drug utilization review
Summary: Formal programs for assessing drug prescription against some standard. Drug utilization review may consider clinical appropriateness, cost effectiveness, and, in some cases, outcomes. Review is usually retrospective, but some analysis may be done before drugs are dispensed (as in computer systems which advise physicians when prescriptions are entered). Drug utilization review is mandated for Medicaid programs beginning in 1993.
Publications229 found, 100 shown here
- Inappropriate drug combinations among privately insured patients with HIV diseaseFred J Hellinger
Center for Delivery Organization and Markets Agency for Healthcare Research and Quality, Rockville, Maryland 20850, USA
Med Care 43:III53-62. 2005..The objective of this study was to examine inappropriate drug combinations among privately insured patients with HIV disease...
- Appropriateness of prescribing among elderly patients in a Dutch residential home: observational study of outcomes after a pharmacist-led medication reviewClementine C M Stuijt
Department of Pharmacy, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
Drugs Aging 25:947-54. 2008..Pharmacy services are increasingly being targeted to minimize the overall number of unnecessary and potential harmful medicines...
- A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care databaseC A C Coupland
Division of Primary Care, University of Nottingham, Nottingham, UK
Health Technol Assess 15:1-202, iii-iv. 2011....
- Drug utilization and potentially inappropriate drug use in elderly residents of a community in Istanbul, TurkeyP Ay
Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
Int J Clin Pharmacol Ther 43:195-202. 2005..This study investigates drug utilization and estimates the prevalence of potentially inappropriate drug use in a Turkish population aged 70 years or older...
- Trends in prescribing and utilization of statins and other lipid lowering drugs across Europe 1997-2003T Walley
Department of Pharmacology and Therapeutics, University of Liverpool, 70 Pembrooke Place, Liverpool L69 3GF, UK
Br J Clin Pharmacol 60:543-51. 2005..To describe trends in utilization and prescribing of statins and other lipid lowering drugs across Europe from data in routine administrative databases...
- Computerized prescribing alerts and group academic detailing to reduce the use of potentially inappropriate medications in older peopleSteven R Simon
HMO Research Network Center for Education and Research in Therapeutics, Harvard Medical School and Harvard Pilgrim Healthcare, Boston, MA 02215, USA
J Am Geriatr Soc 54:963-8. 2006....
- Does home based medication review keep older people out of hospital? The HOMER randomised controlled trialRichard Holland
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ
BMJ 330:293. 2005..To determine whether home based medication review by pharmacists affects hospital readmission rates among older people...
- Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine unitsSuzan N Kucukarslan
Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI 48202, USA
Arch Intern Med 163:2014-8. 2003....
- Inappropriate prescribing of aminoglycosides: risk factors and impact of an antibiotic control teamJean Ralph Zahar
Service de Reanimation Medicale, Hôpital Henri Mondor AP HP, Creteil, France
J Antimicrob Chemother 58:651-6. 2006..We assessed prospectively the impact of an antibiotic control team on the appropriateness of prescriptions...
- Changes to psychotropic medications in the six months after admission to nursing homes in Melbourne, AustraliaDaniel W O'Connor
Aged Mental Health Research Unit, School of Psychology and Psychiatry, Monash University, Melbourne, Australia
Int Psychogeriatr 22:1149-53. 2010..Previous studies suggest that antipsychotic medications are often unnecessary and can be withdrawn without ill effects. Depression, in contrast, is believed to be under-recognized and under-treated...
- Hospital-level performance improvement: beta-blocker use after acute myocardial infarctionElizabeth H Bradley
Section of Health Policy and Administration, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06520, USA
Med Care 42:591-9. 2004....
- Inappropriate long-term use of antipsychotic drugs is common among people with dementia living in specialized care unitsMaria Gustafsson
Maria Gustafsson, Department of Pharmacology and Clinical Neuroscience, Umea University, 901 85, Umea, Sweden
BMC Pharmacol Toxicol 14:10. 2013..The aim of this study was to describe antipsychotic drug therapy among people with dementia living in specialized care units in northern Sweden...
- Prescription habits of dispensing and non-dispensing doctors in ZimbabweBirna Trap
Department of Social Pharmacy, Royal Danish School of Pharmacy, Copenhagen, Denmark
Health Policy Plan 17:288-95. 2002..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 use of conventional antipsychotic medications for patients with schizophrenia in a medicaid population: therapeutic and cost outcomes over 2 yearsJ S McCombs
Department of Pharmaceutical Economics and Policy, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
Value Health 3:222-31. 2000..To evaluate the association between drug therapy patterns achieved with conventional antipsychotics and direct healthcare costs over 2 years...
- Outcomes of an intervention to improve hospital antibiotic prescribing: interrupted time series with segmented regression analysisFaranak Ansari
Department of Clinical Pharmacology, University of Dundee, Dundee DD1 9SY, Dundee
J Antimicrob Chemother 52:842-8. 2003..To evaluate an intervention to reduce inappropriate use of key antibiotics with interrupted time series analysis...
- Antimicrobial stewardship--the state of the art in 2011: focus on outcome and methodsJohn E McGowan
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
Infect Control Hosp Epidemiol 33:331-7. 2012..Attention to evaluation methods must be increased to provide convincing evidence for the continuation of such programs...
- The gap between evidence-based medicine and daily practice in the management of paediatric asthma. A pharmacy-based population study from The NetherlandsTjalling W de Vries
Department of Paediatrics, Medical Centre Leeuwarden, P O Box 888, 8901 BR, Leeuwarden, The Netherlands
Eur J Clin Pharmacol 62:51-5. 2006..We evaluated the adherence to national guidelines for the treatment of asthma in childhood...
