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PubMedDate not supplied

Online support functions of prescription order system and prescription audit in an integrated hospital information system.

The role of the online prescription support functions of a prescription order entry system was analysed and the results of the prescription audit by pharmacists were examined. In the Kochi Medical School Hospital, an online prescription order system has been developed as part of an integrated hospital information system named IMIS (the Integrated Medical Information System), in which all the physicians enter their prescription orders into online display terminals. The prescription order entry system is provided with prescription support functions, which check the entered prescription data, issue warnings, and offer information about drugs or patients. The prescription order system reduces the incidence of simple prescription mistakes and greatly decreases the cases of inquiries by pharmacists. However, results of the analysis show that such functions as warnings of double order and repeated prescription of a drug do not work as well as expected. The system would thus require some kind of intelligence like that of the auditing pharmacists or that of the physicians with accurate knowledge of clinical pharmacology.

Drug Prescriptions↗
PubMed1989

[Errors in prescriptions and control of prescriptions].

In Denmark, there is a tradition for strict control and safety measures in connection with prescribing and dispensing medicine in order to avoid undesirable or incorrect intake of medicine. The basis for this is the circular on dispensing from the Danish Board of Health which provides guidelines for composition of prescriptions by doctors and the control function by pharmacists. The object of this investigation is to describe the material of incorrect prescriptions which pharmacists are required to collect in connection with control of prescriptions. The investigation is based on material collected during a period of one month in the County of Arhus. The commonest type of erroneous prescription is incorrect statement of the strength of the preparation. This was found in 44.3% of the collected prescriptions. Another common problem is absence of the endorsement "for a child" and absence of the age of the child in prescriptions for these. In the material of incorrect prescriptions, statistically significantly more prescriptions were written by hospital doctors and secretaries. In contrast to ordinary prescriptions, telephone prescriptions are characterized a low frequency of errors as telephone prescriptions only constituted 8.2% of the erroneous material as compared with 47.8% in the conventional investigation. The authors consider that in a future revision of the circular on dispensing the requirement concerning repeated dispensing should be made more lenient and the indications and declarations of age should be more strict. Similarly, reduction in the synonymous preparations and the number of strengths should be reduced in order to facilitate clarity for the prescribing doctor.(ABSTRACT TRUNCATED AT 250 WORDS)

Denmark↗
PubMed1992

Multiple medication use in the elderly. Use of prescription and non-prescription drugs in an Australian community setting.

OBJECTIVE: To document the extent of polypharmacy or multiple medication use in the elderly. DESIGN: Cross-sectional examination of an age cohort of a community. SETTING: Community-based study in Dubbo, NSW, in 1988-1989. SUBJECTS: All non-institutionalised residents aged 60 years and over, numbering 1237 men and 1568 women. MAIN OUTCOME MEASURES: Assessment of use of prescription and non-prescription drugs, recent hospitalisation, years of education, psychosocial variables. RESULTS: 18% of men and 25% of women were currently using three or more classes of prescription drugs. The corresponding values for two or more classes of non-prescription drugs were 29% and 44%. Of those who were using multiple prescription drugs 56% of men and 76% of women were also using multiple non-prescription drugs. In a multiple logistic model, the following possible predictors of multiple drug use were included: hospitalisation in the last six months, age, sex, depression, life satisfaction and education. Multiple prescription drug use was significantly predicted by recent hospitalisation (odds ratio [OR] = 2.40; 95% confidence interval [CI], 1.63-3.56), increasing age (e.g. 70-79 years versus 60-69 years; OR = 2.54; CI, 1.97-3.25), female sex (OR = 1.59; CI, 1.25-2.01) and increasing depression (e.g. highest tertile of depression scale versus lowest; OR = 2.52; CI, 1.84-3.42). Multiple non-prescription drug use was significantly predicted by female sex (OR = 2.38; CI, 1.95-2.92) and increasing depression (OR = 2.77; CI, 2.16-3.56). For prescription items, non-prescription items, and both categories in combination levels of use 20% above the population average have been documented. CONCLUSIONS: Polypharmacy in the elderly population appears to be predicted by recent hospitalisation, increasing age, female sex and increasing depression. There is potential for drug-drug interaction to occur, but the findings suggest target areas for preventive action.

Aged↗
PubMed1992

Purchasing prescription medication in Mexico without a prescription. The experience at the border.

