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Accuracy of a provincial prescription database for assessing medication adherence in heart failure patients.

https://arctichealth.org/en/permalink/ahliterature158598
Source
Ann Pharmacother. 2008 Mar;42(3):361-7
Publication Type
Article
Date
Mar-2008
Author
Karen Dahri
Stephen J Shalansky
Linda Jang
Leon Jung
Andrew P Ignaszewski
Catherine Clark
Author Affiliation
CSU Pharmaceutical Sciences, Vancouver Coastal Health, Vancouver, British Columbia, Canada. Karen.Dahri@vch.ca
Source
Ann Pharmacother. 2008 Mar;42(3):361-7
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Aged
British Columbia - epidemiology
Databases, Factual - standards
Drug Monitoring - standards
Drug Prescriptions
Female
Heart Failure - drug therapy - epidemiology
Humans
Longitudinal Studies
Male
Middle Aged
Patient compliance
Prospective Studies
Reproducibility of Results
Abstract
British Columbia's central prescription database, PharmaNet, is often used for both clinical and research applications. However, PharmaNet details prescription transactions, not actual medication consumption, resulting in many potential sources of inaccuracy when the information is assumed to reflect population or individual drug utilization.
To assess the accuracy of PharmaNet for adherence assessment in patients with heart failure who are taking beta-blockers.
A 6-month prospective, longitudinal assessment of adherence to the prescribed beta-blocker regimen was carried out using both PharmaNet data and the Medication Event Monitoring System (MEMS) for each patient enrolled. The limit of agreement between the 2 adherence assessment methods was assessed using the Bland-Altman approach.
Fifteen of 58 patients initially enrolled in the study were excluded, most due to misuse of MEMS or failure to return the MEMS vial despite thorough follow-up. For the 43 patients included in the final analysis, mean +/- SD adherence was 97.8 +/- 11.8% when assessed by PharmaNet and 97.1 +/- 7.3% when MEMS was used. However, the limit of agreement, reported as the mean of the differences +/- 2SD, was 6.8 +/- 18.5%, indicating a moderate-to-high level of agreement between the 2 methods when the confidence interval is taken into consideration.
These results suggest that PharmaNet data accurately reflect medication adherence for most patients. The MEMS system proved unreliable in several cases, illustrating the difficulty of identifying a gold standard for adherence assessment.
PubMed ID
18303147 View in PubMed
Less detail

[Achievement of goal resting heart rate in patients with stable angina and hypertension at the background of therapy with -adrenoblockers in real clinical practice].

https://arctichealth.org/en/permalink/ahliterature106918
Source
Kardiologiia. 2013;53(7):13-23
Publication Type
Article
Date
2013
Author
Zh D Kobalava
G K Kiiakbaev
Iu V Khomitskaia
A A Shavarov
Author Affiliation
Russian University of Peoples Friendship, ul. Mikluho-Maklaya, 6,117198 Moscow, Russia.
Source
Kardiologiia. 2013;53(7):13-23
Date
2013
Language
Russian
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - administration & dosage
Aged
Angina, Stable - complications - drug therapy - epidemiology - physiopathology - psychology
Blood Pressure - drug effects
Demography
Dose-Response Relationship, Drug
Drug Monitoring
Female
Heart Rate - drug effects
Humans
Hypertension - complications - drug therapy - epidemiology - physiopathology - psychology
Male
Middle Aged
Quality of Life
Questionnaires
Russia - epidemiology
Severity of Illness Index
Treatment Outcome
Abstract
ß-Adrenoblockers improve quality of life and in a number of cases life prognosis in patients with stable angina (SA). Dose of -adrenoblockers is considered optimal if at the background of treatment resting heart rate (rHR) is persistently decreased down to 55-60 bpm. But according to data of international registries rate of achievement of target rHR (trHR) in real clinical practice does not exceed 22%. Aim of this study was to determine what portion of patients with SA and arterial hypertension (AH) achieves trHR at the background of therapy with -adrenoblockers in routine practice in this country. Twenty centers in 6 towns in Russian Federation recruited 399 patients (mean age 64+/-10 years) with class I-III angina and concomitant primary AH. These patients for at least 2 months received any -adrenoblocker and did not change its dose during 4 weeks before inclusion into the program. Portion of patients with trHR was 15.5%. There were no significant differences between average daily doses of most frequently used -adrenoblockers (metoprolol, bisoprolol, carvediolol) in groups of patients who achieved and did not achieve trHR. Quality of life of patients who achieved was comparable with that of those who did not achieve trHR. Attainment of trHR was associated with significant decrease of short acting requirement nitrates. There was a significant direct correlation between attainment of trHR and target arterial pressure.
PubMed ID
24087955 View in PubMed
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Adherence and persistence with oral adjuvant chemotherapy in older women with early-stage breast cancer in CALGB 49907: adherence companion study 60104.