- Retrospective drug utilization review: incidence of clinically relevant potential drug-drug interactions in a large ambulatory populationCatherine C Peng
J Manag Care Pharm 9:513-22. 2003..incidence of clinically relevant potential drug-drug interactions (DDIs) in a large population of ambulatory patients utilizing a computerized, retrospective drug utilization review (DUR) program followed by clinical pharmacist audit.
- Antibiotic misuse: a prospective clinical audit in a French university hospitalC Pulcini
Service d Infectiologie, Hopital l Archet 1, Centre Hospitalier Universitaire de Nice, route St Antoine de Ginestière, BP 3079, 06202 Nice Cedex 3, France
Eur J Clin Microbiol Infect Dis 26:277-80. 2007..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...
- Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trialMirjam Christ-Crain
Division of Pneumology, University Hospitals, Petersgraben 4, CH 4031 Basel, Switzerland
Lancet 363:600-7. 2004..We aimed to assess a procalcitonin-based therapeutic strategy to reduce antibiotic use in lower respiratory tract infections with a new rapid and sensitive assay...
- Improving medication safety: influence of a patient-specific prescriber feedback program on rate of medication reviews performed by Australian general medical practitionersElizabeth Roughead
Quality Use of Medicines and Pharmacy Research Centre Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, Australia
Pharmacoepidemiol Drug Saf 16:797-803. 2007..To determine if patient-specific prescriber feedback for general medical practitioners (GPs), supported by educational material mailed to their patients, would increase home medicines review (HMR) rates...
- Determinants of the uptake of medicines use reviews (MURs) by community pharmacies in England: a multi-method studyFay Bradley
Centre for Innovation in Practice, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Oxford Road, Manchester M13 9PT, UK
Health Policy 88:258-68. 2008..To explore and identify the key determinants influencing the uptake of medicines use reviews (MURs), a new community pharmacy service in England...
- Why most interventions to improve physician prescribing do not seem to workSumit R Majumdar
Division of General Internal Medicine, Department of Medicine, University of Alberta, Walter Mackenzie Health Sciences Centre, Edmonton, Alta
CMAJ 169:30-1. 2003
- Procalcitonin-guided antibiotic use versus a standard approach for acute respiratory tract infections in primary care: study protocol for a randomised controlled trial and baseline characteristics of participating general practitioners [ISRCTN73182671]Matthias Briel
Basel Institute for Clinical Epidemiology, University Hospital Basel, CH 4031 Basel, Switzerland
BMC Fam Pract 6:34. 2005..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...
- Drug utilisation 90% profiles--a useful tool for quality assessment of prescribing in primary health care in StockholmBjörn Wettermark
Department of Medical Laboratory Sciences, Division of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden
Pharmacoepidemiol Drug Saf 12:499-510. 2003..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)...
- Implementation of a clinical decision support system for antimicrobial stewardshipElizabeth D Hermsen
Pharmacy Relations and Clinical Decision Support, Nebraska Medical Center, Omaha, Nebraska, USA
Infect Control Hosp Epidemiol 33:412-5. 2012....
- Patterns of antipsychotic and anticholinergic prescribing for hospital inpatientsCarol Paton
Oxleas NHS Trust, Pinewood House, Dartford, Kent, UK
J Psychopharmacol 17:223-9. 2003..Antipsychotic prescribing often deviates from recommended practice. Nursing staff have considerable discretion to administer large doses of antipsychotics on an 'as required' basis...
- Structure and markers of appropriateness, quality and performance of drug treatment over a 1-year period after hospital discharge in a cohort of elderly patients with cardiovascular diseases from GermanySebastian Harder
Pharmazentrum Frankfurt, Institute for Clinical Pharmacology, University Hospital Frankfurt am Main, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany
Eur J Clin Pharmacol 60:797-805. 2005..The lack of a patient's knowledge about their own medication is precarious...
- The impact of an intensive antimicrobial control program in a Taiwanese medical centerMing Tsung Chang
Department of Pharmacy, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
Pharm World Sci 28:257-64. 2006..The study evaluates the short term impacts of an intensive control program for the appropriate us of antimicrobials, and to provide a novel strategy for antimicrobial control in inpatient wards in Taiwan...
- Use of antibiotics in pediatric intensive care and potential savingsJ E Fischer
Department of Neonatology and Pediatric Intensive Care, University Children s Hospital, Zurich, Switzerland
Intensive Care Med 26:959-66. 2000..Because of the heterogeneity between units regarding patient mix and other characteristics, site-specific targets for reduction must be identified. Here we present a model to address the issue by means of an observational cohort study...
- Construction of the Korea Elderly Pharmacoepidemiologic Cohort: drug utilization review of cephalosporins in geriatric inpatientsB J Park
Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon Dong, Chongno Gu, Seoul 110 799, Korea
Pharmacoepidemiol Drug Saf 10:487-92. 2001..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 ..
- Aliskiren for the treatment of essential hypertension under real-life practice conditions: design and baseline data of the prospective 3A registryU Zeymer
Medizinische Klinik B, Klinikum Ludwigshafen, Ludwigshafen, Germany
Int J Clin Pract 66:251-61. 2012..So far little is known about the use and efficacy of aliskiren in the treatment of essential hypertension under clinical practice conditions...
