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[Use of non-conventional amphotericin B at the San Carlos Clinical Hospital].

BACKGROUND: Amphotericin B is the treatment of choice for systemic fungal infections, however, its clinical usefulness is limited by its toxicity. The lipid formulations appear to be equally effective and safer, but are more costly. The increase in the consumption of, and expenditure on these formulas led us to undertake a study in order to identify their profile of use (quantitative and qualitative) and to assess the financial repercussions when used inappropriately. METHODS: A set of rules were developed for the use of amphotericin B, and the quality of the prescription of non-conventional

Clozapine prescribing in Germany: temporal trends and regional variations, 2012-2022.

Clozapine is the most effective and only approved drug for treatment-resistant schizophrenia (TRS). Studies based on data up to 2014 concluded that it is underutilized in most industrialized countries, including Germany. Since 2019, national guidelines have explicitly been recommending clozapine as first-line therapy in TRS. We aimed to assess whether clozapine use in Germany has increased in recent years and to examine regional variations. Using claims data covering about 20% of the German population (GePaRD), we calculated the yearly prescription prevalence and incidence of clozapine among i

ACNAP Congress - perspectives from an established allied professional researcher.

Attending the ACNAP2026 Congress for the first time was a highly valuable and inspiring experience. I particularly appreciated the opportunity to gain insights into different healthcare systems and to learn more about the various roles of healthcare professionals across Europe and other continents. The congress offered a broad scientific programme with poster sessions, workshops and symposia covering various topics in cardiovascular care. I focused on sessions closely related to my clinical and research interests, particularly personalised exercise prescription, cardiovascular rehabilitation a

From guidelines to practice: antihypertensive prescribing preferences in Türkiye-the APP-Türkiye study.

Antihypertensive prescribing patterns vary across countries, potentially influencing BP control rates, which remain suboptimal worldwide. To … cording to the Anatomical Therapeutic Chemical system. This study investigated the antihypertensive prescriptions of 10 705 115 individuals aged over 18. A total of 19 869 235 antihypertensives were prescribed over the one-year study period, with a mean number of 2.67 ± 1.53 per patient. The three most frequently prescribed antihypertensive groups in the genera …

Antibiotic Utilization in Medicaid-Enrolled Children: Associations with Medical Complexity.

OBJECTIVES: To describe contemporary patterns of pediatric outpatient antibiotic utilization and to identify patient-level factors associate … hronic conditions (CCCs). Penicillins, cephalosporins, and macrolides comprised 93.0% of antibiotic prescriptions in healthy children, vs 65.0% in children with ≥3 CCCs. High antibiotic utilization was associated with younger age, female sex, blind/disabled basis of Medicaid eligibility, capitated plans, and increasing CCCs. CONCLUSIONS: Children with multiple …

The Hepatitis C Cascade of Care for Opioid Agonist Therapy Recipients in Australia.

BACKGROUND: People prescribed opioid agonist therapy (OAT) are a key population for hepatitis C virus (HCV) elimination. Health service engagement associated with OAT provision may facilitate hepatitis C testing and treatment. We aimed to quantify the HCV care cascade among people receiving OAT in Australia. METHODS: We extracted linked data from individuals attending any of 58 clinics participating in the ACCESS national sentinel surveillance network of primary care and sexual health clinics from 1 January 2016 to 31 December 2023. Outcomes included evidence of any HCV test (antibody or RNA)

Impact of X-Waiver Elimination on Post-Hospital Discharge Buprenorphine Prescribing: An Interrupted Time Series Analysis.

OBJECTIVES: This study aimed to assess the impact of the X-waiver elimination on buprenorphine prescribing following hospital discharge in p … ved a postdischarge buprenorphine prescription. Unadjusted analysis revealed an initial increase in prescriptions at the start of the postelimination period [odds ratio (OR): 1.2, 95% CI: 1.1-1.3, P < 0.001]. However, after adjusting for potential confounding due to baseline imbalances, both the immediate change in the proportion with prescriptions [OR: 1.12 (0 …

Effects of Osteoporosis Medication Use on Reprocedure Rates Following Vertebral Augmentation: A Nationwide Cohort Study.

