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1

Methadone and prescription drug overdose.  

PubMed

(1) Methadone accounted for 2 percent of painkiller prescriptions and more than 30 percent of prescription painkiller deaths in 2009. (2) Data suggest that the rise in deaths from methadone overdose is not related to its use in treating drug abuse but, rather, to its use for pain management. (3) Preferred drug lists in most Medicaid programs identify methadone as a preferred drug for managing chronic pain, but most experts do no recommend it as a first choice. PMID:25556261

Hendrikson, Hollie; Hansen, Melissa

2014-12-01

2

Associations among Pain, Non-Medical Prescription Opioid Use, and Drug Overdose History  

PubMed Central

Background and Objective Recently, use of prescription opioids (POs) has increased; non-medical PO (NMPO) use is linked to overdose. NMPO use is common among individuals prescribed opioids for pain, and those in Substance Use Disorder (SUD) treatment with pain could be at increased risk for unintentional overdose due to NMPO use. We examined associations between pain, NMPO use, and overdose among SUD treatment patients. Methods Among 342 patients at a residential SUD treatment center, logistic regression examined the association of overdose with pain, adjusting for substance use, suicide attempts, and demographics. Results Pain was positively related to NMPO use. Heroin use, suicide attempts, pain, and NMPO use were positively associated with overdose; but NMPO use attenuated the pain-overdose relationship. Conclusions The relationship between pain and overdose among substance users may be, in part, explained by the association between pain and heavy NMPO use. PMID:24313240

Bonar, Erin E.; Ilgen, Mark A.; Walton, Maureen; Bohnert, Amy S.B.

2014-01-01

3

Drug Overdose Deaths, Hospitalizations,  

E-print Network

Drug Overdose Deaths, Hospitalizations, and Emergency Department Visits in Kentucky, 2000 - 2012 #12; Kentucky Injury Preven on and Research Center Drug Overdose Deaths, Hospitaliza ons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Drug overdose deaths, 20002012

MacAdam, Keith

4

Prescription Drug Abuse  

MedlinePLUS

... by adolescents. The abuse of certain prescription drugs— opioids, central nervous system (CNS) depressants, and stimulants—can ... is an urgent one: unintentional overdose deaths involving opioid pain relievers have quadrupled since 1999, and by ...

5

Antidiarrheal drug overdose  

MedlinePLUS

... containing diphenoxylate or atropine. Diphenoxylate is a weak opioid, a class of drugs which includes morphine and other narcotics. Nonmedicinal use of prescription opioids, in adults and teens, is an extensive and ...

6

Prescription Drugs  

MedlinePLUS

... body, especially in brain areas involved in the perception of pain and pleasure. Prescription stimulants , such as ... of drug that causes changes in your mood, perceptions, and behavior can affect judgment and willingness to ...

7

CDC Vital Signs: Prescription Painkiller Overdoses  

MedlinePLUS

... Overdoses A growing epidemic, especially among women July 2013 48,000 Nearly 48,000 women died of ... Subscribe Listen Download Page last reviewed: July 2, 2013 Page last updated: July 3, 2013 Content source: ...

8

CDC Vital Signs: Prescription Painkiller Overdoses  

MedlinePLUS

... increasingly as a painkiller because it is a generic drug that can provide long-lasting pain relief. But ... methadone. Methadone is available as a low-cost generic drug. It is often listed as a preferred drug ...

9

Prescription Drug Costs  

MedlinePLUS

... right-hand corner of the player. Prescription Drug Costs HealthDay January 30, 2015 Related MedlinePlus Pages Financial Assistance Health Insurance Medicines Transcript Prescriptions drugs can cost a lot, even with health insurance… New research ...

10

Prescription Drug Abuse  

MedlinePLUS

... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that was ... prescription drugs can lead to addiction. These include narcotic painkillers, sedatives, tranquilizers, and stimulants. Every medicine has ...

11

Prescription Drug Abuse  

MedlinePLUS

... more dangerous than people think. In fact, it's drug abuse. And it's just as illegal as taking street ... on the street like other illegal drugs. Prescription drug abuse continues to rise. In 2012, 24% of teens ...

12

Prescription Drug Monitoring Programs: Examining Limitations and Future Approaches  

PubMed Central

Prescription drug abuse is a leading cause of accidental death in the United States. Prescription drug monitoring programs (PDMPs) are a popular initiative among policy makers and a key tool to combat the prescription drug epidemic. This editorial discusses the limitations of PDMPs, future approaches needed to improve the effectiveness of PDMPs, and other approaches essential to curbing the rise of drug abuse and overdose. PMID:25671011

Griggs, Christopher A.; Weiner, Scott G.; Feldman, James A.

2015-01-01

13

Decline in drug overdose deaths after state policy changes - Florida, 2010-2012.  

PubMed

During 2003-2009, the number of deaths caused by drug overdose in Florida increased 61.0%, from 1,804 to 2,905, with especially large increases in deaths caused by the opioid pain reliever oxycodone and the benzodiazepine alprazolam. In response, Florida implemented various laws and enforcement actions as part of a comprehensive effort to reverse the trend. This report describes changes in overdose deaths for prescription and illicit drugs and changes in the prescribing of drugs frequently associated with these deaths in Florida after these policy changes. During 2010-2012, the number of drug overdose deaths decreased 16.7%, from 3,201 to 2,666, and the deaths per 100,000 persons decreased 17.7%, from 17.0 to 14.0. Death rates for prescription drugs overall decreased 23.2%, from 14.5 to 11.1 per 100,000 persons. The decline in the overdose deaths from oxycodone (52.1%) exceeded the decline for other opioid pain relievers, and the decline in deaths for alprazolam (35.6%) exceeded the decline for other benzodiazepines. Similar declines occurred in prescribing rates for these drugs during this period. The temporal association between the legislative and enforcement actions and the substantial declines in prescribing and overdose deaths, especially for drugs favored by pain clinics, suggests that the initiatives in Florida reduced prescription drug overdose fatalities. PMID:24990490

Johnson, Hal; Paulozzi, Leonard; Porucznik, Christina; Mack, Karin; Herter, Blake

2014-07-01

14

Prescription Drug Abuse  

ERIC Educational Resources Information Center

This article presents current statistics on nonmedical use of both categories of prescription medications by high school and college students. The incidence of nonmedical use of prescription medications continues to increase among high school and college students. Two categories of drugs that are commonly used for reasons other than those for…

Hamilton, Gloria J.

2009-01-01

15

Abuse of prescription drugs.  

PubMed

An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801

Wilford, B B

1990-05-01

16

Injection drug users trained by overdose prevention programs: Responses to witnessed overdoses  

PubMed Central

In response to the growing public health problem of drug overdose, community-based organizations have initiated overdose prevention programs (OPP), which distribute naloxone, an opioid antagonist, and teach overdose response techniques. Injection drug users (IDUs) have been targeted for this intervention due to their high risk for drug overdose. Limited research attention has focused on factors that may inhibit or prevent IDUs who have been trained by OPPs to undertake recommended response techniques when responding to a drug overdose. IDUs (n=30) trained by two OPPs in Los Angeles were interviewed in 2010–11 about responses to their most recently witnessed drug overdose using an instrument containing both open and closed-ended questions. Among the 30 witnessed overdose events, the victim recovered in 29 cases while the outcome was unknown in one case. Participants responded to overdoses using a variety of techniques taught by OPP. Injecting the victim with naloxone was the most common recommended response while other recommended responses included stimulating the victim with knuckles, calling 911, and giving rescue breathing. Barriers preventing participants from employing recommended response techniques in certain circumstances included prior successes using folk remedies to revive a victim, concerns over attracting police to the scene, and issues surrounding access to or use of naloxone. Practical solutions, such as developing booster sessions to augment OPP, are encouraged to increase the likelihood that trained participants respond to a drug overdose with the full range of recommended techniques. PMID:22847602

Lankenau, Stephen E.; Wagner, Karla D.; Silva, Karol; Kecojevic, Aleksander; Iverson, Ellen; McNeely, Miles; Kral, Alex H.

