Estimation of Asthma Severity from Electronic Prescription Records using British Thoracic Society and Scottish Intercollegiate Guidelines Network Treatment Steps

2021 ◽  
Author(s):  
Holly Tibble ◽  
Aziz Sheikh ◽  
Athanasios Tsanas
Keyword(s):  
Asthma Severity ◽  
British Thoracic Society ◽  
Electronic Prescription

scholarly journals Exacerbation risk and characterisation of the UK’s asthma population from infants to old age

Thorax ◽  
2017 ◽  
Vol 73 (4) ◽  
pp. 313-320 ◽  
Author(s):  
Chloe I Bloom ◽  
Francis Nissen ◽  
Ian J Douglas ◽  
Liam Smeeth ◽  
Paul Cullinan ◽  
...  
Keyword(s):  
Asthma Severity ◽  
Population Based ◽  
Mild Asthma ◽  
Practice Research ◽  
British Thoracic Society ◽  
Clinical Practice Research Datalink ◽  
Total Study Population ◽  
Age Cohorts ◽  
Exacerbation Risk

BackgroundFew studies have examined the characteristics of a general asthma population; most have focused on more severe patients or severe exacerbations.MethodsThis population-based cohort study, from April 2007 to September 2015, used linked primary and secondary care electronic healthcare records (Clinical Practice Research Datalink, Hospital Episode Statistics). Characteristics of four age cohorts, ‘Under 5s’, ‘5 to 17s’, ‘18 to 54s’, ‘55+’, were described. Exacerbation risk factors, including asthma severity (measured by the British Thoracic Society (BTS) stepwise approach), were assessed using Poisson regression.Results424 326 patients with current asthma were eligible (n, median follow-up: ‘Under 5s’=17 320, 1 year; ‘5 to 17s’=82 707, 3.3 years; ‘18 to 54s’=210 724, 4 years; ‘55+’=113 575, 5.1 years). Over 60% of the total study population had mild asthma (BTS steps 1/2). There were differences between the cohort’s characteristics, including by gender, disease severity and exacerbation pattern. The rate of exacerbations was highest in the oldest cohort and lowest in the ‘5 to 17s’ cohort (rate per 10 person-years (95% CI), ‘Under 5s’=4.27 (4.18 to 4.38), ‘5 to 17s’=1.48 (1.47 to 1.50), ‘18 to 54s’=3.22 (3.21 to 3.24), ‘55+’=9.40 (9.37 to 9.42)). In all cohorts, exacerbation rates increased with increasing asthma severity, after adjusting for confounders including gender, socioeconomic status, smoking, body mass index, atopy, rhinitis, gastro-oesophageal reflux, anxiety, depression and COPD.ConclusionThe majority of UK patients with asthma had mild asthma and did not experience an exacerbation during follow-up. Patients aged ≥55 years had the lowest proportion with mild asthma and highest rate of exacerbations; the opposite was found in patients aged between 5 and 18 years.

scholarly journals Time for change in practice of in-patient oxygen therapy: a period-limited, multidimensional approach to improve oxygen prescription compliance: quality improvement project at Hamad General Hospital, Qatar

2021 ◽  
Vol 10 (4) ◽  
pp. e001574
Author(s):  
Samman Rose ◽  
Sundus Sardar ◽  
Sreethish Sasi ◽  
Dabia Hamad S H Al Mohanadi ◽  
Ahmed Ali A A Al-Mohammed ◽  
...  
Keyword(s):  
Quality Improvement ◽  
General Hospital ◽  
Oxygen Therapy ◽  
Poor Compliance ◽  
Target Range ◽  
Small Scale ◽  
British Thoracic Society ◽  
Electronic Prescription ◽  
Improvement Project ◽  
Prescription Practice

Prescription of oxygen therapy has traditionally poor compliance across the globe and mostly given to patients on verbal orders leading to under or overuse. The British Thoracic Society (BTS) guidelines (2017) recommend that oxygen therapy must be prescribed. Our study aimed to assess the prescription practice of oxygen therapy for patients admitted to acute medical assessment unit and general medical wards at Hamad General Hospital, Qatar and to achieve 80% compliance of valid oxygen therapy prescription implementing the quality improvement model against the BTS guidelines.The prescription practice of oxygen therapy was audited between April 2019 and August 2019. Using a Plan, Do, Study, Act (PDSA) model of improvement and multiple interventions was performed in the eight PDSA cycles, including (1) educational sessions for residents/fellows/nurses, (2) introduction of electronic prescription, (3) emails, posters/flyers, (4) nurse-led reminders and (5) re-enforced teaching for new residents. Data were then collected using a questionnaire assessing electronic prescriptions and documentation. Our baseline study regarding oxygen therapy showed limited awareness of BTS guidelines regarding the documentation of initiation and further adjustment of oxygen therapy. There was a lack of compliance with oxygen prescription; none of the patients had a valid prescription on our computer-based prescription (Cerner). The duration, target range and indications of Oxygen therapy were documented in 25% (18/72), 45.8% (33/72) and 42% (30/72) patients, respectively. Oxygen was initiated by communication order only. In a total of 16 weeks period, the repeated PDSA cycles showed significant improvement in safe oxygen prescription practices. Following intervention, oxygen electronic prescription, documentation of indications for oxygen therapy, target oxygen saturation and wean-off plan improved to 93%, 85%, 86 % and 80 %, respectively.We concluded that poor compliance to oxygen therapy Orders is a universal issue, which can be successfully managed using small-scale PDSA cycles to ensure sustained improvement through multidimensional interventions, continuous reinforcement and frequent reassessments.