https://arctichealth.org/en/permalink/ahliterature144428
Source
J Clin Oncol. 2010 May 10;28(14):2418-22
Publication Type
Article
Date
May-10-2010
Author
Ann H Partridge
Laura Archer
Alice B Kornblith
Julie Gralow
Debjani Grenier
Edith Perez
Antonio C Wolff
Xiaofei Wang
Helen Kastrissios
Donald Berry
Clifford Hudis
Eric Winer
Hyman Muss
Author Affiliation
Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA. ahpartridge@partners.org
Source
J Clin Oncol. 2010 May 10;28(14):2418-22
Date
May-10-2010
Language
English
Publication Type
Article
Keywords
Administration, Oral
Age Factors
Aged
Aged, 80 and over
Antimetabolites, Antineoplastic - administration & dosage - adverse effects
Breast Neoplasms - drug therapy - mortality - pathology - surgery
Canada
Chemotherapy, Adjuvant
Deoxycytidine - administration & dosage - adverse effects - analogs & derivatives
Drug Administration Schedule
Drug Monitoring - instrumentation
Female
Fluorouracil - administration & dosage - adverse effects - analogs & derivatives
Humans
Kaplan-Meier Estimate
Linear Models
Logistic Models
Mastectomy
Medication Adherence
Micro-Electrical-Mechanical Systems - instrumentation
Neoplasm Staging
Risk assessment
Risk factors
Time Factors
Treatment Outcome
United States
Abstract
Patient adherence is critical in evaluating the effectiveness of an oral therapy. We sought to measure adherence among women randomly assigned to capecitabine in a preplanned substudy of a multicenter clinical trial.
Cancer and Leukemia Group B study CALGB 49907 was a randomly assigned trial comparing standard chemotherapy versus oral chemotherapy with capecitabine in patients age 65 years or older with early-stage breast cancer. We used microelectronic monitoring system (MEMS) caps on participants' capecitabine bottles to record pill bottle openings. Capecitabine was given in two divided daily doses for 14 consecutive days of a 21-day cycle for six cycles. Adherence was calculated as the number of doses taken divided by doses expected, taking into account toxicity-related dosing changes. A participant was defined as adherent if 80% or more of expected doses were recorded by MEMS.
Overall, 161 patients were enrolled. Median age was 71 years (range, 65 to 89 years); 124 patients (83%) persisted with capecitabine to completion of planned protocol therapy. Adherence was 78% across all cycles, and adherence did not vary by cycle (P = .32). Twenty-five percent of participants took fewer than 80% of expected doses and were nonadherent. In a logistic regression model, participants with node-negative disease (P = .01) and mastectomy (P = .01) were more likely to be nonadherent. Adherence was not related to age, tumor stage, or hormone receptor status. Adherence was not significantly associated with relapse-free survival or grade 3 or 4 toxicity.
Most older women with early-stage breast cancer were adherent to short-term oral chemotherapy in a randomized clinical trial. Age was not associated with adherence.
Notes
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Cites: Br J Cancer. 2008 Dec 2;99(11):1763-818985046
Cites: Breast Cancer Res Treat. 2009 Oct;117(3):615-2319294501
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Cites: N Engl J Med. 2009 May 14;360(20):2055-6519439741
PubMed ID
20368559 View in PubMed
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[Adherence of patients with stable angina to treatment with trimetazidine MR and frequency of emergency medical care: results of the EFFECT study].

