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Prescription Records (prescription + record)
Selected AbstractsHormone Use and Cognitive Performance in Women of Advanced AgeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004J. Galen buckwalter PhD Objectives: To explore the association between hormone replacement therapy (HRT) and cognitive performance in a group of elderly women (,75) using a battery of well-standardized neuropsychological instruments. Design: Equivalent samples from existing cohort. Setting: Healthcare provider organization. Participants: All women enrolled were participants in an ongoing study of the association between HRT and the prevalence and incidence of dementia. Prescription records were used to establish HRT status. Fifty-eight users and 47 nonusers of HRT participated in this substudy. Measurements: Given previous reports that HRT has a positive effect on verbal memory, the California Verbal Learning Test and the Logical Memory Test were used as primary outcomes. A range of validated tests that assess other cognitive domains was also included. Results: There were no significant differences between users and nonusers of HRT on any cognitive measures. Conclusion: Given equivalent groups of users and nonusers of HRT no support was found for the hypothesis that use of HRT improves cognitive performance in older women. [source] Usefulness of prescription monitoring programs for surveillance,analysis of Schedule II opioid prescription data in Massachusetts, 1996,2006,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 2 2010Nathaniel Katz Abstract Purpose Electronic prescription monitoring programs (PMPs) have been developed in many states as a public health surveillance tool. We analyze herein 11 years of Massachusetts PMP data to evaluate trends in opioid prescribing, dispensing, and usage. Methods Prescription records from the Massachusetts PMP for Schedule II opioids from fiscal year 1996 to 2006 were analyzed. ,Questionable activity' (potential ,doctor shopping') estimates were based on individual use of multiple prescribers and pharmacies, and early refills. Results The number of prescriptions, doses prescribed, and individuals receiving Schedule II prescription opioids steadily increased from 1996 to 2006. Most individuals (87.5%) used 1,2 prescribers, 1,2 pharmacies, and had no early refills (2006). The greater the number of prescribers used, the greater the number of pharmacies used. When defined as the use of ,4 prescribers and ,4 pharmacies, questionable activity accounted for 2748 individuals, 47,953 prescriptions, and 2,966,056 doses (2006). The Schedule II opioid most highly associated with questionable activity was short-acting oxycodone. Conclusions PMPs can become a useful public health surveillance tool to monitor the medical and non-medical use of prescription opioids and to inform public health and safety policy. Copyright © 2009 John Wiley & Sons, Ltd. [source] Antiepileptic drug utilization: a Danish prescription database analysisACTA NEUROLOGICA SCANDINAVICA, Issue 1 2001P. Rochat Objectives, The purpose of the study was to use prescription data from a Danish database to analyse and evaluate antiepileptic drug (AED) utilization, and compare with other prevalence studies. Methods, A Danish research database covering outpatient prescription data from a population of 471,873 persons was used. Prescription records on all patients prescribed AEDs during 1998 were retrieved. A cohort was extracted from the group of AED users. Results, We identified 5426 AED users. A total of 3756 of the 5426 AED users were included in our cohort. Of the subjects in the cohort 74% were on monotherapy, 19% used two AEDs and only 7% used three or more AEDs. The eight most frequent regimens were all monotherapy: carbamazepine, oxcarbazepine, phenobarbital, valproic acid, lamotrigine, clonazepam, phenytoin and primidon in that order. The estimated crude 1-year prevalence of AED use was 0.77% for women and 0.83% for men (P<0.001), and it increased with age for both genders. Conclusions, The prescription pattern reported here is in accordance with the general guidelines for the treatment of epilepsy in Denmark, except for a surprisingly extensive use of phenobarbital. With specific reservations the figures appear to be reasonable estimates of the prevalence of epilepsy. [source] New use of rosiglitazone decreased following publication of a meta-analysis suggesting harmDIABETIC MEDICINE, Issue 7 2008B. R. Shah Abstract Aims It is uncertain whether meta-analyses lead to changes in prescribing practices. We studied trends in the prescribing of glucose-lowering therapy before and after the publication of a meta-analysis suggesting harm from rosiglitazone. Methods We examined the prescription records of all residents of Ontario, Canada, aged , 66 years. For each week between January and December 2007, we identified new users of five categories of glucose-lowering medications: rosiglitazone, pioglitazone, metformin, glibenclamide (glyburide) and insulin. The effect of the meta-analysis was assessed using interventional autoregressive integrated moving-average models. Results Following the release of the meta-analysis, there was a sudden decline in new users of