- Effect of a retrospective drug utilization review on potentially inappropriate prescribing in the elderlyCatherine I Starner
Prime Therapeutics, Eagan, Minnesota, USA
Am J Geriatr Pharmacother 7:11-9. 2009..Although the literature suggests DAE are associated with negative health outcomes, educational interventions have had a positive impact on inappropriate prescribing...
- Audit and feedback to reduce broad-spectrum antibiotic use among intensive care unit patients: a controlled interrupted time series analysisMarion Elligsen
Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Infect Control Hosp Epidemiol 33:354-61. 2012..We aimed to rigorously evaluate the impact of prospective audit and feedback on broad-spectrum antimicrobial use among critical care patients...
- Assessing the accuracy of computerized medication historiesPeter J Kaboli
Center for Research in the Implementation of Innovative Strategies in Practice at the Iowa City VA Medical Center, Iowa City, Iowa, USA
Am J Manag Care 10:872-7. 2004..To determine the accuracy of computerized medication histories...
- Drugs of last resort? The use of polymyxins and tigecycline at US Veterans Affairs medical centers, 2005-2010Benedikt Huttner
VA Salt Lake City Health Care System and University of Utah, Salt Lake City, Utah, United States of America
PLoS ONE 7:e36649. 2012..Polymyxin use in particular is associated with the presence of MDR Gram-negative pathogens and may be useful as a surveillance measure in the future...
- Drug-related problems identified in post-discharge medication reviews for patients taking warfarinLeanne Stafford
Unit for Medication Outcomes Research and Education, School of Pharmacy, University of Tasmania, Private Bag 26, Hobart Tasmania 7001, Australia
Int J Clin Pharm 33:621-6. 2011....
- Implementation and outcomes of a hospital-wide computerised antimicrobial stewardship programme in a large medical centre in TaiwanYuk Ying Chan
Department of Pharmacy, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
Int J Antimicrob Agents 38:486-92. 2011..HCAAS is a sustainable system for providing antibiotic stewardship and exerts a positive impact on the hospital by reducing antimicrobial consumption and expenditure whilst not compromising healthcare quality...
- Parenteral to oral conversion of fluoroquinolones: low-hanging fruit for antimicrobial stewardship programs?Makoto Jones
IDEAS Center, VA Salt Lake City Health Care System, Salt Lake City, Utah 84148, USA
Infect Control Hosp Epidemiol 33:362-7. 2012..To estimate avoidable intravenous (IV) fluoroquinolone use in Veterans Affairs (VA) hospitals...
- Reducing antibiotic use in children: a randomized trial in 12 practicesJ A Finkelstein
Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts, USA
Pediatrics 108:1-7. 2001..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...
- A Quality Use of Medicines program for general practitioners and older people: a cluster randomised controlled trialSabrina W Pit
School of Medical Practice and Public Health, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
Med J Aust 187:23-30. 2007..To investigate the effectiveness of an educational Quality Use of Medicines program, delivered at the level of general practice, on medicines use, falls and quality of life in people aged > or = 65 years...
- Prescription practices of public and private health care providers in Attock District of PakistanS Siddiqi
Multi donor Support Unit, Social Action Programme, World Bank Bldg, Shatirah e Jamhuriyat, Sector G 5 1, Islamabad, Pakistan
Int J Health Plann Manage 17:23-40. 2002..Improper prescription practices will not improve without consumer targeted interventions that educate and empower communities regarding the hazards of inappropriate drug use...
- Surveillance of monthly antimicrobial consumption rates stratified by patient-care area: a tool for triggering and targeting antibiotic policy changes in the hospitalE I Kritsotakis
Department of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, University Hospital of Heraklion, Crete, Greece
J Chemother 18:394-401. 2006..Stratification of rates according to clinical service allowed areas of concern to be specified and targeted antibiotic policy changes to be initiated...
- Medication reviews in the community: results of a randomized, controlled effectiveness trialLene Sorensen
Theraputics Research Unit, Dept of Medicine, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Queensland 4102, Australia
Br J Clin Pharmacol 58:648-64. 2004..To examine the effectiveness of a multidisciplinary service model delivering medication review to patients at risk of medication misadventure in the community...
- How was patient empowerment portrayed in information leaflets describing the community pharmacy Medicines Use Review service in the UK?Melandi Van den Berg
Boots UK and Kingston University, UK
Patient Educ Couns 80:274-6. 2010..We investigated the depiction of the patient-pharmacist power relationship within MUR patient information leaflets...
- Antipsychotic medication coprescribing in a large state hospital systemAri B Jaffe
Nathan S Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA
Pharmacoepidemiol Drug Saf 12:41-8. 2003..To systematically characterize antipsychotic medication coprescribing ('polypharmacy') in a large state hospital system...
- New drug uptake: qualitative comparison of high and low prescribing GPs' attitudes and approachHelen Prosser
Prescribing Research Group, Department of Pharmacology and Therapeutics, The Infirmary, 70 Pembroke Place, Liverpool L69 3GF, UK
Fam Pract 20:583-91. 2003..Prescribing varies considerably between GPs, and a minority of GPs account for a large proportion of new drug prescribing...
- Antibiotic prescription practice in an intensive care unit using twice-weekly collection of screening specimens: a prospective audit in a large UK teaching hospitalM M Warren
The Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK
J Hosp Infect 59:90-5. 2005..After our audit, we stopped regular collection of screening samples and used more targeted and invasive sampling, in response to clinical suspicion, to guide therapy and maintain data concerning local microbial epidemiology...