2012-01-01

17

Preventing and Recognizing Prescription Drug Abuse  

MedlinePLUS

... Abuse » Preventing and recognizing prescription drug abuse Prescription Drug Abuse Email Facebook Twitter Preventing and recognizing prescription drug abuse To ensure proper medical care, patients should discuss ...

18

Fatal toxicity of antidepressant drugs in overdose  

Microsoft Academic Search

A fatal toxicity index (deaths per million National Health Service prescriptions) was calculated for antidepressant drugs on sale during the years 1975-84 in England, Wales, and Scotland. The tricyclic drugs introduced before 1970 had a higher index than the mean for all the drugs studied (p less than 0.001). In this group the toxicity of amitriptyline, dibenzepin, desipramine, and dothiepin

S Cassidy; J Henry

1987-01-01

19

prescription drug program highlights retail pharmacy prescriptions  

E-print Network

interactions and duplicate therapies. Brand name and generic drugs are included in your pharmacy benefit, but you will save the most money by selecting generic drug options when available. On myinformedRx.com youprescription drug program highlights SHIP retail pharmacy prescriptions The informedRx retail

Scharer, John E.

20

Trends in Prescription Drug Abuse  

MedlinePLUS

... Email Facebook Twitter Trends in prescription drug abuse In This Section How many people abuse prescription drugs? Adolescents and young adults Older adults Gender differences How many people suffer adverse health consequences from ...

21

Prescription Drugs and Cold Medicines  

MedlinePLUS

... Cold Medicines Email Facebook Twitter What is Prescription Drug Abuse: Some medications have psychoactive (mind-altering) properties and, ... Unused Medicines: What You Should Know (FDA) Prescription Drug Abuse Learn what you can do to prevent medicine ...

22

Prescription Drug Monitoring Programs and Other Interventions to Combat Prescription Opioid Abuse  

PubMed Central

The Center for Disease Control and Prevention (CDC) has published significant data and trends related to opioid prescription pain relievers (OPR). In 2008, 20,044 deaths were attributed to prescription drug overdose of which 14,800 (73.8%) were due to OPR, an amount greater than the number of overdose deaths from heroin and cocaine combined. The majority of these deaths were unintentional. Between 1999–2008, overdose deaths from OPR increased almost four-fold. Correspondingly, sales of OPR were four times greater in 2010 than in 1999. Most significant to emergency physicians is the estimate that 39% of all opioids prescribed, administered or continued come from the emergency department (ED). We present findings from the CDC’s Morbidity and Mortality Weekly Report (MMWR) with commentary on current recommendations and policies for curtailing the OPR epidemic.1 PMID:23357954

Chakravarthy, Bharath; Shah, Shyam; Lotfipour, Shahram

2012-01-01

23

What Are Some Commonly Abused Prescription Drugs?  

MedlinePLUS

... some of the commonly abused prescription drugs? Prescription Drug Abuse Email Facebook Twitter What are some of the ... 2014 Contents From the Director What is prescription drug abuse? What are some of the commonly abused prescription ...

24

Overdose  

MedlinePLUS

... on purpose, it is called an intentional or deliberate overdose. If the overdose happens by mistake, it ... J, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice . 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006: ...

25

Adolescent Nonmedical Prescription Drug Use  

ERIC Educational Resources Information Center

For many adolescents today, the most common form of substance use is nonmedical prescription drug use. Fittingly, many researchers, policy makers, and people who work with youth are concerned about the serious problems associated with nonmedical prescription drug use (NMPDU). In this article, authors Jason Ford and William Watkins provide an…

Ford, Jason A.; Watkins, William C.

2012-01-01

26

Therapeutic drug monitoring in drug overdose  

PubMed Central

The treatment of poisoned patients is still largely defined by history, clinical assessment and interpretation of ancillary investigations. Measurement of drug concentrations is clinically important for relatively few compounds. Most measurements form an adjunct to and should not be considered a substitute for clinical assessment. Drug concentrations are particularly important for those compounds where the concentration is predictive of serious toxicity in an otherwise asymptomatic patient. PMID:11564057

Dawson, Andrew H; Whyte, Ian M

2001-01-01

27

CDC Vital Signs: Prescription Painkiller Overdoses in the US  

MedlinePLUS

... health plans that identify and address improper patient use of painkillers. Pass, enforce and evaluate pill mill, doctor shopping and other laws to reduce prescription painkiller abuse. Encourage professional licensing ...

28

Popping Pills: Prescription Drug Abuse in America  

MedlinePLUS

... Prescription Drug Abuse in America Popping Pills: Prescription Drug Abuse in America Email Facebook Twitter NIDA recently challenged ... Infographics that present current scientific information about prescription drug abuse in interesting, novel, and creative ways to help ...

29

Treating Prescription Drug Addiction  

MedlinePLUS

... approach may be best. Some addictions, such as opioid addiction, can be treated with medications. These pharmacological ... best. In This Section Treating addiction to prescription opioids Treating addiction to CNS depressants Treating addiction to ...

30

76 FR 51245 - Branded Prescription Drug Fee  

Federal Register 2010, 2011, 2012, 2013, 2014

...multiple manufacturers and/or multiple drugs--(i) Step one. For each HCPCS...a mixture of branded prescription drugs made by different manufacturers and...mixture of branded prescription and generic drugs, CMS will determine-- (A)...

2011-08-18

31

Drug-induced hyperthermic syndromes: part I. Hyperthermia in overdose.  

PubMed

Drugs and natural compounds that affect the thermoregulatory system can induce or contribute to hyperthermia when used in excess. Hyperthermia associated with drug overdose is dangerous and potentially lethal. This article reviews the body's process of maintaining thermodynamic equilibrium, and describes the mechanisms by which it is influenced by sympathomimetic and anticholinergic drugs, salicylates, and thyroid replacement medications. Appropriate treatment strategies such as cooling and the administration of counteractive medications are discussed. PMID:24176476

Hayes, Bryan D; Martinez, Joseph P; Barrueto, Fermin

2013-11-01

32

“I Felt Like a Superhero”: The Experience of Responding to Drug Overdose Among Individuals Trained in Overdose Prevention  

PubMed Central

Background Overdose prevention programs (OPPs) train people who inject drugs and other community members to prevent, recognise and respond to opioid overdose. However, little is known about the experience of taking up the role of an “overdose responder” for the participants. Methods We present findings from qualitative interviews with 30 participants from two OPPs in Los Angeles, CA, USA from 2010–2011 who had responded to at least one overdose since being trained in overdose prevention and response. Results Being trained by an OPP and responding to overdoses had both positive and negative effects for trained “responders”. Positive effects include an increased sense of control and confidence, feelings of heroism and pride, and a recognition and appreciation of one’s expertise. Negative effects include a sense of burden, regret, fear, and anger, which sometimes led to cutting social ties, but might also be mitigated by the increased empowerment associated with the positive effects. Conclusion Findings suggest that becoming an overdose responder can involve taking up a new social role that has positive effects, but also confers some stress that may require additional support. OPPs should provide flexible opportunities for social support to individuals making the transition to this new and critical social role. Equipping individuals with the skills, technology, and support they need to respond to drug overdose has the potential to confer both individual and community-wide benefits. PMID:23932166

Wagner, Karla D.; Davidson, Peter J.; Iverson, Ellen; Washburn, Rachel; Burke, Emily; Kral, Alex H.; McNeeley, Miles; Bloom, Jennifer Jackson; Lankenau, Stephen E.

