3,850 results match your criteria prescribing recommendations

Going shopping or consulting in medical visits: Caregivers' roles in pediatric antibiotic prescribing in China.

Soc Sci Med 2021 May 25:114075. Epub 2021 May 25.

School of Law, Hunan University, No.2 Lushan Rd., Changsha, Hunan Province, 410082, China.

Antimicrobial Resistance (AMR) is one of the gravest global public health crises today. Over-prescription in clinical settings is a primary driver. Despite its magnitude and scale, the problem of antibiotic over-prescription in China has not been understood adequately nor addressed effectively. Read More

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Prescribing Antibiotics in Adults with Respiratory Tract Infections in Lebanon.

Int J Clin Pract 2021 Jun 12:e14514. Epub 2021 Jun 12.

Department of Family Medicine, American University of Beirut Medical Center (AUBMC, Beirut, Lebanon.

Background: Antibiotic resistance is a global concern that has significant health and economic burden. The inappropriate use of antibiotics is a major cause of antibiotic resistance; this includes both unnecessary and incorrect prescriptions. Most antibiotics are prescribed in primary care, mainly for respiratory tract infections. Read More

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Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): protocol for a cluster randomised controlled trial.

Trials 2021 Jun 11;22(1):390. Epub 2021 Jun 11.

Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT, Australia.

Background: Medication management in residential aged care facilities is an ongoing concern. Numerous studies have reported high rates of inappropriate prescribing and medication use in aged care facilities, which contribute to residents' adverse health outcomes. There is a need for new models of care that enhance inter-disciplinary collaboration between residential aged care facility staff and healthcare professionals, to improve medication management. Read More

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Association of the 2016 US Centers for Disease Control and Prevention Opioid Prescribing Guideline With Changes in Opioid Dispensing After Surgery.

JAMA Netw Open 2021 Jun 1;4(6):e2111826. Epub 2021 Jun 1.

Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Importance: While the 2016 US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids for chronic pain was not intended to address postoperative pain management, observers have noted the potential for the guideline to have affected postoperative opioid prescribing.

Objective: To assess changes in postoperative opioid dispensing after vs before the CDC guideline release in March 2016.

Design, Setting, And Participants: This cross-sectional study included 361 556 opioid-naive patients who received 1 of 8 common surgical procedures between March 16, 2014, and March 15, 2018. Read More

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Potentially Inappropriate Medication Use in Older Adults with Alzheimer's Disease and Related Dementias Living in the Community: A Cross-Sectional Analysis.

Drugs Real World Outcomes 2021 Jun 10. Epub 2021 Jun 10.

University of Kentucky College of Pharmacy, Lexington, KY, USA.

Background: With the older adult population in the USA increasing, so is the population of those with Alzheimer's disease and related dementias (ADRD). Older adults are vulnerable to the effects of potentially inappropriate medications as established by the Beers Criteria; however, some medications continue to be prescribed against recommendations.

Objectives: Our objectives were to describe potentially inappropriate medication (PIM) use linked to cognitive impairment or decline (referred to as Cog-PIM) in older adults with and without ADRD and to investigate whether the odds of Cog-PIM report differ by ADRD status in ambulatory care (i. Read More

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Clinical Impact of Reporting Coronary Artery Calcium Scores of Non-Gated Chest Computed Tomography on Statin Management.

Cureus 2021 May 5;13(5):e14856. Epub 2021 May 5.

Radiology, Brookwood Baptist Medical Center, Birmingham, USA.

Introduction Coronary artery calcium (CAC) scoring is used as a screening tool for patients with intermediate 10-year arteriosclerotic cardiovascular disease (ASCVD) risk. Results obtained on non-contrast non-gated chest CT (ngCCT) correlate well to those obtained on gated CTs. This paper aims to determine how the routine reporting of CAC scores on ngCCT scans with ASCVD risk of less than 12. Read More

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An Evaluation of the Use of Corticosteroids for the Management of Immune-Mediated Adverse Events in Cancer Patients Treated With Immune Checkpoint Inhibitors.