https://arctichealth.org/en/permalink/ahliterature118141
Source
Kardiologiia. 2012;52(11):4-11
Publication Type
Article
Date
2012
Author
M G Glezer
R T Saigitov
Source
Kardiologiia. 2012;52(11):4-11
Date
2012
Language
Russian
Publication Type
Article
Keywords
Aged
Angina, Stable - drug therapy - epidemiology - physiopathology - psychology
Drug Monitoring - methods
Drug Substitution - statistics & numerical data
Electrocardiography
Emergencies - epidemiology
Emergency Medical Services - statistics & numerical data
Episode of Care
Female
Hospitalization - statistics & numerical data
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Outcome and Process Assessment (Health Care)
Prospective Studies
Risk assessment
Risk factors
Russia - epidemiology
Therapeutic Equivalency
Treatment Outcome
Trimetazidine - administration & dosage - pharmacokinetics
Vasodilator Agents - administration & dosage - pharmacokinetics
Abstract
The adherence of patients with stable angina to antianginal therapy is the key factor of controlling the disease. The purpose of the study was to evaluate the relationship of adherence of patients with stable angina to treatment with trimetazidine modified release (MR) with frequency (risk) of emergency medical care. We consistently included in the study patients with stable angina in primary health care. The results of treatment for 16 weeks were monitored at patients with angina attacks three times per week or more, use of short nitrate and treatment with generic trimetazidine. To strengthen the antianginal therapy generic was replaced with original trimetazidine MR. Adherence is considered relatively high while taking 80-120% of the recommended dose of the drug (70 mg/day). The effectiveness of treatment evaluated by the frequency of emergency hospitalizations and/or ambulance calls because of the pain, discomfort, tightness in the chest or ischemic changes on the electrocardiogram. 870 patients were included in the study, the results of treatment in 185 were assessed. Patients with a relatively high adherence to trimetazidine MR (n=151) were used (median) 99% (98, 104), with low (<80%, n=34) adherence - 67% (49, 76) of the recommended dose of the drug. During the study period, the primary end point is fixed in 7 (21%) patients with low and in 18 (12%) - with relatively high adherence (p=0.182). The number of angina attacks, having necessitated taking short-nitrate, decreased in the groups, respectively, with 5 (3; 10) and 6 (4; 10) to 2 (1; 3) per week (p=0.791). Thus, replacing generic trimetazidine with original trimetazidine MR in patients with a high frequency of angina attacks can achieve significant antianginal effect. Adherence of patients to the reception of the drug by an average 1/3 below the recommended amount does not affect the risk of emergency hospitalizations and/or ambulance calls for 16 weeks.
PubMed ID
23237390 View in PubMed
Less detail

[Adverse drug reaction reporting and drug monitoring].

https://arctichealth.org/en/permalink/ahliterature186243
Source
Tidsskr Nor Laegeforen. 2003 Feb 6;123(3):331-2
Publication Type
Article
Date
Feb-6-2003
Author
Pernille Harg
Harald Lislevand
Ingebjørg Buajordet
Steinar Madsen
Author Affiliation
Seksjon for legemiddelovervåking Statens legemiddelverk Sven Oftedals vei 8, 0950 Oslo.
Source
Tidsskr Nor Laegeforen. 2003 Feb 6;123(3):331-2
Date
Feb-6-2003
Language
Norwegian
Publication Type
Article
Keywords
Adverse Drug Reaction Reporting Systems - organization & administration
Drug Monitoring
Humans
Norway
PubMed ID
12640902 View in PubMed
Less detail

Adverse drug reactions of antidepressants and antipsychotics: experience, knowledge and attitudes among Norwegian psychiatrists.

https://arctichealth.org/en/permalink/ahliterature82134
Source
Nord J Psychiatry. 2006;60(3):227-33
Publication Type
Article
Date
2006
Author
Castberg Ingrid
Reimers Arne
Sandvik Pål
Aamo Trond O
Spigset Olav
Author Affiliation
Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway. ingrid.castberg@stolav.no
Source
Nord J Psychiatry. 2006;60(3):227-33
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Adverse Drug Reaction Reporting Systems - statistics & numerical data
Antidepressive Agents - adverse effects - therapeutic use
Antipsychotic Agents - adverse effects - therapeutic use
Attitude of Health Personnel
Demography
Depressive Disorder, Major - diagnosis - drug therapy - epidemiology
Drug Monitoring - methods
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Norway - epidemiology
Questionnaires
Abstract
Efficient prevention of adverse drug reactions (ADRs) requires knowledge about their severity and pharmacological mechanisms and is dependent on reliable data on their frequencies and possible risk factors. The study was conducted to investigate the prescribers' experience and understanding of the ADRs of psychotropic drugs, and their attitude towards reporting these. In a questionnaire, physicians treating adult psychiatric patients were asked which ADRs that they regarded bothersome for some of the most widely used antidepressants and antipsychotics. Questions about the relationship between blockade of drug receptors and ADRs, and about the physicians' personal experience of and attitudes towards reporting of ADRs were also included. In total, 70 of 91 questionnaires (78%) were returned. The mean number of ADRs regarded bothersome ranged from 2.4 to 9.3 for the various drugs/drug classes. Qualified psychiatrists stated a significantly higher number of bothersome ADRs than did the residents. The percentage of physicians associating blockade of a receptor with a specific ADR varied from 76% (histamine receptor blockade and sedation) to 37% (alpha(1)-adrenergic blockade and tachycardia). Thirty-nine per cent of the physicians had never reported an ADR to the Norwegian Medicines Agency. The number of ADRs considered bothersome was relatively high. The pattern of these ADRs generally mirrored the typical ADR profiles of the drugs. The knowledge of the underlying mechanisms of ADRs was more or less incomplete. The reporting rate of ADRs to the national regulatory authorities was low.
PubMed ID
16720514 View in PubMed
Less detail