2013-01-01

33

Prescriptions, Over-the-Counter Drugs, Supplements and Herbal Products  

MedlinePLUS

... acid Warfarin (Coumadin® and Jantoven® ) What is prescription drug abuse? Prescription drug abuse is when you use a prescription drug in ... than ordered by a health care provider. Prescription drug abuse is a serious and growing problem. Nearly 1 ...

34

Overdose of drugs for attention-deficit hyperactivity disorder: clinical presentation, mechanisms of toxicity, and management.  

PubMed

The prevalence of attention-deficit hyperactivity disorder (ADHD) in the USA is estimated at approximately 4-9% in children and 4% in adults. It is estimated that prescriptions for ADHD medications are written for more than 2.7 million children per year. In 2010, US poison centers reported 17,000 human exposures to ADHD medications, with 80% occurring in children <19 years old and 20% in adults. The drugs used for the treatment of ADHD are diverse but can be roughly separated into two groups: the stimulants such as amphetamine, methylphenidate, and modafinil; and the non-stimulants such as atomoxetine, guanfacine, and clonidine. This review focuses on mechanisms of toxicity after overdose with ADHD medications, clinical effects from overdose, and management. Amphetamine, dextroamphetamine, and methylphenidate act as substrates for the cellular monoamine transporter, especially the dopamine transporter (DAT) and less so the norepinephrine (NET) and serotonin transporter. The mechanism of toxicity is primarily related to excessive extracellular dopamine, norepinephrine, and serotonin. The primary clinical syndrome involves prominent neurological and cardiovascular effects, but secondary complications can involve renal, muscle, pulmonary, and gastrointestinal (GI) effects. In overdose, the patient may present with mydriasis, tremor, agitation, hyperreflexia, combative behavior, confusion, hallucinations, delirium, anxiety, paranoia, movement disorders, and seizures. The management of amphetamine, dextroamphetamine, and methylphenidate overdose is largely supportive, with a focus on interruption of the sympathomimetic syndrome with judicious use of benzodiazepines. In cases where agitation, delirium, and movement disorders are unresponsive to benzodiazepines, second-line therapies include antipsychotics such as ziprasidone or haloperidol, central alpha-adrenoreceptor agonists such as dexmedetomidine, or propofol. Modafinil is not US FDA approved for treatment of ADHD; however, it has been shown to improve ADHD signs and symptoms and has been used as an off-label pharmaceutical for this diagnosis in both adults and children. The mechanism of action of modafinil is complex and not fully understood. It is known to cause an increase in extracellular concentrations of dopamine, norepinephrine, and serotonin in the neocortex. Overdose with modafinil is generally of moderate severity, with reported ingestions of doses up to 8 g. The most common neurological effects include increased anxiety, agitation, headache, dizziness, insomnia, tremors, and dystonia. The management of modafinil overdose is largely supportive, with a focus on sedation, and control of dyskinesias and blood pressure. Atomoxetine is a selective presynaptic norepinephrine transporter inhibitor. The clinical presentation after overdose with atomoxetine has generally been mild. The primary effects have been drowsiness, agitation, hyperactivity, GI upset, tremor, hyperreflexia, tachycardia hypertension, and seizure. The management of atomoxetine overdose is largely supportive, with a focus on sedation, and control of dyskinesias and seizures. Clonidine is a synthetic imidazole derivative with both central and peripheral alpha-adrenergic agonist actions. The primary clinical syndrome involves prominent neurological and cardiovascular effects, with the most commonly reported features of depressed sensorium, bradycardia, and hypotension. While clonidine is an anti-hypertensive medication, a paradoxical hypertension may occur early with overdose. The clinical syndrome after overdose of guanfacine may be mixed depending on central or peripheral alpha-adrenoreceptor effects. Initial clinical effects may be drowsiness, lethargy, dry mouth, and diaphoresis. Cardiovascular effects may depend on time post-ingestion and may present as hypotension or hypertension. The management of guanfacine overdose is largely supportive, with a focus on support of blood pressure. Overdose with ADHD medications can produce major morbidity, with many cases requiring intensive care medicine an

Spiller, Henry A; Hays, Hannah L; Aleguas, Alfred

2013-07-01

35

Changing Prescription Drug Sector: New Expenditure Methodologies  

PubMed Central

Estimating spending for prescription drugs has become increasingly difficult over the past 15 years as extensive changes have taken place within the retail prescription drug industry. Expenditures for prescription drugs in retail outlets grew rapidly during the 1980s and early 1990s. New retail outlets emerged and existing sites lost market share. New mechanisms for reimbursing drug purchases led to the flow of rebates between manufacturers and insurers, bypassing retailers. These and other major industry changes required the development of new estimating methodologies for tracking prescription drug expenditures within the National Health Accounts (NHA). PMID:10158730

Genuardi, James S.; Stiller, Jean M.; Trapnell, Gordon R.

1996-01-01

36

Are You Shopping Smart for Prescription Drugs?  

MedlinePLUS

... recently launched Consumer Reports Best Buy Drugs . The project compares prescription drugs based on their effectiveness, safety, side effects, and cost. The results are offered free at www.CRBestBuyDrugs. ...

37

Physician acquisition of prescription drug information.  

PubMed

The authors explore how the characteristics of prescription drug information sources influence the perceived usefulness of those sources. Physicians were asked in a survey to assess several prescription drug information sources and source characteristics. Their perceptions were examined statistically to determine whether they vary among physician subgroups (general practitioners versus specialists and younger versus older physicians). The results show that physician subgroups differ not only in their likelihood of using prescription drug information sources, but also in the importance they attribute to the information source characteristics. A situationally derived model of physician prescription drug information acquisition is advanced and a variety of academic and practitioner implications are discussed. PMID:10280368

Evans, K R; Beltramini, R F

1986-12-01

38

Underrepresentation of heroin involvement in unintentional drug overdose deaths in Allegheny County, PA.  

PubMed

Drugs contributing to overdose deaths are listed on death certificates, but their validity is rarely studied. To assess the accuracy of "morphine" and "codeine" listings on death certificates for unintentional overdose deaths in Allegheny County, PA, investigative and laboratory reports were reviewed. Deaths were reclassified as heroin-related if documentation showed 6-monoacetylmorphine in blood or urine, "stamp bags" or drug paraphernalia at scene, history of heroin use, or track marks. Deaths were considered morphine-related if notes indicated morphine use, prescription, or morphine at scene, or codeine-related if the codeine blood level exceeded morphine. Of 112 deaths with morphine but not heroin listed on the death certificate, 74 met heroin criteria and 21 morphine criteria. Of 20 deaths with both morphine and heroin listed, only one met morphine criteria. Of 34 deaths with codeine listed, only five were attributed to codeine. Consideration of patient history, death scene evidence, and expanded toxicology testing may improve the accuracy of death certificate drug listings. PMID:25041514

Mertz, Kristen J; Janssen, Jennifer K; Williams, Karl E

2014-11-01

39

Medicare Health and Prescription Drug Plans  

MedlinePLUS

... Plans Medicare Health and Prescription Drug Plans This data collection covers private plans participating in the Medicare Advantage ... Drug Plans: Average Premium for PDPs about this data collection The data and information are based on analysis ...

40

The “Black Box” of Prescription Drug Diversion  

PubMed Central

A variety of surveys and studies are examined in an effort to better understand the scope of prescription drug diversion and to determine if there are consistent patterns of diversion among various populations of prescription drug abusers. Data are drawn from the RADARS® System, the National Survey of Drug Use and Health (NSDUH), the Delaware School Survey, and a series of quantitative and qualitative studies conducted in Miami, Florida. The data suggest that the major sources of diversion include drug dealers, friends and relatives, smugglers, pain patients, and the elderly, but these vary by the population being targeted. In all of the studies examined, the use of the Internet as a source for prescription drugs is insignificant. Little is known about where drug dealers are obtaining their supplies, and as such, prescription drug diversion is a “black box” requiring concentrated systematic study. PMID:20155603

Inciardi, James A.; Surratt, Hilary L.; Cicero, Theodore J.; Kurtz, Steven P.; Martin, Steven S.; Parrino, Mark W.