J Adv Pract Oncol 2021 Mar 1;12(2):137-145. Epub 2021 Mar 1.

Allegheny Health Network, Kittanning, Pennsylvania.

Immune checkpoint inhibitors (ICIs) have gained prominence for the treatment of a variety of malignancies. However, they are associated with the development of immune-mediated adverse events (IMAEs). Appropriate management of IMAEs and subsequent rechallenging of patients with ICI therapy remains an important area of research. Read More

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Evidence-Based Recommendations for Opioid Prescribing after Endourological and Minimally Invasive Urological Surgery.

J Endourol 2021 Jun 9. Epub 2021 Jun 9.

Johns Hopkins University School of Medicine, Baltimore, Maryland, United States;

Introduction: Procedure-specific guidelines for postsurgical opioid use can decrease overprescribing and facilitate opioid stewardship. Initial recommendations were based on feasibility data from limited pilot studies. This study aims to refine opioid prescribing recommendations for endourological and minimally invasive urological procedures by integrating emerging clinical evidence with a panel consensus. Read More

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PEARL study protocol: a real-world study of fremanezumab effectiveness in patients with chronic or episodic migraine.

Pain Manag 2021 Jun 9. Epub 2021 Jun 9.

Department of First Neurology, Aeginition Hospital, Medical School, National & Kapodistrian University of Athens, Athens, 11528, Greece.

Fremanezumab is a humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide and is approved in Europe for migraine prevention in adults with ≥4 migraine days/month. The Pan-European Real Life (PEARL) study is a 24-month, prospective, observational study of fremanezumab in chronic or episodic migraine. End points include proportion of patients with ≥50% reduction in monthly migraine days during 6 months of treatment (primary); changes in monthly migraine days, disability scores and acute headache medication use; adherence and persistence; and effectiveness in patients switching from another calcitonin gene-related peptide pathway-targeting monoclonal antibody. Read More

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Prescription attitudes and practices regarding clozapine among Serbian psychiatrists: results of a nationwide survey.

Ther Adv Psychopharmacol 2021 29;11:20451253211020235. Epub 2021 May 29.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Objective: Despite clozapine being the most effective treatment for treatment-resistant schizophrenia (TRS), a clear explanation as to why it is underutilized and why its initiation is delayed remains unclear. The first aim of the study was to conduct a nation-wide assessment of both the psychiatrists' attitudes of the obstacles for prescribing clozapine as well as their prescription practices. The second aim was to make recommendations, based on the results obtained, for improving the Serbian clozapine guidelines. Read More

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Characterization of Prophylactic Antimicrobial Therapy Practices for Patients With Marine-Associated Injuries in the Emergency Department.

J Pharm Pract 2021 Jun 8:8971900211021058. Epub 2021 Jun 8.

College of Pharmacy, 2629University of South Carolina, Columbia, SC, USA.

Background: Centers for Disease Control and Prevention (CDC) recommendations for the treatment of marine-associated wound infections include empiric coverage for species with a combination of a third-generation cephalosporin and doxycycline. These recommendations are based on limited data and it remains unclear if this regimen is also indicated for prophylaxis.

Objective: The purpose of this analysis was to assess the antibiotic regimens used in the emergency department (ED) for prophylaxis of marine-associated injuries relative to the CDC recommendations and evaluate any clinical impact. Read More

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A review of the evidence base for utilizing Child-Pugh criteria for guiding dosing of anticancer drugs in patients with cancer and liver impairment.

ESMO Open 2021 Jun 4;6(3):100162. Epub 2021 Jun 4.

Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.

As the liver is vital for the metabolism of many anticancer drugs, determining the correct starting doses in cancer patients with liver impairment is key to safe prescription and prevention of unnecessary adverse effects. Clinicians typically use liver function tests when evaluating patients; however, prescribing information and summaries of product characteristics often suggest dosing of anticancer drugs in patients with liver impairment based on the Child-Pugh criteria, even though the criteria were not developed for this purpose. In this review, we assessed all the oncological small molecule and cytotoxic drugs approved by the United States Food and Drug Administration (FDA) over a 5-year period from 2014 to 2018. Read More

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Changing Results to Change Results: Nudging Antimicrobial Prescribing for .

