Effect of Electronic Prescribing Compared to Paper-Based (Handwritten) Prescribing on Primary Medication Adherence in an Outpatient Setting: A Systematic Review

2021 ◽  
Vol 12 (04) ◽  
pp. 845-855
Author(s):  
David Aluga ◽  
Lawrence A. Nnyanzi ◽  
Nicola King ◽  
Elvis A. Okolie ◽  
Peter Raby
Keyword(s):  
Medication Adherence ◽  
Randomized Study ◽  
The United States ◽  
Outpatient Setting ◽  
Electronic Prescribing ◽  
Future Research ◽  
Medical Subject Headings ◽  
Keywords And Phrases ◽  
Significant Difference ◽  
The Impact

Abstract Background Electronic prescriptions are often created and delivered electronically to the pharmacy while paper-based/handwritten prescriptions may be delivered to the pharmacy by the patients. These differences in the mode of creation and transmission of the two types of prescription could influence the rate at which outpatients fill new prescriptions of previously untried medications. Objectives This study aimed to evaluate literatures to determine the impact of electronic prescribing compared with paper-based/handwritten prescribing on primary medication adherence in an outpatient setting. Methods The keywords and phrases “outpatients,” “e-prescriptions,” “paper-based prescriptions,” and “primary medication adherence” were combined with their relevant synonyms and medical subject headings. A comprehensive literature search was conducted on EMBASE, CINAHL, and MEDLINE databases, and Google Scholar. The results of the search were screened and selected using predefined inclusion and exclusion criteria. The Critical Appraisal Skills Program (CASP) was used for quality appraisal of included studies. Data relevant to the objective of the review were extracted and analyzed through narrative synthesis. Results A total of 10 original studies were included in the final review, including 1 prospective randomized study and 9 observational studies. Nine of the 10 studies were performed in the United States. Four of the studies indicated that electronic prescribing significantly increases initial medication adherence, while four of the studies suggested the opposite. The remaining two studies found no significant difference in primary medication adherence between the two methods of prescribing. The variations in the studies did not allow the homogeneity required for meta-analysis to be achieved. Conclusion The conflicting findings relating to the efficacy of primary medication adherence across both systems demonstrate the need for a standardized measure of medication adherence. This would help further determine the respective benefits of both approaches. Future research should also be conducted in different countries to give a more accurate representation of adherence.

Who is ‘Molly’? MDMA adulterants by product name and the impact of harm-reduction services at raves

2017 ◽  
Vol 31 (8) ◽  
pp. 1056-1060 ◽  
Author(s):  
Sarah Saleemi ◽  
Steven J Pennybaker ◽  
Missi Wooldridge ◽  
Matthew W Johnson
Keyword(s):  
Harm Reduction ◽  
Legal Protection ◽  
The United States ◽  
Future Research ◽  
Testing Methods ◽  
Music Festivals ◽  
Significant Difference ◽  
Intent To Use ◽  
Colorimetric Reagent ◽  
The Impact

Methylenedioxymethamphetamine (MDMA), often sold as ‘Ecstasy’ or ‘Molly’, is commonly used at music festivals and reported to be responsible for an increase in deaths over the last decade. Ecstasy is often adulterated and contains compounds that increase morbidity and mortality. While users and clinicians commonly assume that products sold as Molly are less-adulterated MDMA products, this has not been tested. Additionally, while pill-testing services are sometimes available at raves, the assumption that these services decrease risky drug use has not been studied. This study analyzed data collected by the pill-testing organization, DanceSafe, from events across the United States from 2010 to 2015. Colorimetric reagent assays identified MDMA in only 60% of the 529 samples collected. No significant difference in the percentage of samples testing positive for MDMA was determined between Ecstasy and Molly. Individuals were significantly less likely to report intent to use a product if testing did not identify MDMA (relative risk (RR) = 0.56, p = 0.01). Results suggest that Molly is not a less-adulterated substance, and that pill-testing services are a legitimate harm-reduction service that decreases intent to consume potentially dangerous substances and may warrant consideration by legislators for legal protection. Future research should further examine the direct effects of pill-testing services and include more extensive pill-testing methods.

