Prescribing Practices and the Prescription Drug Epidemic: Physician Intervention Strategies

2012 ◽  
Vol 44 (1) ◽  
pp. 68-71 ◽  
Author(s):  
David E. Smith
Keyword(s):  
Prescription Drug ◽  
Intervention Strategies ◽  
Prescribing Practices ◽  
Physician Intervention

Tie Decay and Dissolution: Contentious Prescribing Practices in the Prescription Drug Epidemic

2021 ◽  
Author(s):  
Victoria (Shu) Zhang ◽  
Marissa D. King
Keyword(s):  
Longitudinal Data ◽  
Prescription Drug ◽  
Formation Processes ◽  
Prescribing Practices ◽  
Data Set ◽  
Substantial Body ◽  
Nuanced Understanding

Although a substantial body of work has investigated drivers of tie formation, there is growing interest in understanding why relationships decay or dissolve altogether. The networks literature has tended to conceptualize tie decay as driven by processes similar to those underlying tie formation. Yet information that is revealed through ongoing interactions can exert different effects on tie formation and tie decay. This paper investigates how tie decay and tie formation processes differ by focusing on contentious practices. To the extent that information about dissimilarities in contentious practices is learned through ongoing interactions, it can exert diverging effects on tie formation and tie decay. Using a longitudinal data set of 141,543 physician dyads, we find that differences in contentious prescribing led ties to weaken or dissolve altogether but did not affect tie formation. The more contentious the practice and the more information available about the practice, the stronger the effect on tie decay and dissolution. Collectively, these findings contribute to a more nuanced understanding of relationship evolution as an unfolding process through which deeper-level differences are revealed and shape the outcome of the tie.

scholarly journals Prescription Drug Monitoring Program Use: National Dental PBRN Results

2018 ◽  
Vol 4 (2) ◽  
pp. 178-186 ◽  
Author(s):  
J.L. McCauley ◽  
G.H. Gilbert ◽  
D.L. Cochran ◽  
V.V. Gordan ◽  
R.S. Leite ◽  
...  
Keyword(s):  
Pain Management ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
Prescribing Practices ◽  
Opioid Prescribing ◽  
Practice Characteristics ◽  
Prescription Drug Monitoring Program ◽  
Barriers To Use ◽  
Outreach And Education

Introduction: The American Dental Association recommends that dentists use a prescription drug monitoring program (PDMP) prior to prescribing an opioid for acute pain management. Objective: The objective of this study was to examine dentists’ experiences using their state PDMP, as well as the impact that state-mandated registration policies, mandated use policies, and practice characteristics had on the frequency with which dentists used their PDMP. Methods: We conducted a web-based cross-sectional survey among practicing dentist members of the National Dental Practice-Based Research Network ( n = 805). The survey assessed prescribing practices for pain management and implementation of risk mitigation strategies, including PDMP use. Survey data were linked with network Enrollment Questionnaire data to include practitioner demographics and practice characteristics. Results: Nearly half of respondents ( n = 375, 46.6%) reported having never accessed a PDMP, with the most common reasons for nonaccess being lack of awareness ( n = 214, 57.1%) and lack of knowledge regarding registration and use ( n = 94, 25.1%). The majority of PDMP users reported the program to be very helpful (58.1%) or somewhat helpful (31.6%). Dentists reported that PDMP use most often did not change their intended prescribing behavior (40.2%), led them not to prescribe an opioid (33.5%), or led them to prescribe fewer opioid doses (25.5%). Presence of a mandated use policy was significantly associated with increased frequency of PDMP use across a variety of situations, including prior to 1) prescribing any opioid for pain management, 2) issuing refills, 3) prescribing to new patients, and 4) prescribing to patients deemed high risk. Conclusion: Findings suggest that the majority of dentists find PDMPs helpful in informing their opioid-prescribing practices. Whereas the existence of a state-mandated use policy is a consistent predictor of dentists’ PDMP use, outreach and education efforts may overcome key barriers to use identified in this study. Knowledge Transfer Statement: Findings from this national survey suggest that the majority of practicing dentists find PDMPs helpful in informing their opioid-prescribing practices; however, consistent PDMP use was not common. Whereas the existence of a state-mandated use policy is a consistent predictor of dentists’ PDMP use, outreach and education efforts may overcome key barriers to use identified in this study.