rosiglitazone (P = 0.01), mirrored by a nearly identical but transient increase in new users of pioglitazone (P < 0.001). There was also a net decline in new users of thiazolidinediones as a class (P < 0.001). The number of new users of other glucose-lowering medications did not change. Conclusions A highly-publicized meta-analysis regarding rosiglitazone's potential harms led to an abrupt decline in new users of the drug, as well as a transient surge in new use of pioglitazone. [source] Divalproex sodium vs. valproic acid: drug utilization patterns, persistence rates and predictors of hospitalization among VA patients diagnosed with bipolar disorderJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 6 2007S. U. Iqbal MBA MPH MD Summary Objectives:, To compare divalproex sodium and valproic acid for therapeutic patterns, persistence rates and predictors of hospitalization among bipolar patients on monotherapy in the Veterans Affairs (VA) healthcare system. Methods:, Using VA administrative data bases, we conducted a retrospective inception cohort study of VA patients', 18 years of age who had at least one outpatient diagnoses of bipolar disorder and two continuous prescription records for the study drugs in the VA PBM pharmacy database during the study period of 1st April 2001 to 30th September 2003. Persistence for the comparative drugs was reported as continuous variable and compared using t -tests. Logistic regression models were used to examine the risk of hospitalization whereas Cox proportional hazard regression models were used to evaluate the time to hospitalization and time to interruption of therapy for the two drug groups. Results:, We identified 4624 bipolar patients on monotherapy with valproic acid (n = 4036) and divalproex sodium (n = 588) during the study period. The descriptive statistics included sociodemographics, disability and comorbidity status and were similar for the two groups. For the crude persistence rates there were no statistically significant differences between divalproex sodium (120 days) and valproic acid (110 days). The logistic regression model for risk of hospitalization showed no statistically significant difference between the two comparators [odds ratio = 1·06, 95% confidence interval (CI) = 0·787,1·444]. The Cox model for time to interruption of therapy showed an insignificant hazard ratio (HR) for divalproex sodium vs. valproic acid (HR = 0·928, 95% CI = 0·844,1·020) and for time to hospitalization also no statistically significant difference in the HR for the two drugs (HR = 0·984, 95% CI = 0·784,1·295). Conclusion:, The study showed a comparable profile of generic valproic acid with divalproex sodium for persistence and predictors of hospitalization for bipolar patients on monotherapy in the VA. Results have important healthcare implications for treatment and costs. [source] The use of nationwide on-line prescription records improves the drug history in hospitalized patientsBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 2 2008Bente Glintborg What is already known about this subject ,,Structured medication interviews improve the medication history upon hospitalization ,,Pharmacy records are valid lists of the prescribed medications available to individual patients ,,In Denmark, treating doctors now have access to their patients' pharmacy records through a real-time online electronic database What this study adds ,,Omission errors are frequent among hospitalized patients despite structured drug interviews and home visits ,,Pharmacy records may be used to minimize patients' recall bias and improve the medication lists Background Structured medication interviews improve the medication history in hospitalized patients. In Denmark, a nationwide electronic version of individual pharmacy records (PR) has recently been introduced. Use of these records could improve the medication lists in hospitalized patients. Methods We prospectively included 500 patients admitted to an acute medical department. In individual patients, the PR was compared with (i) the medication list written in the patient chart and (ii) drug information provided by the patient during a structured drug interview upon admission and during a home visit after discharge. Results Median patient age was 72 years. Upon admission, patients reported using 1958 prescription-only medications (POM) (median four drugs per patient, range 0,14), of which 114 (6%) were not registered in PR. In PR, 1153 POM (median one per patient, range 0,11) were registered during the month preceding admission. The patients did not report 309 (27%) of these upon admission. Home visits were performed in a subgroup of 115 patients. During home visits, 18% of POM registered in PR during the preceding month were not reported. Drug type was predictive of reporting irrespective of patient sex or age. Cardiovascular drugs were reported most and dermatologicals were reported less frequently. Underreporting might be due to recall bias, non-adherence or discontinuation of drugs. Conclusions Omission errors are frequent despite structured medication interviews. Pharmacy records or medication lists from all treating doctors must be included in medication reviews in order to reduce recall bias. [source] | ||||||||||