- Prospective survey of antibiotic utilization in pediatric hospitalized patients to identify targets for improvement of prescriptionM Potocki
Division of Infectious Diseases, University Children s Hospital of Zurich, Steinwiesstrasse 75, CH 8032 Zurich, Switzerland
Infection 31:398-403. 2003..Little is known about the general misuse of antibiotics in hospitalized children. We evaluated the utilization of antibiotics in a pediatric teaching hospital aiming to identify targets for improvement of prescription...
- Professional status in a changing world: The case of medicines use reviews in English community pharmacyRuth McDonald
University of Nottingham, Business School and CLAHRC, Sir Colin Campbell Building, Triumph Road, Nottingham, United Kingdom
Soc Sci Med 71:451-8. 2010..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...
- Discrepancies between prescribed daily doses and WHO defined daily doses of antibacterials at a university hospitalArno Muller
Service d Hygiène Hospitalière, CHU Jean Minjoz, Besancon, France
Br J Clin Pharmacol 61:585-91. 2006..However, discrepancies exist between countries in terms of antibiotic dosage. The aim of the present study was to compare, for each antibacterial agent available at our university hospital, the prescribed daily doses (PDD) with the DDD...
- Inappropriate medication use among frail elderly inpatientsJoseph T Hanlon
Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, MN 55455, USA
Ann Pharmacother 38:9-14. 2004..Inappropriate prescribing in frail elderly inpatients has not received as much investigation as in frail elderly nursing home patients...
- Patterns of drug use during a 15 year period: data from a Swedish county, 1988--2002Louise Silwer
Apoteket AB, Halmstad and Nordic School of Public Health, Goteborg, Sweden
Pharmacoepidemiol Drug Saf 14:813-20. 2005..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...
- Antimicrobial consumption data from pharmacy and nursing records: how good are they?Gail S Itokazu
John H Stroger, Jr Hospital of Cook County, Division of Infectious Diseases, 637 S Wood St, Durand Building Room 110, Chicago, IL 60612, USA
Infect Control Hosp Epidemiol 26:395-400. 2005..To determine whether randomly selected intravenous (IV) antimicrobial doses dispensed from an inpatient pharmacy were administered...
- Multidisciplinary medication review in nursing home residents: what are the most significant drug-related problems? The Bergen District Nursing Home (BEDNURS) studyS Ruths
Section for Geriatric Medicine, Department of Public Health and Primary Health Care, University of Bergen, Norway
Qual Saf Health Care 12:176-80. 2003..Based on a multidisciplinary review of drug use in nursing home residents, this study aimed to identify the most frequent clinically relevant medication problems and to analyse them according to the drugs involved and types of problems...
- Differences between prescribed daily doses and defined daily doses of antiepileptics--therapeutic drug monitoring as a marker of the quality of the treatmentB Koristkova
Department of Clinical Pharmacology, Ostrava University Hospital and Medico Social Faculty, University of Ostrava, Czech Republic
Int J Clin Pharmacol Ther 44:438-42. 2006..Plasma levels were used as an indicator of the quality of treatment...
- Drug utilization review across jurisdictions--a reality or still a distant dream?Lisa K Pulver
School of Pharmacy, University of Queensland, 4072, Brisbane, QLD, Australia
Eur J Clin Pharmacol 62:97-106. 2006..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.
- Improving the performance of Drug and Therapeutics Committees in hospitals--a quasi-experimental study in LaosChu Vang
Department of Cardiology, Mahosot Hospital, Vientiane, P O Box 5202, Lao People s Democratic Republic Laos, and Nordic School of Public Health, Goteborg, Sweden
Eur J Clin Pharmacol 62:57-63. 2006....
- Ceftriaxone and cefotaxime use in Victorian hospitalsMarion B Robertson
Department of Clinical Pharmacology and Therapeutics, The Royal Melbourne Hospital, VIC 3050, Australia
Med J Aust 176:524-9. 2002..To determine patterns of use of ceftriaxone and cefotaxime (CEFX) in Victorian hospitals and to identify areas for improvement...
- Evaluation of an antimicrobial stewardship program at a pediatric teaching hospitalTalene A Metjian
Department of Pharmacy Services, The Children s Hospital of Philadelphia, PA 19104, USA
Pediatr Infect Dis J 27:106-11. 2008..Despite increased awareness about the benefits of these programs, few pediatric ASPs exist and fewer comprehensive studies evaluate their effects...
- Clinical medication review is effective in care homesArnold G Zermansky
BMJ 334:169-70. 2007
- Comparison of antibiotic dispensing data with administration data in intensive careT Solano
J Hosp Infect 58:87-8. 2004
- Surveillance of antibiotic use in hospitals: methods, trends and targetsE I Kritsotakis
Clin Microbiol Infect 12:701-4. 2006..When usage rates are supplemented and interpreted according to changes in hospital resource indicators, benchmarking is facilitated. This provides an efficient tool for triggering and targeting antibiotic control interventions...
- Evaluation of antibiotic use in intensive care units of a tertiary care hospital in TurkeyA Erbay
Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
J Hosp Infect 59:53-61. 2005..In particular, antibiotic use was inappropriate in surgical ICUs. Additional interventions such as postgraduate training programmes and elaboration of local guidelines could be beneficial...
- Determinants of the range of drugs prescribed in general practice: a cross-sectional analysisDinny H de Bakker
NIVEL Netherlands Institute for Health Services Research, PO Box 1568, Utrecht, The Netherlands
BMC Health Serv Res 7:132. 2007....