Alaska nurse practitioners' barriers to use of prescription drug monitoring programs.

https://arctichealth.org/en/permalink/ahliterature297608
Source
J Am Assoc Nurse Pract. 2018 Jan; 30(1):35-42
Publication Type
Journal Article
Date
Jan-2018
Author
Heath Christianson
Elizabeth Driscoll
Aicha Hull
Author Affiliation
Department of Clinical Services, Colorado Suncrest Hospice, Colorado Springs, Colorado.
Source
J Am Assoc Nurse Pract. 2018 Jan; 30(1):35-42
Date
Jan-2018
Language
English
Publication Type
Journal Article
Keywords
Alaska
Clinical Competence - standards
Health Knowledge, Attitudes, Practice
Humans
Nurse Practitioners - psychology - standards - statistics & numerical data
Prescription Drug Monitoring Programs - statistics & numerical data
Prescription Drugs - administration & dosage
Surveys and Questionnaires
Abstract
Prescription drug monitoring programs (PDMPs) have begun to demonstrate themselves as useful tools in enhancing safe and responsible prescription of controlled substances. The purpose of this project was to describe current practice, beliefs, and barriers of Alaska nurse practitioners (NPs) regarding the Alaska PDMP.
A questionnaire was sent to 635 Alaskan NPs with a 33% return rate. The data depicted prescribing habits, barriers to use, barriers to registering, and opinions on how to make the PDMP more clinically useful.
More attention is needed to maximize PDMP exposure and incorporation into daily workflow if it is to achieve full potential. Registered users should be able to delegate PDMP authority to select staff members to reduce time commitments and increase usage. Many providers felt that assigning unique patient identifiers could prevent consumers from filling prescriptions under aliases. Finally, an overwhelming majority of users wanted faster data entry and proactive reports.
This project explored the differences between PDMP users and nonusers and outlined NP suggestions for process improvement. A better understanding of PDMP use will aid providers in safe prescribing while curbing the prescription drug epidemic and ultimately reducing abuse, misuse, and death from overdose.
PubMed ID
29757920 View in PubMed
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The alpha-tocopherol, beta-carotene lung cancer prevention study: design, methods, participant characteristics, and compliance. The ATBC Cancer Prevention Study Group.

https://arctichealth.org/en/permalink/ahliterature219137
Source
Ann Epidemiol. 1994 Jan;4(1):1-10
Publication Type
Article
Date
Jan-1994
Source
Ann Epidemiol. 1994 Jan;4(1):1-10
Date
Jan-1994
Language
English
Publication Type
Article
Keywords
Adjuvants, Immunologic - therapeutic use
Aged
Carotenoids - therapeutic use
Clinical Protocols
Double-Blind Method
Drug Monitoring
Drug Therapy, Combination
Finland - epidemiology
Follow-Up Studies
Humans
Incidence
Lung Neoplasms - epidemiology - mortality - prevention & control - psychology
Male
Middle Aged
Patient compliance
Population Surveillance
Primary prevention - methods
Research Design
Risk factors
Smoking - adverse effects
Vitamin E - therapeutic use
beta Carotene
Abstract
The Alpha-Tocopherol, Beta-Carotene (ATBC) Lung Cancer Prevention Study was a randomized, double-blind, placebo-controlled, 2 x 2 factorial design, primary prevention trial testing the hypothesis that alpha-tocopherol (50 mg/day) and beta-carotene (20 mg/day) supplements reduce the incidence of lung cancer and possibly other cancers. Total and disease-specific mortality and incidence of various diseases and symptoms were monitored for safety. Between 1985 and 1993, 29,133 eligible male smokers aged 50 to 69 years at entry were randomized to receive daily active supplements or placebo capsules for 5 to 8 years (median 6.1 years), accumulating 169,751 follow-up years. This report describes the study design, methods, and protocol as well as the baseline characteristics and capsule compliance of the participants. The ATBC Study is the largest lung cancer chemoprevention trial conducted to date.
Notes
Comment In: Ann Epidemiol. 1994 Jan;4(1):758205274
PubMed ID
8205268 View in PubMed
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An algorithm to detect adverse drug reactions in the neonatal intensive care unit.