Abstract 257: Urban Teaching and Non-Teaching Hospitals Outcomes: Myocardial Infarction

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Priscilla O Okunji ◽  
Johnnie Daniel
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Income Group ◽  
The United States ◽  
Teaching Hospitals ◽  
Age Difference ◽  
Age Group ◽  
Urban Teaching ◽  
Significant Difference ◽  
The Impact

Background: Patients with myocardial infarction reportedly have different outcomes on discharge according to hospital characteristics. In the present study, we evaluated the differences between urban teaching hospitals (UTH) and non-teaching hospitals (NTH), discharged in 2012. We also investigated on the outcomes. Methods: Sample of 117,808 subjects diagnosed with myocardial infarction were extracted from a nationwide inpatient stay dataset using the International Classification Data, ICD 9 code 41000 in the United States, according to hospital location, size, and teaching status. Results: The analysis of the data showed that more whites were admitted to both teaching and non teaching hospitals with more males (~24%) admitted than their female counterparts. However, blacks were admitted more (~15%) in urban teaching hospitals than medium urban non teaching hospitals. Age difference was noted as well, while age group (60-79 years) were admitted more in UTH, inversely urban non-teaching hospitals admitted more older (80 years or older) age group. A significant difference (~28%) was observed in both hospital categories with UTH admitting more patients of $1.00 - $38,999.00 income group than other income categories. In addition, it was observed that patients with MI stayed more (~5%) for 14 or more days, and charged more especially for income group of $80,000 or above in UTH than NTH. No significant difference was found in the mortality rate for both hospital categories. Conclusion: The overall outcomes showed that the mortality rate between urban teaching and non-teaching hospitals were non significant, though the inpatients MI stayed longer and were charged more in UTH than NTH. The authors call for the study to be replicated with a higher level of statistical measures to ascertain the impact of the variables on the outcomes for a more validated result.

Evolving oncology provider perspectives on care delivery during the COVID-19 pandemic.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18609-e18609
Author(s):  
Divya Ahuja Parikh ◽  
Meera Vimala Ragavan ◽  
Sandy Srinivas ◽  
Sarah Garrigues ◽  
Eben Lloyd Rosenthal ◽  
...  
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Advanced Practice ◽  
Curative Surgery ◽  
Time Points ◽  
Patients With Cancer ◽  
Provider Perspectives ◽  
Significant Difference ◽  
The Impact

e18609 Background: The COVID-19 pandemic prompted rapid changes in cancer care delivery. We sought to examine oncology provider perspectives on clinical decisions and care delivery during the pandemic and to compare provider views early versus late in the pandemic. Methods: We invited oncology providers, including attendings, trainees and advanced practice providers, to complete a cross-sectional online survey using a variety of outreach methods including social media (Twitter), email contacts, word of mouth and provider list-serves. We surveyed providers at two time points during the pandemic when the number of COVID-19 cases was rising in the United States, early (March 2020) and late (January 2021). The survey responses were analyzed using descriptive statistics and Chi-squared tests to evaluate differences in early versus late provider responses. Results: A total of 132 providers completed the survey and most were white (n = 73/132, 55%) and younger than 49 years (n = 88/132, 67%). Respondents were attendings in medical, surgical or radiation oncology (n = 61/132, 46%), advanced practice providers (n = 48/132, 36%) and oncology fellows (n = 16/132, 12%) who predominantly practiced in an academic medical center (n = 120/132, 91%). The majority of providers agreed patients with cancer are at higher risk than other patients to be affected by COVID-19 (n = 121/132, 92%). However, there was a significant difference in the proportion of early versus late providers who thought delays in cancer care were needed. Early in the pandemic, providers were more likely to recommend delays in curative surgery or radiation for early-stage cancer (p < 0.001), delays in adjuvant chemotherapy after curative surgery (p = 0.002), or delays in surveillance imaging for metastatic cancer (p < 0.001). The majority of providers early in the pandemic responded that “reducing risk of a complication from a COVID-19 infection to patients with cancer” was the primary reason for recommending delays in care (n = 52/76, 68%). Late in the pandemic, however, providers were more likely to agree that “any practice change would have a negative impact on patient outcomes” (p = 0.003). At both time points, the majority of providers agreed with the need for other care delivery changes, including screening patients for infectious symptoms (n = 128/132, 98%) and the use of telemedicine (n = 114/132, 86%) during the pandemic. Conclusions: We found significant differences in provider perspectives of delays in cancer care early versus late in the pandemic which reflects the swiftly evolving oncology practice during the COVID-19 pandemic. Future studies are needed to determine the impact of changes in treatment and care delivery on outcomes for patients with cancer.

