Trends and patterns of neurotology drug prescriptions on a nationwide insurance database

SummaryA computer-assisted system designed to write drug prescriptions and patient instructions has been in operation in a dermatologist’s office for two years. Almost all prescriptions are generated by the machine. Drug dosages, directions, and labeling phrases are retrieved from a diagnosis-oriented formulary of 300 drug products. A prescription template with preselected default options is displayed on a terminal screen where selection is made with the use of the video pointer. Typing skill is not required, as a detailed prescription can be produced from the use of only five function keys. Prescriptions and sets of relevant instructions for the patient are computer-printed. Therapy summaries for the medical record also are automatically composed and printed.

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A General Model of Drug Prescription

Methods of Information in Medicine ◽

10.1055/s-0038-1634606 ◽

1995 ◽

Vol 34 (04) ◽

pp. 310-317 ◽

Cited By ~ 6

Author(s):

B. Séné ◽

I. de Zegher ◽

C. Milstein ◽

S. Errore ◽

F de Rosis ◽

...

Keyword(s):

User Interface ◽

Life Events ◽

Drug Prescription ◽

Clinical Signs ◽

Object Oriented ◽

Drug Prescriptions ◽

Free Text ◽

Medical Procedures ◽

Dosage Regimens ◽

Structured Representation

Abstract:Currently, there is no widely accepted structured representation of drug prescription. Nevertheless, a structured representation is required for entering and storing drug prescriptions avoiding free text in computerized systems, and for drug prescription reviews. Derived from part of the work of the European OPADE project, we describe an object-oriented model of drug prescription which incorporates important concepts such as the phase and triggering event concepts. This model can be used to record all drug prescriptions, including infusions, in a structured way avoiding free text. The phase concept allows the storage of sequentially ordered dosage regimens for a drug within the same prescription. The prescription triggering event concept allows recording of the administration of a drug conditional to dates, symptoms and clinical signs, medical procedures, and everyday life events. This model has been implemented within the OPADE project; the corresponding aspects of the user interface are presented to show how this model can be used in practice. Even if other new attributes may be added to the described objects, the structure of this model is suitable for general use in software which requires the entry, storage and processing of drug prescriptions.

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Drug Prescriptions Associated with Long-acting. Pharmacoeconomic Aspects

10.26226/morressier.5885d714d462b8028d8918f9 ◽

2017 ◽

Author(s):

Fabio Tassi

Keyword(s):

Drug Prescriptions ◽

Long Acting

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Two-year continuation rates of long-acting reversible contraceptive methods: A cohort study in the French national healthcare insurance database

10.26226/morressier.5912d9ead462b80292385fcb ◽

2017 ◽

Author(s):

Aubert Agostini

Keyword(s):

Cohort Study ◽

Contraceptive Methods ◽

National Healthcare ◽

Healthcare Insurance ◽

Long Acting ◽

Long Acting Reversible Contraceptive ◽

Insurance Database ◽

Continuation Rates

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POLYPHARMACY IN ELDERLY OUT PATIENTS

Ulyanovsk Medico-biological Journal ◽

10.34014/2227-1848-2019-2-16-22 ◽

2019 ◽

pp. 16-22

Author(s):

E.A. Panova ◽

V.A. Serov ◽

A.M. Shutov ◽

N.N. Bakumtseva ◽

M.Yu. Kuzovenkova

Keyword(s):