https://arctichealth.org/en/permalink/ahliterature116413
Source
J Clin Pharmacol. 2013 Jan;53(1):87-95
Publication Type
Article
Date
Jan-2013
Author
Wei Du
Victoria Tutag Lehr
Mary Lieh-Lai
Winston Koo
Robert M Ward
Michael J Rieder
John N Van Den Anker
Jaxk H Reeves
Merene Mathew
Mirjana Lulic-Botica
Jacob V Aranda
Author Affiliation
Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA. duw@med.wayne.edu
Source
J Clin Pharmacol. 2013 Jan;53(1):87-95
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Algorithms
Drug Monitoring - methods
Drug-Related Side Effects and Adverse Reactions - diagnosis
Female
Hospitals, Pediatric
Humans
Infant
Infant, Newborn
Intensive Care Units, Neonatal
Male
Ontario
Pharmacovigilance
Reproducibility of Results
Abstract
Critically ill newborns in neonatal intensive care units (NICUs) are at greater risk of developing adverse drug reactions (ADRs). Differentiation of ADRs from reactions associated with organ dysfunction/immaturity is difficult. Current ADR algorithm scoring was established arbitrarily without validation in infants. The study objective was to develop a valid and reliable algorithm to identify ADRs in the NICU. Algorithm development began with a 24-item questionnaire for data collection on 100 previously suspected ADRs. Five pediatric pharmacologists independently rated cases as definite, probable, possible, and unlikely ADRs. Consensus "gold standard" was reached via teleconference. Logistic regression and iterative C programs were used to derive the scoring system. For validation, 50 prospectively collected ADR cases were assessed by 3 clinicians using the new algorithm and the Naranjo algorithm. Weighted kappa and intraclass correlation coefficient (ICC) were used to compare validity and reliability of algorithms. The new algorithm consists of 13 items. Kappa and ICC of the new algorithm were 0.76 and 0.62 versus 0.31 and 0.43 for the Naranjo algorithm. The new algorithm developed using actual patient data is more valid and reliable than the Naranjo algorithm for identifying ADRs in the NICU population. Because of the relatively small and nonrandom samples, further refinement and additional testing are needed.
PubMed ID
23400748 View in PubMed
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An overview of the current status of national reporting systems for adverse reactions to dental materials.

https://arctichealth.org/en/permalink/ahliterature179689
Source
J Dent. 2004 Jul;32(5):351-8
Publication Type
Article
Date
Jul-2004
Author
Richard van Noort
Nils R Gjerdet
Andreas Schedle
Lars Björkman
Anders Berglund
Author Affiliation
Department of Adult Dental Care, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK. r.vannoort@sheffield.ac.uk
Source
J Dent. 2004 Jul;32(5):351-8
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Adult
Adverse Drug Reaction Reporting Systems - organization & administration - statistics & numerical data
Age Factors
Dental Alloys - adverse effects
Dental Amalgam - adverse effects
Dental Auxiliaries - statistics & numerical data
Dental Materials - adverse effects
Dentists - statistics & numerical data
Drug Monitoring - statistics & numerical data
Female
Great Britain
Humans
Male
Middle Aged
Norway
Patients - statistics & numerical data
Product Surveillance, Postmarketing - statistics & numerical data
Safety
Sex Factors
Sweden
Abstract
Since all dental materials pose a potential risk to patients and members of the dental team, the post-market monitoring of adverse reactions caused by dental materials should be considered essential. This article reviews the current status of post-market monitoring of adverse reactions to dental materials and highlights some of the issues that arise in trying to establish an evidence base on the characteristics of adverse reactions to dental materials.
Norway, Sweden and more recently the UK have sought to monitor adverse reactions to dental materials systematically and proactively in an effort to add to the evidence base on the safety of dental materials. Their experiences in undertaking post-market surveillance have been combined in preparing this article.
To date the Norwegian, Swedish and the UK projects has received 1268 reports over 11 years, 848 reports over 5.5 years and 1117 reports over 3 years, respectively, relating to adverse reactions seen or experienced by dental personnel and patients. Presently, there are no harmonized criteria for what can be classified as an adverse reaction related to dental materials. Under reporting is a recognised problem and lack of awareness and lack of clarity as to what constitutes an adverse reaction may be contributory factors. A pro-active reporting system takes a considerable time to become established, but can generate a lot of potentially useful information.
There is a need to raise the awareness among dental professionals of the potential for adverse reactions due to dental materials and to develop an internationally accepted system of data gathering that can produce the evidence that reflect the extent, severity and incidence of adverse reactions to dental materials.
PubMed ID
15193782 View in PubMed
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261 records – page 1 of 27.