scholarly journals Training Preservice Mental Health Counselors for Suicide Assessment: A Multiple Baseline Study

2019 ◽  
Author(s):  
Teal Bohrer ◽  
Cass Dykeman
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Self Efficacy ◽  
The United States ◽  
Multiple Baseline ◽  
Future Research ◽  
Probe Design ◽  
Mental Health Clinicians ◽  
Suicide Assessment ◽  
The Impact

Rates of death by suicide continue to increase across the United States. Mental health clinicians often have contact with individuals expressing suicidal ideation, but research suggests clinicians may not be appropriately prepared to assess a client’s suicide risk. Numerous models and theories explain and assess suicidal ideation. In 2009, Thomas Joiner and his colleagues proposed the interpersonal-psychological theory of suicide (IPT), which focused on three main factors strongly supported by research over the preceding decade. The present study utilized a nonconcurrent, multiple-baseline, multiple-probe design as well as a one-group pretest–posttest design to examine the impact of an IPT-based training model. Participants were preservice mental health clinicians currently enrolled in Master’s degree programs. Participants completed assessments on IPT knowledge and suicide-assessment self-efficacy, and results from this study indicated a significant increase in knowledge after completion of the training, as well as a slight decrease in self-efficacy. This study suggests that suicide-assessment training, even when done remotely, can increase suicide-assessment knowledge. Future research should explore preservice mental health clinicians’ self-efficacy as well as those factors influencing the confidence these professionals feel in their assessments of risk.

Adolescent Birth Rates and Rural–Urban Differences by Levels of Deprivation and Health Professional Shortage Areas in the United States, 2017–2018

2021 ◽  
Vol 111 (1) ◽  
pp. 136-144
Author(s):  
Sylvester O. Orimaye ◽  
Nathan Hale ◽  
Edward Leinaar ◽  
Michael G. Smith ◽  
Amal Khoury
Keyword(s):  
United States ◽  
Rural Communities ◽  
Health Professional ◽  
Health Resources ◽  
The United States ◽  
Future Research ◽  
Birth Rates ◽  
Rural Counties ◽  
Adolescent Birth ◽  
The Impact

Objectives. To examine the differences in adolescent birth rates by deprivation and Health Professional Shortage Areas (HPSAs) in rural and urban counties of the United States in 2017 and 2018. Methods. We analyzed available data on birth rates for females aged 15 to 19 years in the United States using the restricted-use natality files from the National Center for Health Statistics, American Community Survey 5-year population estimates, and the Area Health Resources Files. Results. Rural counties had an additional 7.8 births per 1000 females aged 15 to 19 years (b = 7.84; 95% confidence interval [CI] = 7.13, 8.55) compared with urban counties. Counties with the highest deprivation had an additional 23.1 births per 1000 females aged 15 to 19 years (b = 23.12; 95% CI = 22.30, 23.93), compared with less deprived counties. Rural counties with whole shortage designation had an additional 8.3 births per 1000 females aged 15 to 19 years (b = 8.27; 95% CI = 6.86, 9.67) compared with their urban counterparts. Conclusions. Rural communities across deprivation and HPSA categories showed disproportionately high adolescent birth rates. Future research should examine the extent to which contraceptive access differs among deprived and HPSA-designated rural communities and the impact of policies that may create barriers for rural communities.

