. ..

..We will estimate a combination of two-part random-effects models for longitudinal data, latent class random-effects models, logistic regression models, Poisson regression models, and hazard models to address these aims. ..

..To pre-test these interventions as part of a feasibility study within physician offices likely to service low literate geriatric patients...

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..The significance of this project lies in its potential to help clinicians and policymakers assess and manage competing risk and benefit claims. ..

..Ultimately, the goal is to tailor HIV drug regimens to individual patients'metabolic profile with the result being improved outcomes in HIV disease, and ultimately, improved public health. ..

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..If successful, this intervention will not only result in improved clinical outcomes in individuals who take part, but may also decrease the emergence of resistant HIV if incorporated into standard of care for HIV management. ..

..Ultimately, the goal is to tailor HIV drug regimens to individual patients' metabolic profile with the result being improved outcomes in HIV disease, and ultimately, improved public health. ..

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..This improvement in the quality of neonatal care delivered to this high-risk population of infants should result in short and long-term improvements in the public health, outcome, and medical-related costs of caring for VLBW infants. ..

..By understanding these underlying explanations for the racial disparities in these outcomes, particularly families'trust in the health care system, we can aid in the development of interventions to reduce these differences in care. ..

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..We will use these estimates to simulate the effect of changes in the age of Medicare eligibility on health, medical service use and Medicare expenditure. ..

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..Improved understanding of the impact of such service reductions in the obstetric market will result in more efficient use of health care services and optimize the value of health care dollars spent on obstetric care. ..

..In summary, this clinical trial will assess the efficacy and safety of inhaled nitric oxide for amelioration of a major disease of premature infants. ..

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..This study will provide systematic information on the nature and extent of HMO changes, and their impact on alcohol service delivery, during this time period. ..

..We hypothesize that this approach will enhance appropriate use of antimicrobials for both VAP and CAUTI and improve patient outcomes by reducing the known sequelae of antimicrobial overuse. ..

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..This intensive didactic and mentored training will allow for the development of a future independent pediatric clinical investigator. ..

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..They will also provide important information on trends in treatment patterns and shed light on the impact of health care system changes on the treatment of depression. ..

..The strength of the research team and the depth and breadth of the electronic medical record at the Marshfield Clinic make this the ideal setting for this RFA. ..

..Results of these analyses will provide an important information base for the development of policies and programs to improve the care of this under-studied group within the population living with HIV. ..

..This will clarify how youth mental health treatments are adopted in clinical settings, and will explore alternative methods for improving psychopharmacologic treatments for youths. ..

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..The significance of this project lies in its potential to help clinicians and policymakers assess and manage competing risk and benefit claims. ..