2009-01-01

41

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food... § 202.1 Prescription-drug advertisements. (e) * * * (6...demonstrated by substantial evidence. An advertisement for a prescription drug may...

2014-04-01

42

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food... § 202.1 Prescription-drug advertisements. (e) * * * (6...demonstrated by substantial evidence. An advertisement for a prescription drug may...

2012-04-01

43

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food... § 202.1 Prescription-drug advertisements. (e) * * * (6...demonstrated by substantial evidence. An advertisement for a prescription drug may...

2011-04-01

44

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food... § 202.1 Prescription-drug advertisements. (e) * * * (6...demonstrated by substantial evidence. An advertisement for a prescription drug may...

2013-04-01

45

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food... § 202.1 Prescription-drug advertisements. (e) * * * (6...demonstrated by substantial evidence. An advertisement for a prescription drug may...

2010-04-01

46

Psychosocial and contextual correlates of opioid overdose risk among drug users in St. Petersburg, Russia  

PubMed Central

Background Opioid overdose in Russia is a problem that has grown more severe as heroin abuse expanded over the past decade, yet few studies have explored it in detail. In order to gain a clearer understanding of the situation, 60 drug users, both in and out of drug treatment in St. Petersburg, were interviewed concerning their overdose experience and knowledge about overdose recognition and prevention. Methods Using a semi-structured interview, we sought to identify and describe local attitudes, knowledge and experience (both self-sustained and witnessed) of opioid overdose. Bi-variate and multiple logistic regressions were performed in order to identify the relationship between overdose experience and sociodemographic factors, risk behaviors, and clinical psychiatric measures. Results We found that having experienced or witnessed an opioid overdose within the previous year was common, overdose knowledge was generally high, but nearly half the participants reported low self-efficacy for effectively intervening in an overdose situation. In bivariate analyses, self-reported family problems (i.e., perceived problematic family interactions) were positively associated with both experiencing (t56 = 2.49; p < 0.05) and with witnessing a greater number of overdoses in the previous year (rhos = 0.31; p < 0.05). Having previously overdosed [Adjusted Risk Ratio (ARR) 1.7, 95% Confidence Interval (CI) 1.1–2.6] and higher SCL-90-R somatization scores (ARR 1.2, 95% CI 0.96 – 1.5) were independently associated in multivariable analyses with self-sustained overdose experience in the past year. Greater perceived likelihood of experiencing a future overdose and concern about medical problems were independently associated with witnessing a higher number of overdoses within the previous year. Over two thirds of the participants expressed interest in receiving training in overdose prevention and response. Conclusion Opioid overdose experience is very common among drug users in St. Petersburg, Russia, and interest in receiving training for overdose recognition and prevention was high. Future research should target the development of effective overdose recognition and prevention interventions, especially ones that include naloxone distribution and involve drug users' families. PMID:19630963

Grau, Lauretta E; Green, Traci C; Torban, Mikhail; Blinnikova, Ksenia; Krupitsky, Evgeny; Ilyuk, Ruslan; Kozlov, Andrei P; Heimer, Robert

2009-01-01

47

FDA Policy on Comparative Prescription Drug Advertising  

Microsoft Academic Search

Prescription drug advertising is usually designed to develop a particular approach to convince the prescriber that based on clinical safety and effectiveness, that drug should be used in the treatment of a particular disease. Comparing one drug against another has become an increasingly popular method to advertise and promote drugs. Because of the misuse of comparative claims in recent years

Lloyd G. Millstein

1983-01-01

48

Prescription Drug Misuse Among Antisocial Youths*  

PubMed Central

Objective: The aim of this study was to describe the prevalence and correlates of nonmedical prescription drug misuse (PDM) in a state population of youths in residential care for antisocial behavior. Method: Interviews assessing substance use, psychiatric symptoms, antisocial traits/behavior, and traumatic life experiences were conducted with 723 Missouri youths. Participants were predominantly male (87.0%), averaged 15.5 (SD = 1.2) years of age, and constituted 97.7% of the service population sampled. Results: Overall, 314 youths (43.4%) reported lifetime PDM; 33.7%, 32.0%, and 11.2% had misused prescription opioids, tranquilizers, and barbiturates, respectively. Prescription drug misusers were significantly older, and larger proportions were girls, were White, and resided in small towns, compared with non-prescription drug misusers. Prescription drug misusers evidenced significantly more varied, frequent, and problematic psychoactive drug use; evidenced higher levels of distressing psychiatric symptoms; and were nearly twice as likely to have been diagnosed with a psychiatric disorder, compared with non-prescription drug misusers. Traumatic life events, experiences of criminal victimization, and suicidal ideation were significantly more prevalent in the histories of prescription drug misusers, compared with non-prescription drug misusers. In multiple logistic regression models, older age; White racial status; prior inhalant, marijuana, and LSD (lysergic acid diethylamide) use; residence in a small town; and impulsivity were associated with increased risk for PDM. Conclusions: Adolescents in residential care for antisocial behavior have high rates of PDM, as well as comorbid psychiatric and behavioral problems. Youths served in institutional settings should be routinely screened and treated for PDM and co-occurring disorders. PMID:20946750

Hall, Martin T.; Howard, Matthew O.; Mccabe, Sean Esteban

2010-01-01

49

Enzyme-therapy approaches for the treatment of drug overdose and addiction  

PubMed Central

“Recent progress in the study of cocaine-metabolizing enzymes demonstrates that enzyme-therapy approaches using appropriately designed enzymes show promise for the treatment of drug overdose and addiction.” PMID:21428822

Zheng, Fang; Zhan, Chang-Guo

2015-01-01

50

NonNon--medical Use of Prescription Drugsmedical Use of Prescription Drugs on College Campuseson College Campuses  

E-print Network

NonNon--medical Use of Prescription Drugsmedical Use of Prescription Drugs on College CampusesonNationally, there has been a rise in college students using prescription drugs,students using prescription drugsNon--medical Use of Prescription Drugs on College Campusesmedical Use of Prescription Drugs on College Campuses #12

New Hampshire, University of

51

Characteristics of hospital-treated intentional drug overdose in Ireland and Northern Ireland  

PubMed Central

Objectives This study compared the profile of intentional drug overdoses (IDOs) presenting to emergency departments in Ireland and in the Western Trust Area of Northern Ireland between 2007 and 2012. Specifically the study aimed to compare characteristics of the patients involved, to explore the factors associated with repeated IDO and to report the prescription rates of common drug types in the population. Methods We utilised data from two comparable registries which monitor the incidence of hospital-treated self-harm, recording data from deliberate self-harm presentations involving an IDO to all hospital emergency departments for the period 1 January 2007 to 31 December 2012. Results Between 2007 and 2012 the registries recorded 56?494 self-harm presentations involving an IDO. The study showed that hospital-treated IDO was almost twice as common in Northern Ireland than in Ireland (278 vs 156/100?000, respectively). Conclusions Despite the overall difference in the rates of IDO, the profile of such presentations was remarkably similar in both countries. Minor tranquillisers were the drugs most commonly involved in IDOs. National campaigns are required to address the availability and misuse of minor tranquillisers, both prescribed and non-prescribed. PMID:25079938

Griffin, Eve; Corcoran, Paul; Cassidy, Linda; O'Carroll, Amanda; Perry, Ivan J; Bonner, Brendan

2014-01-01

52

Understanding Medicare Prescription Drug Coverage  

MedlinePLUS

... in 2020. Enrollees also received a discount on generic drugs covered by Medicare Part D. The discount will ... enrollees pay just 25% of the cost of generic drugs in 2020. Where can I learn more? If ...

53

Indomethacin overdose  

MedlinePLUS

Donovan JW. Nonsteroidal anti-inflammatory drugs. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; 2007: ...