BACKGROUD: In this study, we aimed to investigate the effects of osteoporosis medication use and prescription duration on the rates of reprocedures for re-fractures in patients who underwent vertebral augmentation (VA). METHODS: This retrospective cohort study was conducted using data collected from the National Health Insurance Service database of South Korea. Patients aged 50 years or older who underwent VA in 2012 were included in this study. A reprocedure was defined as an additional VA performed for re-fractures during a follow-up period of up to 5 years. Patients were categorized based

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… Reprocedure Rate According to the Prescription Duration of Medications In the comparison of reprocedure rates according to the duration of osteoporosis medication prescriptions, 22% of the patients in the absolute complete prescription group, 11% in the complete prescription group, and 7.8% in the incomplete … Regarding prescription duration, the hazard ratio was 1.22 for the incomplete prescription group and 1.89 for the complete prescription group, with the absolute complete prescription group showing a 9.07 times higher hazard ratio ( Table 4 ). …

Impact of antimicrobial resistance measures and the emergence of COVID-19 on antimicrobial use throughout the Japanese population: A retrospective cohort study using a national claims database.

OBJECTIVE: This study examined the impact of Japan's National Action Plan on Antimicrobial Resistance (NAP) and the COVID-19 pandemic on nat … after COVID-19. No significant trends were detected for other diseases. CONCLUSIONS: Antimicrobial prescriptions for respiratory infections steadily decreased after NAP publication, which may indicate the effects of antimicrobial stewardship activities. Continued monitoring is needed to clarify the long-term effects of the COVID-19 pandemic on antimicrobial us …

Public Perceptions of Opioid Use for Chronic Non-Cancer Pain.

Background: Chronic non-cancer pain affects 20% of Americans. This is significantly impacted by the ongoing opioid crisis and reduced opioid dispensing. Public perceptions additionally shape pain management strategies. Purpose: This study explores public attitudes toward prescription opioids for chronic non-cancer pain. We aim to understand how public attitudes are influenced by the evolving opioid crisis and shifting opioid use patterns. Methods: In Michigan, 823 adults participated in a Qualtrics survey on attitudes toward nonmedical and medical prescription opioid use. Multivariable logisti

A real-world study of the quality of Outpatient Pain Management in patients with Cancer.

PURPOSE: Up to 40% patients with cancer reporting pain may not receive optimal analgesia indicating inadequate treatment of pain. We examined the patterns of outpatient pain management in patients with cancer who reported pain. METHODS: We used the National Ambulatory Medical Care Survey data for outpatient visits from 2006 to 2018 for patients with any cancer and reporting pain. The primary outcome was prescription of pain medications among these patients. We performed multinomial logistic regression to identify factors associated with analgesic prescriptions among patients with cancer who r…

Latent Tuberculosis Infection Treatment Practices in Two Large Integrated Health Systems in California, 2009-2018.

BACKGROUND: Treatment of latent tuberculosis infection (LTBI) is highly effective at preventing active tuberculosis (TB) disease. Understanding LTBI treatment practices in US health system settings is critical to identify opportunities to improve treatment prescription, initiation, and completion, and thus to prevent TB disease. METHODS: We assessed LTBI treatment practices among a cohort of adults after their first positive LTBI test (tuberculin skin test [TST] or interferon gamma release assay [IGRA]) between 2009 and 2018 at 2 large integrated health systems in California. We described the

Comparative effect of varenicline and nicotine patches on preventing repeat cardiovascular events.

OBJECTIVE: To determine the comparative effectiveness of postdischarge use of varenicline versus prescription nicotine replacement therapy (NRT) patches for the prevention of recurrent cardiovascular events and mortality and whether this association differs by sex. METHODS: Our cohort study used routinely collected hospital, pharmaceutical dispensing and mortality data for residents of New South Wales, Australia. We included patients hospitalised for a major cardiovascular event or procedure 2011-2017, who were dispensed varenicline or prescription NRT patches within 90day postdischarge. Expo

[Dosing of basic pharmacotherapy and its effect on the prognosis of patients hospitalized for heart failure].