Exploring the Impact of Service-Learning on Literacy Teachers' Self-Reported Empathy

2018 ◽  
pp. 393-408 ◽  
Author(s):  
Leah Katherine Saal
Keyword(s):  
Service Learning ◽  
Critical Pedagogy ◽  
Quantitative Research ◽  
Learning Experience ◽  
Future Research ◽  
Literacy Teachers ◽  
Significant Difference ◽  
Literacy Teacher Education ◽  
The Impact ◽  
Post Condition

Although (1) literacy teacher education research and professional practice standards highlight the significance of empathy as a central tenant of teachers' professional dispositions, and (2) developing deeper and more empathetic understanding of others is a frequently cited rationale for utilizing service-learning as a critical pedagogy for in-service and pre-service teacher preparation, little quantitative research exists measuring in-service teachers' empathy or empathy development. The purpose of this chapter is to explore how a course-embedded, self-selected, and community-based service-learning experience effected participating literacy teachers' self-reported empathy. While participants scores increased in the pre-post condition, results of a paired sample t-test indicated no significant difference in teachers' self-reported empathy across the pre-post condition. Implications for practice and program administration as well as suggestions for future research are discussed.

Self-Management of Arthritis

2017 ◽  
pp. 171-196
Author(s):  
Jessica M. Brooks ◽  
Kanako Iwanaga ◽  
Fong Chan
Keyword(s):  
Scientific Evidence ◽  
The United States ◽  
Self Management ◽  
Future Research ◽  
Counseling Services ◽  
Evidence Based ◽  
Physical Conditions ◽  
Current State ◽  
The Individual ◽  
The Impact

Arthritis is ranked among the top causes of disability in the United States and worldwide. Despite recent improvements in medications and medical treatment, there is no known cure for arthritis. Providing evidence-based psychoeducation and counseling services to people with arthritis lessens the impact of pain-related symptoms and disability on the individual and society. The purpose of this chapter is to provide an overview of the most common arthritic conditions, co-occurring physical conditions, and psychosocial factors associated with arthritis. Barriers to self-management and existing self-management programs are also discussed along with the current state of scientific evidence. The chapter concludes with some questions for future research.

scholarly journals The Effect of Enteral Tube Feeding on Patients’ Health-Related Quality of Life: A Systematic Review

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1046 ◽  
Author(s):  
Omorogieva Ojo ◽  
Edel Keaveney ◽  
Xiao-Hua Wang ◽  
Ping Feng
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Enteral Feeding ◽  
Tube Feeding ◽  
Future Research ◽  
Measuring Instruments ◽  
Medical Subject Headings ◽  
Enteral Tube Feeding ◽  
Significant Difference

Patients with functional gastrointestinal tract who are unable to meet their nutritional requirements may benefit from the use of enteral nutrition via feeding tubes which could be nasogastric, percutaneous endoscopic gastrostomy and jejunostomy. Although enteral tube feeding has been shown to promote nutritional status, improve wound healing, and enhance patients’ quality of life (QoL), evidence of tube and feed complications and reduced QoL has also been reported. Despite the increasing prevalence of patients on enteral tube feeding, no systematic review examining the role of enteral tube feeding on patients’ QoL appears to have been published. Aim: The aim of this systematic review is to evaluate the effect of enteral tube feeding on patients’ QoL. Method: Three databases (EMBASE, Pubmed, and PsycINFO) plus Google Scholar were searched for relevant articles based on the Population, Intervention, Comparator, Outcomes (PICO) framework. The review was in line with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and involved the use of synonyms and medical subject headings. In addition, search terms were combined using Boolean operators (AND/OR) and all the articles retrieved were exported to EndNote for de-duplication. Results: Fourteen articles which met the criteria were included and three distinct areas were identified: the effect of early versus late enteral tube feeding on QoL; the QoL of patients on gastrostomy versus standard care, and the effect of enteral tube feeding on QoL. Overall, nine studies reported improvement in the QoL of patients on enteral tube feeding, while five studies demonstrated either no significant difference or reduction in QoL. Some factors which may have influenced these outcomes are differences in types of gastrostomy tubes, enteral feeding methods (including time patients spent connected to enteral feed/pump), and patients’ medical conditions, as well as the generic and/or type of QoL measuring instrument used. Conclusion: Most reviewed studies suggest that enteral tube feeding is effective in improving patients’ QoL. The use of enteral tube feeding-specific QoL measuring instruments is recommended for future research, and improved management strategies including use of mobile enteral feeding pumps should further enhance patients’ QoL. More studies on the effect of delivery systems/enteral feeding pumps on QoL are needed as research in this area is limited.