54

Ketoprofen overdose  

MedlinePLUS

Donovan JW. Nonsteroidal anti-inflammatory drugs. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; 2007: ...

55

The context of illicit drug overdose deaths in British Columbia, 2006  

Microsoft Academic Search

BACKGROUND: Illicit drug overdose deaths (IDD) relate to individual drug dose and context of use, including use with other drugs and alcohol. IDD peaked in British Columbia (BC) in 1998 with 417 deaths, and continues to be a public health problem. The objective of this study was to examine IDD in 2006 in BC by place of residence, injury and

Jane A Buxton; Trevor Skutezky; Andrew W Tu; Bilal Waheed; Alex Wallace; Sunny Mak

2009-01-01

56

Get the Facts: Prescription Drug Abuse on College Campuses  

MedlinePLUS

... or get “high” is an example of prescription drug abuse . Someone who abuses prescription medications is also likely ... illegal. a Slippery Slope: the dangerS of preSCription drug abuSe Many students mistakenly believe prescription medications are safe ...

57

It's time for Canadian community early warning systems for illicit drug overdoses  

PubMed Central

Although fatal and non-fatal overdoses represent a significant source of morbidity and mortality, current systems of surveillance and communication in Canada provide inadequate measurement of drug trends and lack a timely response to drug-related hazards. In order for an effective early warning system for illicit drug overdoses to become a reality, a number of elements will be required: real-time epidemiologic surveillance systems for illicit drug trends and overdoses, inter-agency networks for gathering data and disseminating alerts, and mechanisms for effectively and respectfully engaging with members of drug using communities. An overdose warning system in an urban area like Vancouver would ideally be imbedded within a system that monitors drug trends and overdoses by incorporating qualitative and quantitative information obtained from multiple sources. Valuable information may be collected and disseminated through community organizations and services associated with public health, emergency health services, law enforcement, medical laboratories, emergency departments, community-based organizations, research institutions and people with addiction themselves. The present paper outlines considerations and conceptual elements required to guide implementation of such systems in Canadian cities such as Vancouver. PMID:17391529

Fielden, Sarah J; Marsh, David C

2007-01-01

58

Strategies Used by Adults to Reduce Their Prescription Drug Costs  

MedlinePLUS

... Used by Adults to Reduce Their Prescription Drug Costs On This Page Key findings Adults used several ... Adults used several strategies to reduce prescription drug costs. Figure 1. Percentages of adults who used selected ...

59

Resonant Messages to Prevent Prescription Drug Misuse by Teens  

ERIC Educational Resources Information Center

Prescription drug misuse is a major health problem, particularly among teens. A key step in curbing misuse is the development of effective prescription drug prevention messages. This paper explores the elements of prescription drug misuse prevention messages that resonate with teens using data from focus groups with seventh and eighth grade…

Twombly, Eric C.; Holtz, Kristen D.; Agnew, Christine B.

2011-01-01

60

Patterns of Prescription Medication Diversion among Drug Dealers  

ERIC Educational Resources Information Center

This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South…

Rigg, Khary K.; Kurtz, Steven P.; Surratt, Hilary L.

2012-01-01

61

Aminophylline overdose  

MedlinePLUS

Shannon MW. Theophylline and caffeine. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; ...

62

Compazine overdose  

MedlinePLUS

Levine M, Burns MJ. Antipsychotic agents. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; 2007: ...

63

Diazepam overdose  

MedlinePLUS

Farrell SE, Fatovich TM. Benzodiazepines. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; ...

64

Caffeine overdose  

MedlinePLUS

Shannon MW. Theophylline and caffeine. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; ...

65

Imipramine overdose  

MedlinePLUS

Brush DE, Aaron CK. Tricyclic and other cyclic antidepressants. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: ...

66

Prescription Drug Expenditures and Population Demographics  

PubMed Central

Objective To provide detailed demographic profiles of prescription drug utilization and expenditures in order to isolate the impact of demographic change from other factors that affect drug expenditure trends. Data Sources/Study Setting Demographic information and drug utilization data were extracted for virtually the entire British Columbia (BC) population of 1996 and 2002. All residents had public medical and hospital insurance; however their drug coverage resembled the mix of private and public insurance in the United States. Study Design A series of research variables were constructed to illustrate profiles of drug expenditures and drug utilization across 96 age/sex strata. Data Collection/Extraction Methods Drug use and expenditure information was extracted from the BC PharmaNet, a computer network connecting all pharmacies in the province. Principal Findings Per capita drug expenditures increased at an average annual rate of 10.8 percent between 1996 and 2002. Population aging explained 1.0 points of this annual rate of expenditure growth; the balance was attributable to rising age/sex-specific drug expenditures. Conclusions Relatively little of the observed increase in drug expenditures in BC could be attributed to demographic change. Most of the expenditure increase stemmed from the age/sex-specific quantity and type of drugs purchased. The sustainability of drug spending therefore depends not on outside forces but on decisions made by policy makers, prescribers, and patients. PMID:16584456

Morgan, Steven G

2006-01-01

67

Managing heterogeneity in prescription drug coverage policies.  

PubMed

Necessity and fairness require that health plans limit the products and services they cover. The basis for these decisions refers to population averages and related population parameters. However, individuals vary and may not be accurately represented by the parameters used to establish coverage policies. Health plans, therefore, are obligated to anticipate and manage heterogeneity among their member groups. This commentary offers considerations for managing heterogeneity in prescription drug benefits. PMID:24856594

Teagarden, J Russell

2014-06-01

68

21 CFR 201.100 - Prescription drugs for human use.  

Code of Federal Regulations, 2011 CFR

21 Food and Drugs 4 2011-04-01 2011-04-01 false Prescription drugs for human use. 201.100 Section 201.100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

2011-04-01

69

21 CFR 201.100 - Prescription drugs for human use.  

Code of Federal Regulations, 2014 CFR

21 Food and Drugs 4 2014-04-01 2014-04-01 false Prescription drugs for human use. 201.100 Section 201.100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

2014-04-01

70

21 CFR 201.100 - Prescription drugs for human use.  

Code of Federal Regulations, 2013 CFR

21 Food and Drugs 4 2013-04-01 2013-04-01 false Prescription drugs for human use. 201.100 Section 201.100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

2013-04-01

71

21 CFR 201.100 - Prescription drugs for human use.  

Code of Federal Regulations, 2012 CFR

21 Food and Drugs 4 2012-04-01 2012-04-01 false Prescription drugs for human use. 201.100 Section 201.100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

2012-04-01

72

Alcohol and prescription drug safety in older adults  

PubMed Central

Background The objectives of this study were to investigate older adults’ knowledge of prescription drug safety and interactions with alcohol, and to identify pharmacists’ willingness to disseminate prescription drug safety information to older adults. Methods The convenience sample consisted of 48 older adults aged 54–89 years who were recruited from a local pharmacy and who completed surveys addressing their alcohol consumption, understanding of alcohol and prescription drug interactions, and willingness to change habits regarding alcohol consumption and prescription drugs. To address pharmacist willingness, 90 pharmacists from local pharmacies volunteered and answered questions regarding their willingness to convey prescription drug safety information to older adults. Results Older adults reported low knowledge of alcohol and prescription drug safety, with women tending to be slightly more knowledgeable. More importantly, those who drank in the previous few months were less willing to talk to family and friends about how alcohol can have harmful interactions with prescription drugs, or to be an advocate for safe alcohol and prescription drug use than those who had not had a drink recently. Pharmacists reported that they were willing to convey prescription drug safety information to older adults via a variety of formats, including displaying or distributing a flyer, and directly administering a brief intervention. Conclusion In this study, older adults were found to have inadequate knowledge of prescription drug safety and interactions with alcohol, but pharmacists who regularly come in contact with older adults indicated that they were ready and willing to talk to older adults about prescription drug safety. Future research should focus on interventions whereby pharmacists disseminate prescription drug safety information to older adults in order to improve healthy prescription drug and alcohol behavior and reduce medical and health costs associated with interactions between alcohol and prescription drugs. PMID:23467625

Zanjani, Faika; Hoogland, Aasha I; Downer, Brian G

2013-01-01

73

Prevention of overlapping prescriptions of psychotropic drugs by community pharmacists.  