Prescription medication can often be purchased in Mexico without a physician's prescription. United States residents living along the border may have access to dangerous medications by crossing the border and purchasing them in Mexican pharmacies. We sought to determine the extent and frequency of this behavior in a sample of our ambulatory clinic population. Patients from the Texas Tech University Internal Medicine Clinic were surveyed to collect information about their use of medications, use of alternative sources of health care in Mexico, and purchasing of prescription medication in Juarez, Mexico. More than 80% of patients stated they had purchased prescription-type medication at a pharmacy without a physician's prescription. The most common reasons for buying prescription medication in Mexico were because it was less expensive or because a prescription was not necessary. These data indicate a potential for US residents along the border to take medications in an unregulated manner, a practice that could pose problems for health care providers on both sides of the border.

Adult↗
PubMed1989

[Prescription of psychopharmaceuticals in general practice. 3. Prescription of hypnotics].

In a multicentre-questionnaire investigation in general practice in the County of Arhus with participation of 66% of the general practitioners in the county, 1,516 prescriptions for hypnotics were registered during one week. 68% of the prescriptions were for women and 32% for men. The average ages of the patients were 65 and 64 years, respectively. The frequency of prescription increased markedly with age. 83% of the prescriptions and 85% of the hypnotics calculated in defined daily doses were benzodiazepines. The majority of the benzodiazepine hypnotics and sedatives prescribed had long half-lives. At the time of the first prescription of hypnotic, 31% of the patients were in a state of mental crisis while only 7% were so after medication for at least six years. In about 30% of the patients, a co-existing somatic disease contributed to a considerable extent to the prescription of the hypnotic while under 1/5 of the patients suffered from genuine mental illness. Approximately 20% of the patients were considered to be potential or genuine addicts. More than 80% of the renewed prescriptions occurred by indirect doctor-patient contact.

Adolescent↗
PubMed1979

[Prescription profile in French speaking Switzerland and in the Tessin. Analysis of 2006 medical prescriptions].

Analysis of 2006 prescriptions given to 641 unselected patients by 360 doctors in the French- and Italian-speaking parts of Switzerland provides a wealth of information on prescription trends and the cost of medicine. The patients ordinarily received medication belonging to several therapeutic groups, usually 2 or 3 but up to 9 different groups. Each prescription averaged 2.08 drugs with a mean cost of 18.90 Swiss francs. The price varied considerably according to the group of drugs. Those related to the cardiovascular system were the most expensive closely followed by antibiotics, while the ophthalmological prescriptions were the least expensive. Hydergine is the most-sold drug in Switzerland, followed by Bactrim; however, if the various benzodiazepines were grouped together their sale would exceed the others. There are 62 different drugs for rheumatic conditions and 47 penicillins in Switzerland. The abundance of drugs and the prescription of medication with dubious action contribute to the inflationary cost of illness. For any given drug there is a striking parallelism between the number of pages publicizing it in 4 medical journals and total sales. This clearly demonstrates the influence of advertising on prescription trends. Doctors should be aware of this fact and rely on more objective sources of their information about drugs.

Drug Prescriptions↗
PubMed1990

[The study of Chinese herbal medicinal prescription with enzyme inhibitory activity. IV. The study of the prescription containing mineral drug with adenosine 3',5'-cyclic monophosphate phosphodiesterase].

Twenty five Chinese herbal medicinal prescriptions containing gypsum, kaolin, longgu, oyster shell and sodium sulfate were studied for the inhibitory activity of adenosine 3',5'-cyclic monophosphate phosphodiesterase. The inhibitory activity of 15 prescriptions without mineral drug was higher than that of each original prescription. On the contrary, four were lower and six were not recognized to be different. All 11 prescriptions containing gypsum with an exception increased the inhibitory activity by removing gypsum. The half prescriptions containing kaolin or sodium sulfate also increased the inhibitory activity by removing the drug.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1988

Prescription sequence analysis: a new and fast method for assessing certain adverse reactions of prescription drugs in large populations.

Prescription sequence analysis (PSA) uses pharmacy-based prescription drug histories to detect a subset of drug effects: those that are themselves indications for changes in the prescribing of another drug. Dutch pharmacy practice ensures virtually complete drug histories. With a database of 25,000 patients, we used PSA to test an alleged link between the use of the anti-vertigo drug flunarizine and mental depression. The temporal sequence of anti-depressant use among flunarizine users shows no clustering that would suggest a causal link. PSA can be run within a few days, which may make it helpful in resolving certain of the periodic controversies about adverse drug reactions.

Antidepressive Agents↗
PubMed1991

Planning stereotactic surgery using the graphic prescription and explicit prescription MRI programs.