- Off-label use of medicines: consensus recommendations for evaluating appropriatenessMadlen Gazarian
University of New South Wales, Sydney, NSW, Australia
Med J Aust 185:544-8. 2006..This will reduce inappropriate use, enhance patient safety by reducing exposure to unnecessary risk, and may stimulate more clinically relevant medicines research...
- Indicators of prescribing quality in drug utilisation research: report of a European meeting (DURQUIM, 13-15 May 2004)J L Hoven
Department of Clinical Pharmacology, University of Groningen, The Netherlands
Eur J Clin Pharmacol 60:831-4. 2005....
- Current status of prospective drug utilization reviewThomas R Fulda
Center for the Advancement of Patient Safety U S Pharmacopeia, Rockville, Maryland, USA
J Manag Care Pharm 10:433-41. 2004The 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...
- The effect of pharmacotherapy audit meetings on early new drug prescribing by general practitionersStefan R Florentinus
Faculty of Science, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
Ann Pharmacother 41:319-24. 2007..In several countries, general practitioners (GPs) and pharmacists work closely together to ensure proper use of new drugs in clinical practice...
- Use of anti-asthmatic medications as a proxy for prevalence of asthma in children and adolescents in Norway: a nationwide prescription database analysisKari Furu
Department of Pharmacoepidemiology, Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403 Oslo, Norway
Eur J Clin Pharmacol 63:693-8. 2007..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...
- Longitudinal surveillance of antibiotic use in the hospitalD Raveh
Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem, Israel
QJM 94:141-52. 2001..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...
- Changes in prescribed drug doses after market introductionEibert R Heerdink
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences UIPS, The Netherlands
Pharmacoepidemiol Drug Saf 11:447-53. 2002..The aim of this study was to evaluate DDD changes over time (1982-2000) and to identify possible determinants of these changes...
- Improving prescribing patterns for the elderly through an online drug utilization review intervention: a system linking the physician, pharmacist, and computerM Monane
Department of Medical Affairs, Merck Medco Managed Care, LLC, Montvale, NJ 07645, USA
JAMA 280:1249-52. 1998..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...
- Off-label use of medicines in children: can available evidence avoid useless paediatric trials? The case of proton pump inhibitors for the treatment of gastroesophageal reflux diseaseGiovanni Tafuri
Utrecht Institute for Pharmaceutical Sciences, Utrecht University, P O Box 80 082, 3508 TB, Utrecht, The Netherlands
Eur J Clin Pharmacol 65:209-16. 2009..In some cases of drug therapy, the available evidence might be sufficient to extend the indications to children without further clinical studies...
- Drug utilization 90%--a simple method for assessing the quality of drug prescribingU Bergman
Karolinska Institute, Department of Medical Laboratory Sciences and Technology, WHO Collaborating Centre for Drug Utilization Research, Huddinge University Hospital, Sweden
Eur J Clin Pharmacol 54:113-8. 1998..To describe a simple method for assessing the quality of drug prescribing...
- Painful neuropathic disorders: an analysis of the Régie de l'Assurance Maladie du Québec databaseJ Lachaine
University of Montreal, Montreal, Quebec, Canada
Pain Res Manag 12:31-7. 2007..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...
- Optimizing antibiotic therapy-the Aberdeen experienceY Kumarasamy
Department of Medicine and Therapeutics, University of Aberdeen, Foresterhill, Aberdeen, UK
Clin Microbiol Infect 9:406-11. 2003....
- Improving benzodiazepine prescribing for elderly hospital inpatients using audit and multidisciplinary feedbackR A Elliott
Centre forApplied Gerontology, Bundoora Extended Care Centre, Melbourne, Victoria, Australia
Intern Med J 31:529-35. 2001..Benzodiazepines are commonly prescribed for older people. Inappropriate benzodiazepine prescribing may result in serious adverse effects, including confusion and falls...
- Drug utilization review of cholinesterase inhibitors in QuebecFadi Massoud
Can J Neurol Sci 35:508-9. 2008
- Inappropriate use of anti-asthmatic drugs in the Italian paediatric populationAntonio Clavenna
Laboratory for Mother and Child Health, Mario Negri Institute for Pharmacological Research, Milan, Italy
Eur J Clin Pharmacol 59:565-9. 2003..To evaluate anti-asthmatic drug prescriptions in a large Italian paediatric population...
- Retrospective drug utilization review, prescribing errors, and clinical outcomesSean Hennessy
Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia 19104 6021, USA
JAMA 290:1494-9. 2003Retrospective drug utilization review is required of all state Medicaid programs and is performed by most private-sector prescription programs...
- Off-label prescribing among office-based physiciansDavid C Radley
Center for Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH, USA
Arch Intern Med 166:1021-6. 2006..Despite concerns about patient safety and costs to the health care system, little is known about the frequency of off-label drug use or the degree of scientific evidence supporting this practice...
- Evaluation of cyclooxygenase 2 inhibitor use in patients admitted to a large teaching hospitalP G Landsberg
Department of Clinical Pharmacology, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Queensland 4102, Australia
Intern Med J 33:225-8. 2003..This raises questions regarding the appropriateness of prescribing...
- Prescription of fixed dose combination drugs for diarrhoeaAmit Chakrabarti
Department of Pharmacology, Sikkim Manipal Institute of Medical Sciences, Fifth Mile, Tadong, Gangtok 737 102, Sikkim, India
Indian J Med Ethics 4:165-7. 2007..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...