Managing psychopharmaceutical drugs under prescription regimes

2018 ◽  
Author(s):  
Thomas F. Babor ◽  
Jonathan Caulkins ◽  
Benedikt Fischer ◽  
David Foxcroft ◽  
Keith Humphreys ◽  
...  
Keyword(s):  
Prescription Drug ◽  
Developed Countries ◽  
Drug Misuse ◽  
Prescription Medications ◽  
Prescribing Practices ◽  
Prescription Drug Misuse ◽  
Alternative Medicines ◽  
Prescription Drug Use ◽  
Pharmacy System ◽  
Cross National

There is extraordinary cross-national variation in the availability of prescription psychoactive drugs, with most prescription drug use being concentrated in developed countries. A variety of measures aim to prevent abuses such as ‘doctor shopping’ and diversion of psychopharmaceuticals from the medical and pharmacy systems. The evidence suggests that prescription regimes affect the prescribing practices of doctors, often resulting in substitution. Price can be used to channel demand between two drugs that are substitutes for each other, moving demand from a drug with more adverse consequences to a less risky alternative. Advice to physicians on prescribing, has limited effect unless it concerns a new and serious side effect and alternative medicines can be prescribed. The development of a strong pharmacy system can limit illicit diversion of prescription medications, but cannot always prevent periodic epidemics of prescription drug misuse.

Multidisciplinary Evidence to Treat Bilingual Individuals with Aphasia

2008 ◽  
Vol 15 (3) ◽  
pp. 66-72 ◽  
Author(s):  
José G. Centeno
Keyword(s):  
Stroke Rehabilitation ◽  
Culturally Diverse ◽  
Treatment Strategies ◽  
The United States ◽  
Intervention Strategies ◽  
Steady Increase ◽  
Clinical Procedures ◽  
Bilingual Speakers ◽  
Aphasic Clients

Abstract The steady increase in linguistic and cultural diversity in the country, including the number of bilingual speakers, has been predicted to continue. Minorities are expected to be the majority by 2042. Strokes, the third leading cause of death and the leading cause of long-term disability in the U.S., are quite prevalent in racial and ethnic minorities, so population estimates underscore the imperative need to develop valid clinical procedures to serve the predicted increase in linguistically and culturally diverse bilingual adults with aphasia in post-stroke rehabilitation. Bilingualism is a complex phenomenon that interconnects culture, cognition, and language; thus, as aphasia is a social phenomenon, treatment of bilingual aphasic persons would benefit from conceptual frameworks that exploit the culture-cognition-language interaction in ways that maximize both linguistic and communicative improvement leading to social re-adaptation. This paper discusses a multidisciplinary evidence-based approach to develop ecologically-valid treatment strategies for bilingual aphasic individuals. Content aims to spark practitioners' interest to explore conceptually broad intervention strategies beyond strictly linguistic domains that would facilitate linguistic gains, communicative interactions, and social functioning. This paper largely emphasizes Spanish-English individuals in the United States. Practitioners, however, are advised to adapt the proposed principles to the unique backgrounds of other bilingual aphasic clients.

Practical Resources for Provision of Services to Culturally and Linguistically Diverse Users of AAC

2015 ◽  
Vol 22 (1) ◽  
pp. 25-39
Author(s):  
Elena Dukhovny ◽  
E. Betsy Kelly
Keyword(s):  
Best Practices ◽  
Augmentative And Alternative Communication ◽  
Linguistically Diverse ◽  
Intervention Strategies ◽  
Culturally And Linguistically Diverse ◽  
Limited Resources ◽  
Flexible Systems ◽  
Alternative Communication ◽  
Practical Applications ◽  
Provision Of Services

According to the 2010 U.S. Census, over 20% of Americans speak a language other than English in the home, with Spanish, Chinese, and French being the languages most commonly spoken, aside from English. However, few augmentative and alternative communication (AAC) systems offer multilingual support for individuals with limited functional speech. There has been much discussion in the AAC community about best practices in AAC system design and intervention strategies, but limited resources exist to help us provide robust, flexible systems for users who speak languages other than English. We must provide services that take into consideration the unique needs of culturally and linguistically diverse users of AAC and help them reach their full communication potential. This article outlines basic guidelines for best practices in AAC design and selection, and presents practical applications of these best practices to multilingual/multicultural clients.

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