A method is described for planning stereotactic approaches to central nervous system lesions utilizing specialized programs contained within the GE sigma Magnetic Resonance Imaging scanner software. The graphic prescription program creates oblique scans relative to a localizer scan made in any standard orthogonal plane and the explicit prescription program creates slices perpendicular to any two chosen points. Using these programs to advantage, one can create an oblique coronal scan that contains the entry point, the approach tract and the target plus a series of cross sectional oblique scans perpendicular to and progressing along the approach track to the target. These scans can then be employed to modify a proposed approach so as to avoid blood vessels and other vital structures.

Brain↗
PubMed1987

[Hearing aid prescription in ENT practice. II. Forms of hearing aid construction and prescription of bilateral hearing aids].

The fundamental constructional types of hearing aids are box or pocket hearing aids, behind-the-ear devices and in-the-ear devices. Other special forms include hearing aid spectacles. The indications for prescription of the various constructional types are described with consideration of their advantages and disadvantages, supplemented by a comment on the legal aspects of prescription of in-the-ear aids. In binaural deafness, provision of hearing aids for both ears is to be regarded as the normal approach with careful observation of the limits of the indications. The advantages of hearing in both ears compared with monaural hearing, and the contra-indications to binaural provision of hearing aids are described in detail. The legal basis of binaural hearing aid provision is explained.

Auditory Threshold↗
PubMed1990

[General practitioners' training in psychiatry and prescription of psychotropic drugs. 2. Attitudes of physicians to training in psychotherapy and the extent of their prescriptions].

The object of this investigation was to describe and analyse differences in psychiatric training and attitudes to and employment of psychotropic drugs among general practitioners with and without training in psychotherapy, respectively. The investigation was carried out as a multicentre questionnaire investigation in the County of Aarhus with participation of 192 out of 215 (89%) doctors who were invited. Thirty-nine of the participating general practitioners (20%) had participated in a supervised course in psychoanalytically orientated psychotherapy. Doctors who were trained in psychotherapy had more rarely had appointments in psychiatric departments than other doctors. Doctors trained in psychotherapy prescribed fewer benzodiazepines than other doctors (p less than 0.05) and there was psychotherapy chose psychotherapy more frequently (p = 0.02) and more rarely tendency to a lower total prescription of psychotropic drugs. Doctors trained in a psychotropic drugs (p = 0.004) than doctors without this training as treatment for patients with psychosocial conflicts and they more rarely chose psychotropic drugs to supplement psychotherapy (p less than 0.0001). It is concluded that one of the ways of reducing the massive use of psychotropic drugs in Denmark is to improve general practitioners' training in psychotherapy.

Anti-Anxiety Agents↗
PubMed1990

[Drug prescription in myocardial postinfarction: results of the EPPI (étude de prescription postinfarctus). A French cooperative study].

An enquiry into the prescribing behaviour in patients discharged from hospital after myocardial infarction was performed in 36 hospital departments in France and included 528 patients. Each patient was prescribed an average of 3.6 drugs. The most commonly prescribed drug was Aspirin (63.3%) followed by the calcium antagonists (61.7%) long acting nitrate derivatives (49.5%) and betablockers (41.5%). These results suggest that many post-infarction prescriptions disregard recently acquired scientific knowledge.

Adrenergic beta-Antagonists↗
PubMed1989

Effect of a cancer chemotherapy prescription form on prescription completeness.

Completeness of physicians' orders for cancer chemotherapy was compared before and after implementation of a preprinted form for these orders. When an oncology pharmacy service (OPS) in which pharmacy prepared all drugs for cancer chemotherapy was implemented in 1985 at an 879-bed teaching hospital, the pharmacists began educational sessions for house-staff physicians on writing orders for cancer chemotherapy. Pharmacists assessed the effectiveness of these sessions by comparing completeness of orders written before implementation of the OPS with orders during a four-week period starting two months after implementation. Orders were checked for nine components: patient's diagnosis, height, weight, and body surface area and drug regimen, dose, dosage, frequency, and route. Inclusion of the same components was assessed after implementation of a form that physicians were required to use for prescribing all antineoplastic agents. During the baseline period, orders for 143 patients were evaluated. Only two prescription components, dose and route, were present is more than 90% of the orders. Educational intervention led to some improvement in order completeness, but only dose and route appeared in at least 90% of the 87 orders evaluated. The components necessary to verify physicians' calculations for body surface area and dose--height, weight, and dosage--were absent in 29 of the orders, and a pharmacist spent 420 minutes clarifying them. After the order form was implemented, orders for 77 patients were reviewed. Compliance exceeded 90% for eight of the nine components, and 12 medication errors were prevented by the form. A pharmacist spent 70 minutes clarifying five orders.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Agents↗