PubMed

The nonmedical use or abuse of prescription drugs, including psychotropic medicines, is a growing health problem in Japan. Patient access to psychotropic drugs, specifically from the oversupply of medications due to overlapping prescriptions, may increase the risk of drug abuse and dependence. However, very little is known about such overlapping prescriptions. Today, the dispensing of prescriptions is generally moving from inside to outside of hospitals, with psychotropic drugs mainly dispensed at community pharmacies. In this study, we used health insurance claims (i.e., receipts) for dispensing as the main source of information in an investigation of overlapping prescriptions of psychotropic drugs. A total of 119 patients were found to have received overlapping prescriptions, as identified by community pharmacists who were members of the Saitama Pharmaceutical Association, using patient medication records, followed by medication counseling and prescription notes for the patient. According to our findings, the most frequently overlapping medication was etizolam. Etizolam can be prescribed for more than 30 days since it is not regulated under Japanese law as a "psychotropic drug." Generally, when a drug can be prescribed for a greater number of days, it increases the likelihood of an overlapping prescription during the same period. As a result, the long-term prescription of etizolam increases the risk of overlapping prescriptions. We also found that the patients who received overlapping prescriptions of etizolam were mostly elderly and the most common pattern was prescription from both internal medicine and orthopedics physicians. Etizolam has wide range of indications that are covered by health insurance. Our results suggest that patients who received overlapping prescriptions of etizolam may receive prescriptions from different prescribers for different purposes. Therefore, it may be appropriate to regulate etizolam as a "psychotropic drug" under Japanese law, thus setting a limit on the period for which it can be prescribed in order to help prevent long-term and overlapping prescriptions. PMID:23393998

Shimane, Takuya; Matsumoto, Toshihiko; Wada, Kiyoshi

2012-10-01

74

Prescription opioid mortality trends in New York City, 1990–2006: Examining the emergence of an epidemic?  

PubMed Central

Background The drug overdose mortality rate tripled between 1990 and 2006; prescription opioids have driven this epidemic. We examined the period 1990–2006 to inform our understanding of how the current prescription opioid overdose epidemic emerged in urban areas. Methods We used data from the Office of the Chief Medical Examiner to examine changes in demographic and spatial patterns in overdose fatalities induced by prescription opioids (i.e., analgesics and methadone) in New York City (NYC) in 1990–2006, and what factors were associated with death from prescription opioids vs. heroin, historically the most prevalent form of opioid overdose in urban areas. Results Analgesic-induced overdose fatalities were the only types of overdose fatalities to increase in 1990–2006 in NYC; the fatality rate increased sevenfold from 0.39 in 1990 to 2.7 per 100,000 persons in 2006. Whites and Latinos were the only racial/ethnic groups to exhibit an increase in overdose-related mortality. Relative to heroin overdose decedents, analgesic and methadone overdose decedents were more likely to be female and to concurrently use psychotherapeutic drugs, but less likely to concurrently use alcohol or cocaine. Analgesic overdose decedents were less likely to be Black or Hispanic, while methadone overdose decedents were more likely to be Black or Hispanic in contrast to heroin overdose decedents. Conclusions The distinct epidemiologic profiles exhibited by analgesic and methadone overdose fatalities highlight the need to define drug-specific public health prevention efforts. PMID:23357743

Cerdá, Magdalena; Ransome, Yusuf; Keyes, Katherine M.; Koenen, Karestan C.; Tracy, Melissa; Tardiff, Kenneth J.; Vlahov, David; Galea, Sandro

2013-01-01

75

76 FR 59897 - Branded Prescription Drug Fee; Correction  

Federal Register 2010, 2011, 2012, 2013, 2014

...Explanation of terms (temporary). * * * * * (k) Orphan drugs--(1) In general. Except as provided in paragraph (k)(2) of this section, the term orphan drug means any branded prescription drug for which any...

2011-09-28

76

Prescription drug misuse among club drug-using young adults.  

PubMed

Nonmedical prescription (Rx) drug use has recently increased, particularly among young adults. Using time-space sampling to generate a probability-based sample of club-going young adults (18-29), 400 subjects provided data on Rx drug misuse. Club-going young adults misuse Rx drugs at high rates. An overwhelming majority of the sample indicated lifetime use of pain killers, sedatives, and stimulants. A majority indicated recent pain killer use. Variations by gender and sexuality exist in this population. Young lesbian/bisexual women emerged as the group most likely to abuse Rx drugs. Research into the contexts influencing these patterns is imperative. PMID:17994483

Kelly, Brian C; Parsons, Jeffrey T

2007-01-01

77

The Use of Abusable Prescription Drugs: The Role of Gender  

Microsoft Academic Search

It is well documented that women face greater medical exposure to psychotropic drugs than do men, but little research examines whether women also have increased use of prescription drugs with abuse potential. The objectives were to examine gender differences in the use of abusable prescription drugs and to assess how use varies by gender and if patterns of use vary

Linda Simoni-Wastila; B. S. Pharm

2000-01-01

78

Prescription Drug Abuse Information in D.A.R.E.  

ERIC Educational Resources Information Center

This investigation was designed to examine prescription drug-related content and learning objectives in Drug Abuse Resistance Education (D.A.R.E.) for upper elementary and middle schools. Specific prescription-drug topics and context associated with content and objectives were coded. The coding system for topics included 126 topics organized…

Morris, Melissa C.; Cline, Rebecca J. Welch; Weiler, Robert M.; Broadway, S. Camille

2006-01-01

79

Diagnosis-prescription studies - Important steps towards a national drug prescription statistics in Norway  

Microsoft Academic Search

In the first part of this article, drug utilization and prescribing practice is discussed as seen from a Norwegian general practice perspective. Which are the data sources available? What kind of studies have been performed? Prescription-diagnosis studies are reviewed, in particular the Møre & Romsdal Prescription Study (MRPS). Because the wholesales drug statistics do not include information about neither patients,

Jørund Straand

2001-01-01

80

76 FR 71348 - Role of Naloxone in Opioid Overdose Fatality Prevention; Public Workshop; Request for Comments  

Federal Register 2010, 2011, 2012, 2013, 2014

...injectable medicine that can rapidly reverse the overdose of either prescription (e.g., OxyContin) or illicit (e.g., heroin) opioids. It is currently the standard treatment for those who overdose on opioid drugs, but is most commonly used only...

2011-11-17

81

Prescription drug advertising: trends and implications.  

PubMed

Prescription drug advertisements which appeared in two leading American medical journals in 1972, 1977 and 1982 were analyzed to discover possible trends in advertising. The 5016 ads examined showed that ads for the diuretic-cardiovasculars, especially the beta-adrenergic blocking agents and the slow channel inhibitors, as well as the analgesics, had increased, while ads for the anti-infectives and tranquilizers had diminished. The average amount of space allocated for each ad had increased. On the average, most ads (69%) depicted neither male nor female patients in their graphics, and a trend of increased neutrality was observed. When the hormones were excluded, an average of 21% of the ads showed male patients and 10% showed females. Since a relationship was discerned between the leading drugs advertised and the leading prescriptions filled, it was concluded that advertising does have some effect on the prescribing behavior of practitioners. The findings suggest that great investment in advertising is necessary in order to achieve high levels of sales for such drugs as Valium (diazepam) which do not have a clear-cut ameliorative effect on a specific physiological condition. On the other hand, it was suggested that saturation advertising would not significantly enhance the sales of such drugs as Dyazide (triamterene and hydrochlorothiazide) because of its well established therapeutic value in the control of hypertension. Ten advertising companies, on the average, had purchased 67% of all advertising space and five had purchased almost half (47%). The same two pharmaceutical companies were among the top five advertisers and the same five were among the top ten for the three years studied. PMID:3975684

Krupka, L R; Vener, A M

1985-01-01

82

77 FR 12310 - Drugs for Human Use; Drug Efficacy Study Implementation; Prescription Drugs That Contained...  

Federal Register 2010, 2011, 2012, 2013, 2014

...DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-1978-N-0441] (formerly 78N-0324); DESI 10392] Drugs for Human Use; Drug Efficacy Study Implementation; Prescription...