BACKGROUND: We analyzed the prescription and dosage of essential pharmacotherapy in chronic heart failure (HF) at the time of discharge from the hospitalization for cardiac decompensation and how it may have influenced the prognosis of the patients. METHODS: We followed 4097 patients [mean age 70.7, 60.2% males] hospitalized for HF between 2010 and 2020. The vital status we ascertained from the population registry, other circumstances from the hospital information system. RESULTS: The prescription of beta-blockers (BB) was 77.5% (or only 60.8% of BB with evidence in HF), 79% of renin-angiote

Effects of state opioid prescribing cap laws on providers' opioid prescribing patterns among patients with chronic non-cancer pain.

Prior work suggests opioid prescribing cap laws are not associated with changes in opioid prescribing among patients with chronic pain. It i … der's patient panel who received any opioid prescription, as well as on dose and duration of opioid prescriptions. For providers overall, high volume prescribers, all specialties, and patient insurance categories, prescribing cap laws were associated with non-significant changes of <1.0, 1.5, and 3.5 percentage points in the proportion of chronic non-cancer pat …

Study on Medication Rules of Traditional Chinese Medicine in Treating Constipation through Data Mining and Network Pharmacology.

BACKGROUND: To explore the rules of TCM medication in the treatment of constipation in network pharmacology. METHODS: Collect and screen the clinical intervention literature on TCM for constipation from China's national knowledge infrastructure, Wanfang and VIP databases established a database of TCM for constipation, applied R software (3.3.1) to analyze the pattern of prescriptions for TCM for constipation, and summarized the core prescription. The effective active compounds and action targets in the core prescription were screened by Traditional Chinese Medicine Systems Pharmacology (TCMSP…

The CredibleMeds® list: Usage of QT interval prolonging drugs in Germany and discordances with prescribing information.

AIMS: A substantial number of Summaries of Product Characteristics (SmPCs)/Prescribing Information (PI) have warnings or contraindications o … o 2020. The German drug prescription report was used as source for defined daily dose- (DDD-) based prescriptions of the German outpatient drug prescription market of the public health insurance system. German SmPCs and US PI of 253 CredibleMeds® -listed drugs were evaluated for contents regarding QT interval prolongation. RESULTS: Of the drugs currently liste …

Patterns of opioid and benzodiazepine use with gabapentin among disabled Medicare beneficiaries - A retrospective cohort study.

BACKGROUND: Our goal was to describe specific patterns associated with co-prescriptions of gabapentin, opioids, and benzodiazepines among disabled Medicare beneficiaries. METHODS: Using 2013-2015 Medicare data, we conducted a retrospective cohort study among fee-for-service disabled beneficiaries continuously enrolled in Medicare Parts A, B, and D. The index date was defined as the earliest fill date for a gabapentin, opioid, or benzodiazepine prescription. Monotherapy, dual therapy, and tri-therapy were defined as utilization of one, two, and three medication classes, respectively. Augmentat…

Classification of Opioid Usage Through Semi-Supervised Learning for Total Joint Replacement Patients.

Opioid misuse and overdose have become a public health hazard and caused drug addiction and death in the United States due to rapid increase in prescribed and non-prescribed opioid usage. The misuse and overdose are highly related to opioid over-prescription for chronic and acute pain treatment, where a one-size-fits-all prescription plan is often adopted but can lead to substantial leftovers for patients who only consume a few. To reduce over-prescription and opioid overdose, each patient's opioid usage pattern should be taken into account. As opioids are often prescribed for patients after t

Demographic, Clinical, and Prescribing Characteristics Associated with Future Opioid Use in an Opioid-Naive Population in an Integrated Health System.

INTRODUCTION: Health systems and prescribers need additional tools to reduce the risk of opioid dependence, abuse, and overdose. Identifying opioid-naive individuals who are at risk of opioid dependence could allow for the development of needed interventions. METHODS: We conducted a retrospective cohort analysis of 23,804 adults in an integrated health system who had received a first opioid prescription between 2010 and 2015. We compared the demographic, clinical, and prescribing characteristics of individuals who later received a third opioid dispense at least 27 days later, indicating long-