Sample pharmacy records

2020 ◽  
pp. 227-228
Keyword(s):  
Pharmacy Records

Infection with antiretroviral-susceptible HIV in an individual adherent to pre-exposure prophylaxis: strategies for treatment initiation

2021 ◽  
pp. 095646242097112
Author(s):  
Jessica M Hughes ◽  
Darrell HS Tan ◽  
Peter Anderson ◽  
Janani Bodhinayake ◽  
Paul A MacPherson
Keyword(s):  
Viral Load ◽  
Copy Number ◽  
Case Reports ◽  
Pharmacy Records ◽  
Treatment Regimens ◽  
Viral Copy Number ◽  
Low Copy Number ◽  
Viral Copy ◽  
Exposure Prophylaxis ◽  
Tenofovir Diphosphate

HIV pre-exposure prophylaxis (PrEP) is effective at preventing sexual acquisition of HIV, and failures in clinical trials are largely attributable to medication nonadherence. We report here a case of infection with a fully susceptible strain of HIV in an individual adherent to PrEP as demonstrated by pharmacy records and intracellular tenofovir diphosphate levels. At diagnosis, the viral load was 90 copies/mL precluding initial genotype testing due to low copy number. While PrEP failure is rare, this case underscores the importance of regular HIV testing for patient on PrEP and prompts discussion regarding the approach to treatment following failure where an initial genotype is not yet available or not possible due to low viral load. Few other case reports of PrEP failure exist in the literature and approaches to treatment varied widely. We suggest the initial viral copy number may guide next steps and discuss the risks and benefits of stopping PrEP, escalating therapy with integrase inhibitors or boosted protease inhibitors, or switching to non-nucleoside antiretroviral treatment regimens.

Comparison of Prescription and Medical Records in Reflecting Patient Antihypertensive Drug Therapy

1994 ◽  
Vol 28 (1) ◽  
pp. 99-104 ◽  
Author(s):  
Dale B. Christensen ◽  
Barbara Williams ◽  
Harold I. Goldberg ◽  
Diane P. Martin ◽  
Ruth Engelberg ◽  
...  
Keyword(s):  
Medical Record ◽  
Medical Records ◽  
Health Maintenance Organizations ◽  
Antihypertensive Drug Therapy ◽  
Antihypertensive Medications ◽  
Pharmacy Records ◽  
Health Maintenance ◽  
Computer Based ◽  
High Level ◽  
Level Of Agreement

OBJECTIVE: To determine the completeness of prescription records, and the extent to which they agreed with medical record drug entries for antihypertensive medications. SETTING: Three clinics affiliated with two staff model health maintenance organizations (HMOs). PARTICIPANTS: Randomly selected HMO enrollees (n=982) with diagnosed hypertension. METHODS: Computer-based prescription records for antihypertensive medications were reviewed at each location using an algorithm to convert the directions-for-use codes into an amount to be consumed per day (prescribed daily dosage). The medical record was analyzed similarly for the presence of drug notations and directions for use. RESULTS: There was a high level of agreement between the medical record and prescription file with respect to identifying the drug prescribed by drug name. Between 5 and 14 percent of medical record drug entries did not have corresponding prescription records, probably reflecting patient decisions not to have prescriptions filled at HMO-affiliated pharmacies or at all. Further, 5–8 percent of dispensed prescription records did not have corresponding medical record drug entry notations, probably reflecting incomplete recording of drug information on the medical record. The percentage of agreement of medical records on dosage ranged from 68 to 70 percent across two sites. Approximately 14 percent of drug records at one location and 21 percent of records at the other had nonmatching dosage information, probably reflecting dosage changes noted on the medical record but not reflected on pharmacy records. CONCLUSIONS: In the sites studied, dispensed prescription records reasonably reflect chart drug entries for drug name, but not necessarily dosage.

scholarly journals Using Automated Pharmacy Records to Assess the Management of Tuberculosis