2012-02-29

83

75 FR 12756 - Agency Information Collection Activities: Proposed Collection; Comment Request; Prescription Drug...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Comment Request; Prescription Drug Advertisements AGENCY: Food and Drug Administration...FDA's regulations on prescription drug advertisements. DATES: Submit written or electronic...information technology. Prescription Drug Advertisements--21 CFR 202.1 (OMB Control...

2010-03-17

84

Teens and Prescription Drugs: An Analysis of Recent Trends on the Emerging Drug Threat  

ERIC Educational Resources Information Center

This report synthesizes a number of national studies that show the intentional abuse of prescription drugs to get high is a growing concern, particularly among teens. The analysis shows that teens are turning away from street drugs and using prescription drugs to get high. New users of prescription drugs have caught up with new users of marijuana.…

Office of National Drug Control Policy, 2007

2007-01-01

85

Preventing Prescription Drug Abuse in Adolescence: A Collaborative Approach  

ERIC Educational Resources Information Center

With the growing awareness of adolescent prescription drug abuse, communities and schools are beginning to explore prevention and intervention strategies which are appropriate for their youth. This article provides a framework for developing a collaborative approach to prescription drug abuse prevention--called the Prevention Awareness Team--that…

Jones, Beth A.; Fullwood, Harry; Hawthorn, Melissa

2012-01-01

86

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2013 CFR

...GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug...that purport to support an advertising claim but in fact do not...individuals. (xiv) Uses “statistics” on numbers of patients...suggests either that such “statistics” are valid if they are...

2013-04-01

87

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2011 CFR

...GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug...that purport to support an advertising claim but in fact do not...individuals. (xiv) Uses “statistics” on numbers of patients...suggests either that such “statistics” are valid if they are...

2011-04-01

88

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2012 CFR

...GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug...that purport to support an advertising claim but in fact do not...individuals. (xiv) Uses “statistics” on numbers of patients...suggests either that such “statistics” are valid if they are...

2012-04-01

89

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2014 CFR

...GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug...that purport to support an advertising claim but in fact do not...individuals. (xiv) Uses “statistics” on numbers of patients...suggests either that such “statistics” are valid if they are...

2014-04-01

90

Non-Medical Prescription Drug Use among University Students  

ERIC Educational Resources Information Center

Background: Non-medical prescription drug use is an increasing problem among university students. Purpose: The present study investigated university students' involvement in non-medical prescription drug (NMPD) use and associations between use and other risky behaviors. Methods: A sample of 363 university students completed a four page survey…

Vidourek, Rebecca A.; King, Keith A.; Knopf, Ellen E.

2010-01-01

91

Drug prescription practices in Brazil: a structural equation model  

Microsoft Academic Search

Purpose – The paper's aim is to analyze the functional relationships between factors related to the prescription of medical drugs in Brazil. Design\\/methodology\\/approach – A survey was conducted among 232 medical doctors in Brazil. Data were collected using a structured questionnaire. Five hypotheses on the factors impacting drug prescription were proposed, and the constructs were validated using a set of

Wagner Junior Ladeira; Marlon Dalmoro; Alisson Eduardo Maehler; Clécio Falcão Araujo

2011-01-01

92

Four Ways to Help Lower Your Medicare Prescription Drug Costs  

MedlinePLUS

... Ways to Help Lower Your Medicare Prescription Drug Costs Revised December 2014 Are you a person with ... able to save. Consider switching to drugs that cost less. Ask your doctor if there are generic, ...

93

Prescription Drug Abuse & Diversion: Role of the Pain Clinic  

PubMed Central

The goal of this research is to better understand the role that South Florida pain management clinics may be playing in the abuse and diversion of prescription drugs. This study explores 1) the characteristics and practices of pain clinics that may be facilitating the drug-seeking endeavors of prescription drug abusers and 2) the drug-seeking behaviors of prescription drug abusers who use pain clinics as a primary source for drugs. Thirty in-depth interviews were conducted with prescription drug abusers in South Florida. Interviews were transcribed verbatim and codes were generated based on thematic analyses of the data. Using grounded theory strategies, the analysis revealed six main themes: “pill mills”, on-site pharmacies, liberal prescribing habits, “sponsoring” drug diversion, pain doctor/pharmacy shopping, and faking symptoms/documentation. These findings should provide insights for law enforcement, regulatory agencies, and industry as they attempt to develop appropriate policy initiatives and recommendations for best practices. PMID:21278927

Rigg, Khary K.; March, Samantha J.; Inciardi, James A.

2010-01-01

94

Hospitalizations for Alcohol and Drug Overdoses in Young Adults Ages 18–24 in the United States, 1999–2008: Results From the Nationwide Inpatient Sample  

PubMed Central

Objective: Recent reports indicate an increase in rates of hospitalizations for drug overdoses in the United States. The role of alcohol in hospitalizations for drug overdoses remains unclear. Excessive consumption of alcohol and drugs is prevalent in young adults ages 18–24. The present study explores rates and costs of inpatient hospital stays for alcohol overdoses, drug overdoses, and their co-occurrence in young adults ages 18–24 and changes in these rates between 1999 and 2008. Method: Data from the Nationwide Inpatient Sample were used to estimate numbers, rates, and costs of inpatient hospital stays stemming from alcohol overdoses (and their subcategories, alcohol poisonings and excessive consumption of alcohol), drug overdoses (and their subcategories, drug poisonings and nondependent abuse of drugs), and their co-occurrence in 18- to 24-year-olds. Results: Hospitalization rates for alcohol overdoses alone increased 25% from 1999 to 2008, reaching 29,412 cases in 2008 at a cost of $266 million. Hospitalization rates for drug overdoses alone increased 55%, totaling 113,907 cases in 2008 at a cost of $737 million. Hospitalization rates for combined alcohol and drug overdoses increased 76%, with 29,202 cases in 2008 at a cost of $198 million. Conclusions: Rates of hospitalizations for alcohol overdoses, drug overdoses, and their combination all increased from 1999 to 2008 among 18- to 24-year-olds. The cost of such hospitalizations now exceeds $1.2 billion annually. The steepest increase occurred among cases of combined alcohol and drug overdoses. Stronger efforts are needed to educate medical practitioners and the public about the risk of overdoses, particularly when alcohol is combined with other drugs. PMID:21906505

White, Aaron M.; Hingson, Ralph W.; Pan, I-jen; yi, Hsiao-ye

2011-01-01

95

Prescription drugs: issues of cost, coverage, and quality.  