Open Forum Infect Dis 2021 Jun 16;8(6):ofaa605. Epub 2020 Dec 16.

University of Toronto, Faculty of Medicine, Toronto, Ontario, Cananda.

Background: Patients who test positive for by polymerase chain reaction (PCR), with a negative toxin enzyme immunoassay (EIA), are commonly colonized and do not require treatment. However, clinicians often treat based on a positive PCR result regardless of the toxin EIA result. We evaluated the clinical impact of a microbiology reporting nudge, changing from a report that included both assay results along with treatment recommendations to one that suggested clinicians consider colonization or early infection. Read More

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Redesign of computerized decision support system to improve Non Vitamin K oral anticoagulant prescribing-A pre and post qualitative and quantitative study.

Viviane Khalil

Int J Med Inform 2021 Aug 31;152:104511. Epub 2021 May 31.

Peninsula Health Pharmacy Department, 2 Hastings Rd, Frankston, Vic, 3199. Victoria, Australia; Monash University, Melbourne, Australia. Electronic address:

Background: Inappropriate prescribing of non-vitamin K agents (NOAC) contributes to significant economic and personal burden to our society. Studies have shown that when well designed and targeted, computerized alerts can be effective in improving prescribing without contributing to alert fatigue.

Method: A collaborative multidisciplinary review group was set up to review and endorse an upgrade and modification to the hospital electronic medication management system (EMS). Read More

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Monitoring and Managing Lorlatinib Adverse Events in the Portuguese Clinical Setting: A Position Paper.

Drug Saf 2021 Jun 3. Epub 2021 Jun 3.

Centro Hospitalar Universitário de São João, Porto, Portugal.

Rearrangements in the anaplastic lymphoma kinase (ALK) and proto-oncogene tyrosine-protein kinase ROS (ROS1) genes characterise two distinct molecular subsets of non-small cell lung cancer (NSCLC) tumours. Lorlatinib is a third-generation ALK/ROS1 tyrosine kinase inhibitor (TKI) shown to have systemic and intracranial activity in treatment-naive patients and in those who progressed on first- and second-generation TKIs. Despite being generally well tolerated, lorlatinib has a unique and challenging safety profile that includes hyperlipidaemia and central and peripheral nervous system adverse events (AEs). Read More

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Reducing the use of empiric antibiotic therapy in COVID-19 on hospital admission.

BMC Infect Dis 2021 Jun 2;21(1):516. Epub 2021 Jun 2.

Department of Medicine, Section of Infectious Diseases and Global Health, The University of Chicago Medicine, Chicago, IL, USA.

Background: Empiric antibiotics for community acquired bacterial pneumonia (CABP) are often prescribed to patients with COVID-19, despite a low reported incidence of co-infections. Stewardship interventions targeted at facilitating appropriate antibiotic prescribing for CABP among COVID-19 patients are needed. We developed a guideline for antibiotic initiation and discontinuation for CABP in COVID-19 patients. Read More

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A Systematic Review of Complex Polypharmacy in Bipolar Disorder: Prevalence, Clinical Features, Adherence, and Preliminary Recommendations for Practitioners.

J Clin Psychiatry 2021 Jun 1;82(3). Epub 2021 Jun 1.

Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.

Extensive combination pharmacotherapy regimens for bipolar disorder have gained increasing use in routine practice in ways that outpace data from evidence-based clinical trials. The present review examined the prevalence of complex pharmacotherapy regimens in bipolar disorder patients and sought to characterize factors that most influence polypharmacy prescribing patterns.

The authors independently systematically searched the MEDLINE, PsycINFO, and Embase databases for English-language observational/naturalistic or randomized controlled polypharmacy trials, using the keywords and or and and . Read More

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Antimicrobial Stewardship Interventions to Optimize Treatment of Infections in Nursing Home Residents: A Systematic Review and Meta-Analysis.