1999 ◽  
Vol 5 (6) ◽  
pp. 788-791 ◽  
Author(s):  
Girish S. Subramanyan ◽  
Deborah S. Yokoe ◽  
Sharon Sharnprapai ◽  
Edward Nardell ◽  
Eugene McCray ◽  
...  
Keyword(s):  
Pharmacy Records

scholarly journals Utilizing Pharmacy Records to Assess Antibiotic Prescribing Patterns on the Incidence of Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections in Children

2007 ◽  
Vol 12 (2) ◽  
pp. 91-101
Author(s):  
Peter N. Johnson ◽  
Robert P. Rapp ◽  
Christopher T. Nelson ◽  
J.S. Butler ◽  
Sue Overman ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Prescribing Patterns ◽  
Control Group ◽  
Antibiotic Prescribing ◽  
Antibiotic Exposure ◽  
Pharmacy Records ◽  
Methicillin Resistant ◽  
Prior Antibiotic Therapy

OBJECTIVE To assess the effect of prior antibiotic therapy on the incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in children. METHODS This was a concurrent and retrospective review of antibiotic records for children < 18 years of age with documented CA-MRSA infection identified between January 1, 2004, and December 31, 2005. Antibiotic records were compared against a control group. The primary outcome was the incidence of CA-MRSA using linear regression as a function of age and prior antibiotic therapy (i.e., 3 months prior to admission). Secondary objectives included a comparison of antibiotic courses and classes and a description of antibiotic susceptibilities in patients with CA-MRSA RESULTS Data from 26 patients were included. Nine out of 51 patients (18%) with CA-MRSA were included. Another 17 children were enrolled in the control group. The median age was approximately 1.75 years (0.08–14 years) in the CA-MRSA group versus 2.75 years (0.005-15 years) in the control group. A statistical difference was noted in the number of patients with prior antibiotic exposure between the CA-MRSA and control group, 8 (88.9%) versus 6 (35.3%), respectively (P = .01). Antibiotic exposure was found to be a significant independent risk factor (P = .005; 95% CI, 0.167–0.846) for the development of CA-MRSA. The interaction between antibiotic exposure and age < 3 was the most significant predictor of CA-MRSA (P = .019; 95% CI, 0.139–1.40). CONCLUSIONS Prior antibiotic therapy in patients < 3 years of age was associated with a significant risk of developing CA-MRSA. A comprehensive assessment of CA-MRSA patients should include objective methods of measuring prior antibiotic exposure such as pharmacy records.

scholarly journals Clozapine & constipation: an audit of bowel habit monitoring and laxative prescribing in inpatients on clozapine

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S67-S67
Author(s):  
Holly Boyd ◽  
Anna Manso de Zuniga
Keyword(s):  
Side Effects ◽  
Mortality Rate ◽  
Bowel Habit ◽  
Prescribing Practices ◽  
Pharmacy Records ◽  
Bowel Ischaemia ◽  
Bowel Habits ◽  
Current Medication ◽  
Life Threatening ◽  
Audit Standard

AimsTo establish how often bowel habits are monitored in inpatients on clozapineTo determine how many of these patients are prescribed laxatives and whether these are utilisedBackgroundIt's estimated that 30-60% of patients will suffer from constipation whilst on clozapine; this can lead to ileus, intestinal obstruction and bowel ischaemia, all of which can be fatal. Constipation is much more common than clozapine-induced blood dyscrasias, and has a higher mortality rate. Despite this, there is no strict universal framework for bowel habit monitoring equivalent to the compulsory FBC monitoring. Local trust guidance indicates that bowel habits should be monitored regularly, at least at any point of blood sampling. However, monitoring processes across the trust were noted to be variable, as were laxative prescribing practices.MethodThe data sample of current inpatients on clozapine across the trust was identified from pharmacy records. The patient's Rio notes from the preceding 3 months were searched for predetermined terms relating to bowel habits and constipation, and the notes were then analysed for assessment of bowel habit. The number of FBCs collected during this 3 month period was then used to produce comparison with the audit standard. The data on laxative prescribing were collected from current medication lists on EPMA.ResultA data sample of 31 current inpatients was identified. The audit found that only 54.8% (17) of patients had their bowel habits monitored at least with every FBC taken. There was significant variability between different wards, with the best performing ward having 100% adherence to the audit standard, and the worst performing having 0%. In terms of laxative prescribing, it was found that 87.1% (27) of patients had at least 1 regular or 1 PRN laxative prescribed. Regular laxatives were prescribed for 61.2% (19) of patients, whereas only PRN laxatives were prescribed in 25.8% (8) of patients. Of those prescribed only PRN laxatives, only 50% (4) ever utilised this medication.ConclusionBowel habits are not consistently monitored across the trust in inpatients on clozapine, leaving room for potentially life-threatening side effects to be missed. Additionally, regular laxative prescribing is not standard throughout the trust, which could further add to the potential for significant constipation-related morbidity to occur. A standard method of monitoring bowel habits throughout the trust, as well as a trust laxative prescribing policy, could be a way of remedying this issue and preventing harmful outcomes for our patients on clozapine.