- [Antibiotic use in the pediatric population: factors to consider]V Olmo Quintana
Gobierno de Canarias, Farmaceutico, Grupo Urano Uso Racional de los Antibiotico Orales, Farmaceutico de Atencion Primaria, Canarias, Spain
Rev Esp Quimioter 20:409-20. 2007..Prescribing practices in Las Palmas are based on scientific data, probably because of the continuing education courses on antibiotherapy that began in 2003...
- Delay in filling the initial prescription for a statin: a potential early indicator of medication nonpersistenceAndrew Peng Yu
Department of Pharmaceutical Economics and Policy, School of Pharmacy, University of Southern California, Los Angeles, California, USA
Clin Ther 30:761-74; discussion 716. 2008..Identification of early predictors of medication nonpersistence may allow timely adherence-promoting interventions and potentially reduce the risk of negative health outcomes...
- Potentially inappropriate medication use in hospitalized eldersMichael B Rothberg
Division of General Medicine and Geriatrics, Department of Medicine, Baystate Medical Center, Springfield, Massachusetts 01199, USA
J Hosp Med 3:91-102. 2008..Prescribing of potentially harmful medications has not been well documented in hospitals...
- [General practitioners prescribed less antibiotics but used the CRP test more. Diagnosis-prescription studies in 2000-2005]Malin Andre
Centrum för klinisk forskning Dalarna
Lakartidningen 105:2851-4. 2008
- Identification of inappropriate drug prescribing by computerized, retrospective DUR screening in KoreaJong Hun Yeom
College of Medicine, Han Yang University, Seoul, Korea
Ann Pharmacother 39:1918-23. 2005..However, a high prevalence of inappropriate prescribing has been suspected by the public, pharmacists, and health insurance managers, possibly due to suboptimal DUR practice by pharmacists...
- Compliance with good practice in prescription writing at outpatient clinics in Saudi ArabiaY M Irshaid
Department of Clinical Pharmacology, College of Medicine, King Khalid University, Abha, Saudi Arabia
East Mediterr Health J 11:922-8. 2005..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...
- Changes in intravenous immunoglobulin prescribing patterns during a period of severe product shortages, 1995-2000J M Pendergrast
Canadian Blood Services, 67 College Street, Toronto, Ontario, Canada M5G 2M1
Vox Sang 89:150-60. 2005..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...
- Improved compliance with a gentamicin prescribing policy after introduction of a monitoring formMatthew S Rogers
Department of Microbiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry and Warwickshire Hospital, Stoney Stanton Road, Coventry CV1 4FH, UK
J Antimicrob Chemother 56:566-8. 2005..A gentamicin monitoring form was introduced with the aim of improving staff compliance with the policy thus minimizing the risks of toxicity while ensuring adequate dosing...
- Reliability of assessment of adherence to an antimicrobial treatment guidelineP G M Mol
Department of Clinical Pharmacology, University Medical Center Groningen, The Netherlands Pharmacy Department, University Medical Center Groningen, The Netherlands
J Hosp Infect 60:321-8. 2005..The level of agreement seems to be affected by combination therapy and the immune status of the patient...
- Acute rheumatic fever: adherence to secondary prophylaxis and follow up of Indigenous patients in the Katherine region of the Northern TerritoryTanya Stewart
Katherine District Hospital, Katherine, NT, Australia
Aust J Rural Health 15:234-40. 2007..We aimed to assess the rate of adherence with penicillin prophylaxis and follow-up guidelines in patients with previous ARF and the effect of factors such as age, sex, disease severity and clinic attendance...
- Drug utilization pattern in dental outpatients in tertiary care teaching hospital in western NepalSubish Palaian
Department of Hospital and Clinical Pharmacy, Manipal Teaching Hospital Manipal College of Medical Sciences, Pokhara, Nepal
N Y State Dent J 74:63-7. 2008..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...
- Making a case for employing a societal perspective in the evaluation of Medicaid prescription drug interventionsSanjoy Roy
Department of Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV 26505, USA
Pharmacoeconomics 26:281-96. 2008....
- Topical corticosteroids in infants: prescribing pattern and prescribing errors in BahrainKhalid A J Al Khaja
Department of Pharmacology and Therapeutics, Arabian Gulf University, P O Box 22979, Manama, Kingdom of Bahrain
Pharm World Sci 29:395-9. 2007..A nationwide, primary care-based prescription audit in infants to determine the prescribing pattern and prescribing errors of topical corticosteroid preparations in Bahrain...
- Potential influences on initiation and persistence of extramedical prescription pain reliever use in the US populationKrista Dowling
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
Clin J Pain 22:776-83. 2006..Extramedical prescription pain reliever use has generated much public concern; however, little is known regarding its epidemiology in the general population...
- Impact of the Hospital Pharmacy Initiative for promoting prudent use of antibiotics in hospitals in EnglandH J Wickens
Pharmacy Department, St Mary s NHS Trust, London W2 1NY, UK
J Antimicrob Chemother 58:1230-7. 2006..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...
- Effects of a step-therapy program for angiotensin receptor blockers on antihypertensive medication utilization patterns and cost of drug therapyKrista Yokoyama
WellPoint NextRx, West Hills, CA 91304, USA
J Manag Care Pharm 13:235-44. 2007..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...
- Evaluation of culture and antibiotic use in patients with pharyngitisJustin B Rufener
Department of Otolaryngology, Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
Laryngoscope 116:1727-9. 2006....
- Tools for Optimizing Prescribing, Monitoring and EducationBruce L Lambert; Fiscal Year: 2010..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...