Allergic Rhinitis and Asthma Severity

2004 ◽  
Vol 16 (01) ◽  
pp. 15-19
Author(s):  
Girish Vitalpur ◽  
Cleveland Moore ◽  
Raghubir Mangat ◽  
Raja Mouallem ◽  
Mosanda Mvula ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Asthma Severity

USABILITY INTERNET-PHARMACIES SITES

2020 ◽  
pp. 10-14
Author(s):  
Chudnov A.A. ◽  
Umarov S.Z.
Keyword(s):  
Prescription Drugs ◽  
Storage Conditions ◽  
Ease Of Use ◽  
The Internet ◽  
Electronic Prescription ◽  
Anal Ysis ◽  
Modern Development ◽  
Provision Of Services ◽  
The Usa ◽  
Internet Pharmacies

The modern development of information technology provides the opportunity to use them in many areas of life, which also include medicine and pharmacy. The introduction of technologies such as an electronic prescription system, drug labeling, creates the prereq-uisites for the remote provision of services. Recently, legislative changes have legalized the distance trad-ing of OTC drugs. In this regard, soon the supply chain of the drug to the end user may include a mini-mum number of professionals. Thus, in these condi-tions, the role of information that users can receive via the Internet is significantly increasing. Such a term as the "usability" of the site, or its ease of use, appeared back in 1998 and every year is of increasing importance. In relation to online pharmacies, the usa-bility assessment is especially relevant in terms of both general functionality, which is typical for all services selling products via the Internet, and features specific to Internet pharmacies only. On May 8, 2020, an anal-ysis of the "usability" of 20 sites of pharmacy organi-zations was conducted. Some advantages were high-lighted (putting information on the quality of goods (declarations, certificates), warnings, contraindica-tions and storage conditions in a separate block), as well as disadvantages (some clutter of the site with elements, the presence of blank pages and a fuzzy warning about prescription drugs).

Validation of the British Thoracic Society Severity Criteria for Pediatric Community-Acquired Pneumonia

2018 ◽  
Author(s):  
Lilliam Ambroggio ◽  
Cole Brokamp ◽  
Rachel Mantyla ◽  
Bradley DePaoli ◽  
Richard M. Ruddy ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
British Thoracic Society ◽  
Severity Criteria

Expression Levels of MicroRNA-125b in Serum Exosomes of Patients with Asthma of Different Severity and its Diagnostic Significance

2019 ◽  
Vol 20 (10) ◽  
pp. 781-784 ◽  
Author(s):  
Meizhen Zhao ◽  
Li Juanjuan ◽  
Fan Weijia ◽  
Xie Jing ◽  
Huang Qiuhua ◽  
...  
Keyword(s):  
Correlation Analysis ◽  
Roc Curve ◽  
Quantitative Polymerase Chain Reaction ◽  
Persistent Asthma ◽  
Asthma Severity ◽  
Control Group ◽  
Spearman Correlation ◽  
Diagnostic Efficacy ◽  
Expression Levels ◽  
Serum Exosomes

Background: This study aimed to investigate the expression levels of microRNA (miRNA)-125b in serum exosomes and its diagnostic efficacy for asthma severity. Methods: The study included 80 patients with untreated asthma and 80 healthy volunteers. The patients were divided into 4 groups according to disease severity: 20 with the intermittent state, 20 with the mildly persistent state, 20 with the moderately persistent state, and 20 with the severely persistent state. The expression levels of miRNA-125b in serum exosomes of each group were detected using a quantitative polymerase chain reaction and compared. The Spearman correlation analysis was used to study the correlation between the expression levels of miRNA-125b in serum exosomes and asthma severity. The diagnostic efficacy of the expression levels of miRNA-125b in exosomes for asthma severity was evaluated using the Receiver Operating Characteristic (ROC) curve. Results: The expression levels of miRNA-125b in serum exosomes of patients with intermittent, mildly persistent, moderately persistent, and severely persistent asthma were all higher than those in the healthy control group, with statistically significant differences. The expression levels of miRNA-125b were also statistically significantly different among patients in each group. The Spearman correlation analysis showed a positive correlation of the relative expression of miRNA-125b in serum exosomes with asthma severity. The area under the ROC curve of the diagnostic efficacy of miRNA-125b in serum exosomes for patients with intermittent, mildly, moderately, and severely persistent asthma was 0.7770, 0.8573, 0.9111, and 0.9995, respectively. Conclusion: The expression levels of miRNA-125b in serum exosomes had a high diagnostic efficacy and might serve as a noninvasive diagnostic marker for asthma severity.

scholarly journals The potential role of local pharmacies to assess asthma control: an Italian cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Caminati ◽  
L. Cegolon ◽  
M. Bacchini ◽  
N. Segala ◽  
A. Dama ◽  
...  
Keyword(s):  
Asthma Control ◽  
Multinomial Logistic Regression ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Disease Assessment ◽  
Community Pharmacies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Disease Community

Abstract Background Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay between secondary and primary care services as an effective strategy to control the disease, community pharmacies’ are seldom involved in asthma control assessment. The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control in community pharmacies within the health district of the city of Verona (Veneto Region, North-Eastern Italy). Methods A call for participation was launched through the Pharmacists’ Association of Verona. Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to complete the Asthma Control Test (ACT) and a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined asthma severity. A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI). Results Fifty-seven community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were consecutively recruited from 1st January to 30th June 2018 (6 months). Based upon ACT score 50.5% patients had a controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion of patients with uncontrolled asthma were observed for every level of severity, although more frequently with mild persistent form of asthma. Most patients (92%) self-reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR = 0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT< 16 compared to those not taking medications regularly. Conclusions Overall, our findings highlighted an unsatisfactory asthma control in the general population, independently of the severity level of the disease. Community pharmacies could be a useful frontline interface between patients and the health care services, supporting an effective asthma management plan, from disease assessment and monitoring treatment compliance to referral of patients to specialist medical consultancies.

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