scholarly journals An algorithm to identify medication nonpersistence using electronic pharmacy databases

2015 ◽  
Vol 22 (5) ◽  
pp. 957-961 ◽  
Author(s):  
Melissa M Parker ◽  
Howard H Moffet ◽  
Alyce Adams ◽  
Andrew J Karter
Keyword(s):  
Healthcare Systems ◽  
Healthcare Operations ◽  
Timely Manner ◽  
Pharmacy Records ◽  
Grace Period ◽  
Adult Diabetes ◽  
Primary Nonadherence ◽  
Medication Taking Behavior ◽  
Novel Algorithm

Abstract Objective Identifying patients who are medication nonpersistent (fail to refill in a timely manner) is important for healthcare operations and research. However, consistent methods to detect nonpersistence using electronic pharmacy records are presently lacking. We developed and validated a nonpersistence algorithm for chronically used medications. Materials and Methods Refill patterns of adult diabetes patients (n = 14,349) prescribed cardiometabolic therapies were studied. We evaluated various grace periods (30-300 days) to identify medication nonpersistence, which is defined as a gap between refills that exceeds a threshold equal to the last days’ supply dispensed plus a grace period plus days of stockpiled medication. Since data on medication stockpiles are typically unavailable for ongoing users, we compared nonpersistence to rates calculated using algorithms that ignored stockpiles. Results When using grace periods equal to or greater than the number of days’ supply dispensed (i.e., at least 100 days), this novel algorithm for medication nonpersistence gave consistent results whether or not it accounted for days of stockpiled medication. The agreement (Kappa coefficients) between nonpersistence rates using algorithms with versus without stockpiling improved with longer grace periods and ranged from 0.63 (for 30 days) to 0.98 (for a 300-day grace period). Conclusions Our method has utility for health care operations and research in prevalent (ongoing) and new user cohorts. The algorithm detects a subset of patients with inadequate medication-taking behavior not identified as primary nonadherent or secondary nonadherent. Healthcare systems can most comprehensively identify patients with short- or long-term medication underutilization by identifying primary nonadherence, secondary nonadherence, and nonpersistence.

Evaluation of Glipizide and Glyburide in a Health Maintenance Organization

1992 ◽  
Vol 26 (10) ◽  
pp. 1215-1220 ◽  
Author(s):  
Margaret A. Noyes ◽  
Barry L. Carter ◽  
Dennis K. Helling ◽  
William C. McCormick ◽  
Ramie Ramirez
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Statistical Difference ◽  
Fasting Blood Glucose ◽  
Health Maintenance Organization ◽  
Percentage Increase ◽  
Pharmacy Records ◽  
Health Maintenance ◽  
Daily Dose