- EFFECTIVENESS OF RETROSPECTIVE DRUG UTILIZATION REVIEWBRIAN STROM; Fiscal Year: 1999..b>Drug utilization review (DUR) is a procedure that seeks to reduce the consequences of improper prescribing...
- ASSESSING AMBULATORY DUR COST EFFECTIVENESSJacques Tremblay; Fiscal Year: 1980The objective of this project is to evaluate the cost-effectiveness of an ambulatory drug utilization review (DUR) program with respect to a traditional care process, in terms of quality and economy of prescribing...
- ASSESSING RECALL ACCURACY FOR PRESCRIPTION MEDICATIONSSuzanne West; Fiscal Year: 1991b>Drug utilization review (DUR) programs are conducted to improve the effectiveness of drug use and are instituted in a majority of managed care institutions...
- REDUCING GERIATRIC DRUG THERAPY--TWO APPROACHESHELENE LIPTON; Fiscal Year: 1993..outpatients by improving the quality of prescribing: 1) the application of a prospective computerized drug utilization review (DUR) system, and (2) ongoing clinical pharmacists' drug regimen reviews and consultations to providers...
- MEDICATION USE IN ASSESSING AND IMPROVING ASTHMA CONTROLTina Hartert; Fiscal Year: 2003..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 ..
- ALCOHOL & PRESCRIPTION DRUG INTERACTION IN THE ELDERLYFrank Ahern; Fiscal Year: 1991..significance for the design and implementation of programs that include alcohol-related information in drug utilization review, drug surveillance and drug education activities in existing and several newly-emerging federal and state ..
- Impact of Medicaid Policy on cardiovascular drug use and clinical outcomesMichael A Fischer; Fiscal Year: 2010....
- Effects of Mental Parity on High-Cost and Severely-Ill IndividualsHaiden A Huskamp; Fiscal Year: 2011..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. ..
- Economics of Formulary Design and Mental Health PolicyHaiden Huskamp; Fiscal Year: 2006..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. ..
- Impact of Medicaid Prescription Copayments in Patients with SchizophreniaJalpa Doshi; Fiscal Year: 2009..The findings of our study will help inform policymakers about the intended and unintended consequences of prescription copayments in Medicaid patients with schizophrenia. ..
- BENZODIAZEPINE USE AND RISK OF DISABILITY IN THE ELDERLYShelly Gray; Fiscal Year: 2003....
- Antidepressant Use and SuicideSusan Busch; Fiscal Year: 2009..The significance of this project lies in its potential to help clinicians and policymakers assess and manage competing risk and benefit claims. ..
- Predicting Transitions Among Community-Dwelling EldersIlene Zuckerman; Fiscal Year: 2008....
- Reducing Antimicrobial Use Associated with Ventilator Associated Pneumonia and CaSARA ELIZABETH COSGROVE; Fiscal Year: 2010..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. ..
- RISK FACTORS FOR PHENYTOIN TOXICITYSean Hennessy; Fiscal Year: 2005..abstract_text> ..
- Life Cycle Effects of Health Insurance on Elderly HealthJalpa Doshi; Fiscal Year: 2006..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. ..
- ADHERENCE TO PROTEASE INHIBITORS IN HIVRobert Gross; Fiscal Year: 2003..abstract_text> ..
- Managed problem solving: An HIV adherence trialRobert Gross; Fiscal Year: 2009..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. ..
- Perinatal Regionalization and Quality of CareScott Lorch; Fiscal Year: 2008..unreadable] [unreadable] [unreadable] [unreadable]..
- INHALED NO IN PREVENTION OF CHRONIC LUNG DISEASEScott Lorch; Fiscal Year: 2004..In summary, this clinical trial will assess the efficacy and safety of inhaled nitric oxide for amelioration of a major disease of premature infants. ..
- Statistical Methods in Diagnostic MedicineXiao Hua Zhou; Fiscal Year: 2007..Finally, we will develop general group sequential designs for comparative ROC studies using nonparametrically estimated ROC curves. [unreadable] [unreadable]..
- Cost-effectiveness of automated telephone outreach in patients with lung diseaseDavid H Smith; Fiscal Year: 2010..We will carry out an evaluation of the cost-effectiveness (efficiency) of the automated phone calls. (End of Abstract) ..
- Economic Evaluations of Emerging Genomic Tests for Early Stage Breast CancerYA CHEN SHIH; Fiscal Year: 2008..To estimate the budgetary impact of the emerging pharmacogenomic prognostic and/or predictive tests [unreadable] [unreadable] [unreadable]..
- National Impact of IT Investments on Hospital QualityStephen Parente; Fiscal Year: 2009..This research represents a collaborative effort of investigators at the University of Minnesota, Carnegie Mellon University, and the Medical University of South Carolina. ..
- Risk of Infectious Complications in Nosocomial PneumoniaDarren Linkin; Fiscal Year: 2008..abstract_text> ..
- A Team Model of Hypertension Care in African AmericansBonnie Svarstad; Fiscal Year: 2008..The study is unique because it tests relatively simple and low cost interventions in the community pharmacy, an environment which is one of the most readily accessible components of the health care system. ..
- Research Center on Managed Care and Drug Abuse TreatmentConstance Horgan; Fiscal Year: 2008..This pilot will explore the feasibility for a large-scale study of the incremental impact of adding a substance abuse treatment parity benefit to private health insurance in California. ..
- Reducing Barriers to Pain and Fatigue ManagementBetty Ferrell; Fiscal Year: 2009....
- Exploring the mistreatment of Native eldersLori Jervis; Fiscal Year: 2008..unreadable] [unreadable] [unreadable]..