J Appl Gerontol 2021 Jun 2:7334648211018299. Epub 2021 Jun 2.

Columbia University School of Nursing, New York, NY, USA.

Effects of antibiotic stewardship program (ASP) interventions to optimize antibiotic use for infections in nursing home (NH) residents remain unclear. The aim of this systematic review and meta-analysis was to assess ASPs in NHs and their effects on antibiotic use, multi-drug-resistant organisms, antibiotic prescribing practices, and resident mortality. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we conducted a systematic review and meta-analysis using five databases (1988-2020). Read More

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Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?: A Scientific Statement From the American Heart Association.

Hypertension 2021 Jun 2:HYP0000000000000196. Epub 2021 Jun 2.

Current guidelines published by the American Heart Association and the American College of Cardiology broadly recommend lifestyle approaches to prevent and treat elevated blood pressure and cholesterol. For patients with mildly or moderately elevated blood pressure and blood cholesterol, lifestyle-only approaches are the first line of therapy. The purpose of this scientific statement is to: (1) highlight the mild-moderate-risk patient groups indicated for lifestyle-only treatment for elevated blood pressure or cholesterol; (2) describe recommendations, average effects, and additional considerations when prescribing lifestyle treatment with physical activity; and (3) provide guidance and resources for clinicians to assess, prescribe, counsel, and refer to support increased physical activity in their patients. Read More

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Multi-Institutional Implementation of Clinical Decision Support for and Genotyping in Antihypertensive Management.

J Pers Med 2021 May 27;11(6). Epub 2021 May 27.

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.

(1) Background: Clinical decision support (CDS) is a vitally important adjunct to the implementation of pharmacogenomic-guided prescribing in clinical practice. A novel CDS was sought for the , , and genes to guide optimal selection of antihypertensive medications among the African American population cared for at multiple participating institutions in a clinical trial. (2) Methods: The CDS committee, made up of clinical content and CDS experts, developed a framework and contributed to the creation of the CDS using the following guiding principles: 1. Read More

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Opioid-Induced In-Hospital Deaths: A 10-Year Review of Australian Coroners' Cases Exploring Similarities and Lessons Learnt.

Pharmacy (Basel) 2021 May 7;9(2). Epub 2021 May 7.

UniSA Clinical & Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.

Although opioids are the cornerstone of moderate-to-severe acute pain management they are appropriately recognised as high-risk medicines. Patient and health service delivery factors can contribute to an increased risk of death associated with excessive sedation and respiratory impairment. Despite increasing awareness of opioid-induced ventilation impairment (OIVI), no reliable method consistently identifies individual characteristics and factors that increase mortality risk due to respiratory depression events. Read More

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Appropriateness of Antibiotic Prescription for Prophylactic Purposes among Italian Dental Practitioners: Results from a Cross-Sectional Study.

Antibiotics (Basel) 2021 May 8;10(5). Epub 2021 May 8.

Department of Experimental Medicine, University of Campania ''Luigi Vanvitelli", Via L. Armanni, 5, 80138 Naples, Italy.

The primary objective of this study was to investigate the pattern of antibiotic prescription for prophylaxis purposes among Italian DPs (dental practitioners). A nationwide cross-sectional study was conducted using a multi-stage sampling design. A structured questionnaire was used to collect socio-demographic data and information about antibiotic prophylaxis (AP) prescriptions for selected dental diagnoses and surgical procedures. Read More

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Development and Pilot of an Interactive Online Course on Antimicrobial Stewardship in Companion Animals.

Antibiotics (Basel) 2021 May 20;10(5). Epub 2021 May 20.

Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Yalelaan 1, 3584 CL Utrecht, The Netherlands.