scholarly journals A-44 ImPACT of Amnesia Related Concussions Across Developmental Stages

2020 ◽  
Vol 35 (5) ◽  
pp. 640-640
Author(s):  
K Unjia ◽  
R Bennett ◽  
L Lashley
Keyword(s):  
Retrograde Amnesia ◽  
Sports Medicine ◽  
Developmental Stages ◽  
Future Research ◽  
Age Group ◽  
Adolescent Athletes ◽  
Significant Difference ◽  
The Impact ◽  
The Relationship ◽  
One Way Anova

Abstract Objective This study aimed to examine the relationship between developmental stages and concussions that resulted in amnesia as measured by ImPACT. Method Participants were selected from an archival de-identified sports medicine ImPACT database. The sample (N = 4,200) was primarily male (62.2%) student athletes with ages ranging from 10 to 25 years. Participants were divided into three groups: Young athletes (n = 1,400), Adolescent (n = 1,400), and Adult (n = 1,400). A One-Way ANOVA was conducted to determine the relationship between age group and prevalence of concussions resulting in anterograde or retrograde amnesia. Results The One-Way ANOVA revealed significant differences between age group and anterograde F(2,4197) = 107.449, p &lt; .001 and retrograde amnesia F(2,4197) = 82.949, p &lt; .001. Bonferroni pairwise comparison revealed the adolescent athlete group experienced more concussions that result in both anterograde and retrograde amnesia compared to young and adult athletes. There was no significant difference between young and adult athletes. Additionally, there is a significant difference regarding total games missed following concussion F(2,4197) = 117.723, p &lt; .001, with adolescent athletes missing more games compared to young and adult athletes. Conclusions The findings of this study suggest adolescent athletes tend to experience more amnesia-related concussions compared to young and adult athletes. Additionally, adolescent athletes miss more games following these types of concussions. This study highlights the impact that certain types of concussions have on athletes across the developmental stages. Future research should analyze the cognitive effects of various types of concussions across the developmental stages.

scholarly journals Federal, State, and Local Nutrition Policies for Cancer Prevention: Perceived Impact and Feasibility, United States, 2018

2020 ◽  
Vol 110 (7) ◽  
pp. 1006-1008
Author(s):  
Lauren Lizewski ◽  
Grace Flaherty ◽  
Parke Wilde ◽  
Ross Brownson ◽  
Claire Wang ◽  
...  
Keyword(s):  
United States ◽  
Cancer Prevention ◽  
The United States ◽  
Federal State ◽  
Future Research ◽  
Assistance Program ◽  
Nutrition Policies ◽  
Perceived Impact ◽  
State And Local ◽  
The Impact

Objectives. To assess stakeholder perceptions of the impact and feasibility of 21 national, state, and local nutrition policies for cancer prevention across 5 domains in the United States. Methods. We conducted an online survey from October through December 2018. Participants were invited to take the survey via direct e-mail contact or an organizational e-newsletter. Results. Federal or state Medicare/Medicaid coverage of nutrition counseling and federal or state subsidies on fruits, vegetables, and whole grains for participants in the Supplemental Nutrition Assistance Program were the policies rated as having the highest perceived impact and feasibility. Overall, the 170 respondents rated policy impact higher than policy feasibility. Polices at the federal or state level had a higher perceived impact, whereas local policies had higher perceived feasibility. Conclusions. Our findings might guide future research and advocacy that can ultimately motivate and target policy actions to reduce cancer burdens and disparities in the United States.

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