Drug Therapy ◽

Elderly Patients ◽

Drug Prescription ◽

Daily Practice ◽

Drug Prescriptions ◽

Ulcer Disease ◽

Start Criteria ◽

Therapeutic Value ◽

Elderly Outpatients ◽

Oncological Diseases

The aim of the work is to study the daily practice of prescribing drugs at the outpatient stage of medical care and to analyze the data obtained based Beers 2012 criteria and STOPP / START version 1. Materials and Methods. The authors analyzed drug prescriptions for 150 outpatients, who were over 65 years old. Results. Cardiovascular diseases, diseases of the osteo-articular system and type 2 diabetes mellitus prevailed in the morbidity structure of patients. Oncological diseases, thyroid diseases, bronchial asthma, cataracts, pancreatitis, anemia, peptic ulcer disease were diagnosed in some patients. All drug prescriptions during the year were taken into account. Simultaneous prescription of more than 4 drugs was considered polypharmacy. All the patients were monitored for a year since drug prescriptions had been made. Death was taken as the end point. The authors considered drug therapy to be irrational according to Beers and STOPP / START criteria. The therapeutic value of drug prescription audit based on restrictive lists was evaluated. Conclusions. Polypharmacy is observed in more than half of elderly outpatients. According to Beers 2012 criteria, irrational drug therapy was detected in 20 % of elderly patients, according to STOPP and START lists – in 43.3 % and 66.6 %, respectively. The lack of drug prescriptions in accordance with START criteria is associated with increased mortality of elderly patients. Keywords: polypharmacy, pharmacotherapy, drug therapy, geriatrics, restrictive lists, Beers criteria, STOPP / START criteria. Цель работы – изучение ежедневной практики назначения лекарственных препаратов на амбулаторном этапе медицинской помощи и анализ полученных данных на основе критериев ограничительных перечней Бирса 2012 г. и STOPP/START версии 1. Материалы и методы. Проанализированы лекарственные назначения 150 пациентам старше 65 лет, находившимся на амбулаторном лечении. Результаты. В структуре заболеваемости пациентов преобладали сердечно-сосудистые заболевания, а также болезни костно-суставной системы и сахарный диабет 2-го типа. Онкологические заболевания, заболевания щитовидной железы, бронхиальная астма, катаракта, панкреатит, анемия, язвенная болезнь диагностированы у единичных больных. Учитывались все лекарственные назначения в течение года. За полипрагмазию принималось одновременное назначение более 4 препаратов. В течение последующего года отслеживалось состояние пациентов, за конечную точку принята смерть. Выявлена нерациональная лекарственная терапия на основе критериев Бирса и STOPP/START. Оценена терапевтическая значимость аудита лекарственных назначений по ограничительным перечням. Выводы. Полипрагмазия наблюдается более чем у половины амбулаторных пациентов пожилого возраста. На основе критериев ограничительных перечней Бирса 2012 г. нерациональная лекарственная терапия выявлена у 20 % пациентов пожилого возраста, на основе критериев STOPP и START – у 43,3 и 66,6 % соответственно. Отсутствие назначений лекарств в соответствии с критериями START ассоциировано с увеличением смертности пациентов пожилого возраста. Ключевые слова: полипрагмазия, фармакотерапия, лекарственная терапия, гериатрия, ограничительные перечни, критерии Бирса, критерии STOPP/START.

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What about regular hematological monitoring during clozapine treatment? A compliance analysis using the French Health Insurance Database

Expert Opinion on Drug Safety ◽

10.1080/14740338.2021.1939304 ◽

2021 ◽

Author(s):

Edouard-Jules Laforgue ◽

Marion Istvan ◽

Marylène Guerlais ◽

Anicet Chaslerie ◽

Pascal Artarit ◽

...

Keyword(s):

Health Insurance ◽

Clozapine Treatment ◽

Health Insurance Database ◽

Insurance Database

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Epidemiology of systemic sclerosis: a multi-database population-based study in Tuscany (Italy)

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-021-01733-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Alessio Coi ◽

◽

Simone Barsotti ◽

Michele Santoro ◽

Fabio Almerigogna ◽

...

Keyword(s):

Systemic Sclerosis ◽

Rare Diseases ◽

Severe Disease ◽

Pulmonary Involvement ◽

Population Based ◽

Vital Statistics ◽

Drug Prescriptions ◽

Malignant Neoplasms ◽

Lower Survival ◽

Treatment And Prevention

Abstract Background Systemic Sclerosis (SSc) is a chronic autoimmune disease with a complex pathogenesis that includes vascular injury, abnormal immune activation, and tissue fibrosis. We provided a complete epidemiological characterization of SSc in the Tuscany region (Italy), considering prevalence and incidence, survival, comorbidities and drug prescriptions, by using a multi-database population-based approach. Cases of SSc diagnosed between 1st January 2003 and 31st December 2017 among residents in Tuscany were collected from the population-based Rare Diseases Registry of Tuscany. All cases were linked to regional health and demographic databases to obtain information about vital statistics, principal causes of hospitalization, complications and comorbidities, and drug prescriptions. Results The prevalence of SSc in Tuscany population resulted to be 22.2 per 100,000, with the highest prevalence observed for the cases aged ≥ 65 years (33.2 per 100,000, CI 95% 29.6–37.3). In females, SSc was predominant (86.7% on the total) with an overall sex ratio F/M of 6.5. Nevertheless, males presented a more severe disease, with a lower survival and significant differences in respiratory complications and metabolic comorbidities. Complications and comorbidities such as pulmonary involvement (HR = 1.66, CI 95% 1.17–2.35), congestive heart failure (HR = 2.76, CI 95% 1.80–4.25), subarachnoid and intracerebral haemorrhage (HR = 2.33, CI 95% 1.21–4.48) and malignant neoplasms (HR = 1.63, CI 95% 1.06–2.52), were significantly associated to a lower survival, also after adjustment for age, sex and other SSc-related complications. Disease-modifying antirheumatic drugs, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors were the drugs with the more increasing prevalence of use in the 2008–2017 period. Conclusions The multi-database approach is important in the investigation of rare diseases where it is often difficult to provide accurate epidemiological indicators. A population-based registry can be exploited in synergy with health databases, to provide evidence related to disease outcomes and therapies and to assess the burden of disease, relying on a large cohort of cases. Building an integrated archive of data from multiple databases linking a cohort of patients to their comorbidities, clinical outcomes and survival, is important both in terms of treatment and prevention.

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