A holistic approach to antimicrobial use (AMU) and prescribing is needed to combat the problem of antimicrobial resistance (AMR). Previously, an antimicrobial stewardship programme (ASP) was developed, introduced, and evaluated in 44 Dutch companion animal clinics, which resulted in an optimization of AMU. As a follow-up to this, an online course was developed to promote awareness of AMU, AMR, and responsible antimicrobial prescribing. Read More

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Current Perspectives on the Attainment of Lipid Modification Goals Relating to the Use of Statins and Ezetimibe for the Prevention of Cardiovascular Disease in the United Kingdom.

Vasc Health Risk Manag 2021 21;17:227-237. Epub 2021 May 21.

Daiichi Sankyo UK Ltd, Uxbridge, UK.

Despite widespread evidence of the effectiveness of lipid modification for the reduction of cardiovascular disease (CVD) risk, lipid modification goals are commonly underachieved in the United Kingdom (UK). In order to understand current UK lipid management guidance and the corresponding attainment of recommended lipid lowering goals relating to treatment with statins and ezetimibe, a literature review was conducted using PubMed focusing on publications between January 2017 and February 2020 in order to capture the most up-to-date literature. Identified publications were reviewed against key clinical guidelines for lipid management in relation to CVD risk from the National Institute for Health and Care Excellence (NICE, CG181), the Scottish Intercollegiate Guidelines Network (SIGN, 149) and European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS). Read More

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Buprenorphine utilization among all Washington State residents' based upon prescription monitoring program data - Characteristics associated with two measures of retention and patterns of care over time.

J Subst Abuse Treat 2021 Aug 25;127:108446. Epub 2021 May 25.

Department of Medicine, University of Washington, Harborview Medical Center, 401 Broadway, Seattle, WA 98122, United States of America.

Background: Opioid use disorder is a serious health condition for which buprenorphine is proven effective, yet providers substantially underutilize buprenorphine. We present two approaches to measuring treatment duration, factors associated with retention, and patterns of care.

Methods: The study determined incident buprenorphine prescribing for all Washingtonians utilizing prescription monitoring program data from 2012 to 2019. Read More

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Comparison of two Borg exertion scales for monitoring exercise intensity in able-bodied participants, and those with paraplegia and tetraplegia.

Spinal Cord 2021 May 26. Epub 2021 May 26.

Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.

Study Design: Cross-sectional cohort study.

Objectives: To compare ratings of perceived exertion (RPE) on Borg's 6-20 RPE scale and Category Ratio 10 (CR10) in able-bodied (AB) participants during upper and lower body exercise, and recreationally active participants with paraplegia (PARA) and athletes with tetraplegia (TETRA) during upper body exercise only.

Setting: University and rehabilitation centre-based laboratories in UK and Netherlands. Read More

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Psychodermatology in Canada: A National Survey Assessment of Dermatologists' Perception, Practice Patterns, and Challenges.

J Cutan Med Surg 2021 May-Jun;25(3):249-256. Epub 2020 Dec 2.

3158 Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Canada.

Objectives: We aimed to assess the perception of psychodermatology, practice patterns, and challenges reported by Canadian dermatologists.

Methods: We designed an online questionnaire based on previous literature, including questions about practitioners' perceptions, practice patterns, training, and challenges in psychodermatology. We solicited their opinions on desired training, research needs, and clinical approach recommendations. Read More

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December 2020

Antibiotic Prophylaxis in Plastic Surgery Correlation Between Practice and Evidence.

Plast Surg (Oakv) 2021 May 2;29(2):132-138. Epub 2021 Mar 2.

Faculty of Medicine, University of British Columbia, Vancouver British Columbia, Canada.

Background: The use of appropriate preoperative antibiotic prophylaxis decreases the risk of surgical site infections (SSI); however, the breadth of plastic surgery procedures makes it challenging to ensure appropriate use for each unique procedure type. Currently, plastic surgeons lack a cohesive and comprehensive set of evidence-based guidelines (EBG) for surgical prophylaxis. We sought to profile the perioperative antibiotic prescribing patterns for plastic surgeons in British Columbia to investigate if they are congruent with published recommendations. Read More

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