- RCT to evaluate guidelines for acute rhinosinusitisJane Garbutt; Fiscal Year: 2008..In addition, knowledge gained from this research could be used to decrease the inappropriate use of antibiotics. [unreadable] [unreadable]..
- Novel Application of Infection Control Strategies to Limit Transmission of ESBL'SEbbing Lautenbach; Fiscal Year: 2008..unreadable] [unreadable] [unreadable]..
- RACIAL/ETHNIC DIFFERENCES AND THE ECONOMIC OF CAM USEKe Xu; Fiscal Year: 2006..unreadable]..
- Personal Digital Assistant for Guideline Adherence TrialDavid Goff; Fiscal Year: 2006..Hence, this innovative strategy holds great promise for making a substantial public health impact through the prevention of CVD and through subsequent translation to other important conditions. ..
- Stepped Pharmacotherapy for Aggressive Youth with ADHDJOSEPH BLADER; Fiscal Year: 2006..The proposed program will therefore culminate in the awardee's competence as a well-rounded clinical scientist focused on the complex treatment needs of youth with severe behavior disorders. ..
- QUINOLONE RESISTANCE IN NOSOCOMIAL URINARY INFECTIONSEbbing Lautenbach; Fiscal Year: 2004....
- Working Conditions & Adverse Events in Home Health CarePenny Feldman; Fiscal Year: 2003..It should lead to sounder intervention research and contribute to the broader literature on working conditions, service quality, and patient safety. ..
- MD Group Characteristics and Quality of Care for CHDBruce Landon; Fiscal Year: 2003..abstract_text> ..
- Why is Cardiac Risk Increased in Rheumatiod ArthritisDaniel Solomon; Fiscal Year: 2002..ability to control for known cardiovascular risk factors, the extensive medication information allowing for us to explore key hypotheses regarding corticosteroid exposure, and the attempt to simultaneously control for disease severity ..
- DCIS--MAMMOGRAPHIC FEATURES AND PROGNOSISLaurel Habel; Fiscal Year: 2003..abstract_text> ..
- UTILIZATION AND COST OF HEALTH SERVICES BY CDUsW Bradford; Fiscal Year: 2003....
- PATIENT AND PUBLIC EDUCATION IN CANCER PAIN MANAGEMENTBetty Ferrell; Fiscal Year: 2002..This course will impact 120 healthcare settings to improve pain management and quality of life in cancer patients and to establish model pain education programs for national dissemination. ..
- IMPROVING DIABETES CARE COLLABORATIVELY IN THE COMMUNITYMarshall Chin; Fiscal Year: 2001..While the interventions are designed to succeed in the particularly challenging CHC setting, the findings should be generalizable to health systems with more resources and to other chronic diseases. ..
- TREATMENT PREFERENCES OF OLDER PATIENTS WITH DIABETESMarshall Chin; Fiscal Year: 2001..abstract_text> ..
- Regression Analysis of Health Care CostsXiao Hua Zhou; Fiscal Year: 2004..Furthermore, contributions will be demonstrated in the area of health services research by applying the proposed methods to analyze of total health care costs in four existing datasets. ..
- Causal Analysis of Encouragement Design StudiesXiao Hua Zhou; Fiscal Year: 2004..In this proposal, we will develop a general statistical methodology for causal treatment analysis of the randomized EDS when data have a complicated structure. ..
- Racial Disparities in Diabetes in the US and the UKArch Mainous; Fiscal Year: 2005..abstract_text> ..
- Immune Thrombocytopenia and Low-Level Mercury ExposureJodi Segal; Fiscal Year: 2006..Segal with the necessary support for successful completion [unreadable] [unreadable] [unreadable]..
- Herpes Zoster and Medications in the ElderlyKenneth Schmader; Fiscal Year: 2005..The award fits into past and future career development by providing a bridge from earlier academic activities to the expansion of mentoring and research skills and to program leadership in geriatrics. ..
- End of Life Nursing Education through Graduate ProgramsBetty Ferrell; Fiscal Year: 2006..This proposal includes extensive evaluation planned to monitor individual and institutional dissemination. ..
- Conference on Assessing Quality of Care for DiabetesEve Kerr; Fiscal Year: 2005..abstract_text> ..
- Native Elders, Dementia and Family CaregivingLori Jervis; Fiscal Year: 2005....
- Mammographic Density in a Multi-Ethnic CohortLaurel Habel; Fiscal Year: 2005..abstract_text> ..
- Diversity of Antimicrobial Use and Emergence of Resistance in PseudomonasDarren Linkin; Fiscal Year: 2008..The results of our study will be generalizable to inpatients in tertiary acute care centers everywhere. [unreadable] [unreadable] [unreadable]..
- Clinical Impact of Quinolone-Resistant E.coli carriageEbbing Lautenbach; Fiscal Year: 2007..unreadable] [unreadable]..
- Approaches to Improve Youth Psychotropic ServicesSusan dosReis; Fiscal Year: 2007..This will clarify how youth mental health treatments are adopted in clinical settings, and will explore alternative methods for improving psychopharmacologic treatments for youths. [unreadable] [unreadable]..
- Depression Care Among Elderly Nursing Home ResidentsStephen Crystal; Fiscal Year: 2008....
- Mental Health Systems and Juvenile Justice OutcomesAlison Evans Cuellar; Fiscal Year: 2008..unreadable] [unreadable]..
- Major Mental Disorders and HIV -- Health Services UseStephen Crystal; Fiscal Year: 2009....