OBJECTIVE: To determine if there was a difference in the long-term glycemic control, average daily dose, and cost of therapy in patients with noninsulin-dependent diabetes mellitus (NIDDM) treated with glyburide and glipizide in a health maintenance organization (HMO). DESIGN: Retrospective evaluation of medical and pharmacy records. SETTING: Multispecialty group practice HMO. PATIENTS: 140 NIDDM patients being treated with either glyburide (n=70) or glipizide (n=70) were randomly selected from the populations of patients receiving either drug using computerized pharmacy records. MAIN OUTCOME MEASURE: Mean daily doses and blood glucose measurements (fasting blood glucose, random blood glucose, hemoglobin A1C) were stratified in 3-month periods from the time the drug therapy was started or the patient first presented to the clinic for a total of 18 months. Long-term glycemic control was defined as fasting blood glucose <8.33 mmol/L (150 mg/dL). RESULTS: The groups were comparable with regard to age (53.4 y glyburide, 56.7 y glipizide), gender (43 M:27 F glyburide, 47 M:23 F glipizide), race (38 W/16 B/16 H glyburide, 45 W/16 B/9 H glipizide), concurrent medical conditions, adverse effects, and compliance. Long-term glycemic control was similar in both groups. Although the number of subjects who were controlled (by definition) tended to be greater in the glyburide group, no clinical or statistical difference was found. There was no statistical difference in mean daily dose between the ethnic groups, but the small numbers preclude further analysis. The glipizide group had a larger percentage increase in dose within the first year than did the glyburide group; however, the percentage increase from the 3-month dose was similar after 18 months (22.7 percent glyburide, 27.5 percent glipizide.) Average daily cost of therapy, based on mean daily dose, was slightly lower for glyburide-treated patients. CONCLUSIONS: If glycemic control is similar with glyburide and glipizide, as seen in this study, economic considerations regarding choice of therapy and formulary inclusion may be appropriate.

The use of palliative sedation for intractable symptoms in a palliative care unit (PCU) in a comprehensive cancer center

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8577-8577 ◽  
Author(s):  
A. Elsayem ◽  
E. Curry ◽  
J. Boohene ◽  
H. Ibrahim ◽  
E. Pace ◽  
...  
Keyword(s):  
Palliative Care ◽  
Head And Neck ◽  
Poor Prognosis ◽  
Palliative Sedation ◽  
Palliative Care Unit ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Pharmacy Records ◽  
Progressive Dyspnea ◽  
Midazolam Infusion

8577 Background: There is wide variation in the frequency of reported use of palliative sedation (PS) to control intractable and refractory symptoms. Institutions have established policies for midazolam infusion in cases of PS. The indications and outcomes of this procedure have not been well characterized Methods: Our midazolam policy for PS requires 1:1 nursing for the first 24 hours and documentation of discussions regarding sedation. We reviewed our PCU database for all admissions for the first 11 months of 2005. We used pharmacy records for all patients who received medications used for sedation (chlorpromazine, lorazepam, midazolam). We reviewed all charts of pts who received any of these drugs to establish if the indication had been PS. Results: 148/484 admissions died in the PCU [31%]. 65/484 admissions (13%), and 47/ 148 patients who died (32%) received PS. Median age of patients (pts) was 58, 42 pts were male [65%], and the most frequent primaries observed were lung 24 [37%], hematologic 12 [18%], head and neck 7 [11%], and gastrointestinal 7 [11%]. Results are indicated in the table. * 2 patients had more than one indication for sedation The main causes for PS in our patients were delirium 57 [88%], dyspnea 6 [9%], and bleeding 4 [6%]. 18/65 patients who received PS [35%] were discharged alive, versus 318/419 [76%] who did not receive PS [p< 0.001]. Midazolam was used in 11/65 episodes [17%]. 4/6 pts with PS for dyspnea received midazolam [66%], versus 8/57 with PS for delirium or bleeding [14%], p=0.01]. 18/54 pts who received PS using other drug were discharged alive [33%], versus 0/11 pts who received midazolam [p=0.02]. Conclusions: Palliative sedation was required in 32% of pts who died in the hospital. Reporting midazolam utilization rates for monitoring overall PS outcomes, results in significant under reporting. Midazolam was used more frequently in cases of progressive dyspnea and poor prognosis. Less restrictive policies in the use of midazolam may result in more use for PS. Data accrual continues. [Table: see text] No significant financial relationships to disclose.

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