PubMed

This Issue Brief closely examines expenditures on prescription drugs, and discusses their potential to substitute for other types of health care services. In addition, it describes employer coverage of prescription drugs, direct-to-consumer advertising of prescription drugs, and potential legislation affecting the prescription drug market. Prescription drug expenditures grew at double-digit rates during almost every year since 1980, accelerating to 14.1 percent in 1997. In contrast, total national health expenditures, hospital service expenditures, and physician service expenditures growth rates decreased from approximately 13 percent in 1980 to less than 5 percent in 1997. Private insurance payments for prescription drugs increased 17.7 percent in 1997, after growing 22.1 percent in 1995 and 18.3 percent in 1996. This growth in prescription drug payments compares with 4 percent or less overall annual growth in private insurance payments for each of those three years. From 1993 to 1997, the overwhelming majority of the increases in expenditures on prescription drugs were attributable to increased volume, mix, and availability of pharmaceutical products. In 1997, these factors accounted for more than 80 percent of the growth in prescription drug expenditures. A leading explanation for the sharp growth in drug expenditures is that prescription drugs are a substitute for other forms of health care. While it is difficult to determine the extent to which this substitution occurs, various studies have associated cost savings with the use of pharmaceutical products in treating specific diseases. Evidence suggests that more appropriate utilization of prescription drugs has the potential to lower total expenditures and improve the quality of care. Also, some studies indicate the U.S. health care system needs to improve the way patients use and physicians prescribe current medications. Prescription drug plans offered by employers are likely to undergo changes to ensure that only the most efficacious drugs are covered. Anecdotal evidence suggests that copayments for prescriptions are going to increase. Some health plans are including prescription drug costs in their capitated payments to physicians. Furthermore, prescription drug plans are expected to use formularies more aggressively. In 1996, an average 5.47 outpatient prescriptions were written for those ages 55-64, compared with more than eight for those age 65 and older. Inevitably, this translated to significantly more spending for prescription drugs by the elderly. In 1994-1995, the average elderly individual (age 65 or older) spent $558 on prescription drugs, while the average 55-64-year-old spent $355. While prescription drugs are showing sharp price increases, they are also becoming more important in the treatment of many diseases. Consequently, both employers and policymakers must carefully balance the design and cost of a drug benefit so that continual innovation is preserved and the benefit can remain affordable and effective. PMID:10539445

Copeland, C

1999-04-01

96

Direct-to-consumer advertising of prescription drugs.  

PubMed

In 2007, the pharmaceutical industry spent more than $4.9 billion on direct-to-consumer advertising (DTCA) of prescription drugs in the U.S. Controversy over DTCA has grown since the Food and Drug Administration liberalized its regulations in 1997. Proponents claim that such advertising educates consumers, promotes patient participation in clinical decisions, and improves patient adherence to medication instructions. Opponents argue that such advertising is meant to persuade, not educate, and that it promotes inappropriate use of prescription drugs, or diverts consumers from better alternatives. This Issue Brief summarizes the evidence about the effects of DTCA, and proposes guidelines for improving the utility of prescription drug advertising. PMID:20469541

Frosch, Dominick L; Grande, David

2010-01-01

97

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2011 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2011-10-01

98

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2010-10-01

99

42 CFR 423.56 - Procedures to determine and document creditable status of prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...document creditable status of prescription drug coverage. 423.56 Section 423.56...PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Eligibility and Enrollment...document creditable status of prescription drug coverage. (a) Definition....

2010-10-01

100

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

Code of Federal Regulations, 2011 CFR

...Requirements for qualified retiree prescription drug plans. 423.884 Section 423.884...PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.884 Requirements for...

2011-10-01

101

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2012 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2012-10-01

102

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2013 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2013-10-01

103

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

Code of Federal Regulations, 2012 CFR

...Requirements for qualified retiree prescription drug plans. 423.884 Section 423.884...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.884 Requirements for...

2012-10-01

104

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2014 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2014-10-01

105

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

Code of Federal Regulations, 2013 CFR

...Requirements for qualified retiree prescription drug plans. 423.884 Section 423.884...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.884 Requirements for...

2013-10-01

106

42 CFR 423.56 - Procedures to determine and document creditable status of prescription drug coverage.  

Code of Federal Regulations, 2013 CFR

...document creditable status of prescription drug coverage. 423.56 Section 423.56...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Eligibility and Enrollment ...document creditable status of prescription drug coverage. (a) Definition....

2013-10-01

107

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

Code of Federal Regulations, 2014 CFR

...Requirements for qualified retiree prescription drug plans. 423.884 Section 423.884...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.884 Requirements for...

2014-10-01

108

78 FR 28860 - Announcement of Requirements and Registration for: “Data Rx: Prescription Drug Abuse Infographic...  

Federal Register 2010, 2011, 2012, 2013, 2014

...for: ``Data Rx: Prescription Drug Abuse Infographic Challenge'' Authority...The ``Data Rx: Prescription Drug Abuse Infographic Challenge Concept...the growing trend of prescription drug abuse. The infographic should be...

2013-05-16

109

45 CFR 156.295 - Prescription drug distribution and cost reporting.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 false Prescription drug distribution and cost reporting...Standards § 156.295 Prescription drug distribution and cost reporting...percentage of prescriptions for which a generic drug was available and dispensed...

2012-10-01

110

45 CFR 156.295 - Prescription drug distribution and cost reporting.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 false Prescription drug distribution and cost reporting...Standards § 156.295 Prescription drug distribution and cost reporting...percentage of prescriptions for which a generic drug was available and dispensed...

2013-10-01

111

45 CFR 156.295 - Prescription drug distribution and cost reporting.  

Code of Federal Regulations, 2014 CFR

...2014-10-01 false Prescription drug distribution and cost reporting...Standards § 156.295 Prescription drug distribution and cost reporting...percentage of prescriptions for which a generic drug was available and dispensed...

2014-10-01

112

76 FR 41434 - Removal of Certain Requirements Related to the Prescription Drug Marketing Act; Opportunity for...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Requirements Related to the Prescription Drug Marketing Act; Opportunity for Public Comment...remove a section of the Prescription Drug Marketing Act (PDMA) regulations requiring that...various aspects of human prescription drug marketing and distribution. The primary...

2011-07-14

113

Acute Drug Overdose: Clinical Profile, Etiologic Spectrum and Determinants of Duration of Intensive Medical Treatment  

PubMed Central

Objectives Acute drug overdosing is an important cause of organ dysfunction and metabolic derangements and the patients often require intensive care. This study aims to determine the clinical pattern of severe drug overdose as well as the factors influencing the duration of intensive care Methods The clinical characteristics and course of consecutive adult patients admitted with a diagnosis of acute drug poisoning in the ICU of a tertiary hospital in Oman from January 2007 to December 2008 were reviewed retrospectively from the electronic case records. Results Acute drug poisoning (n=29) constituted 3.9% of admissions to the ICU. Mean age was 29.38±7.9 years. They were brought in by their relatives (72%) or the state services (24%). Accidental poisoning was noted in 21 patients (72%) and suicidal overdosing in 6 (21%). The commonest drug was an opioid (65.5%). Glasgow Coma Scale score of ?8 was recorded in 18 (62.1%). Sixty two percent of patients required mechanical ventilation. The prominent complications were hypotension in 9 (31%), pulmonary in 19 (65.5%), hepatic in 18 (62.1%) and renal in 12 (41.4%) patients. The major electrolytes abnormalities were low bicarbonate in 11 (37.9%), hyponatremia in 5 (17.2%) and hypokalemia in 4 (13.8%). Patients stayed in the ICU for 1 to 20 days (median-2 days). Factors associated with a longer ICU stay included hypotension upon arrival (p=0.048) and the need for mechanical ventilation on the first (p=0.001) and second (p=0.001) days of hospitalization. There was no mortality. Conclusion Early and prompt intensive medical therapy in acute drug poisoning can favorably influence the outcome. In addition, the presence of hypotension and requirement of mechanical ventilation on the first two days of hospitalization were responsible for prolonged ICU stay. PMID:23226824

Jayakrishnan, B; Al Asmi, Abdullah; Al Qassabi, Ahmed; Nandhagopal, R; Mohammed, Irshad

2012-01-01

114

State System of Higher Education Prescription Drug Card Program*  

E-print Network

Retail Pharmacy Mail Service Pharmacy Deductible Per Calendar Year $0 Generic Prescription Drug $0 $0 you purchase a brand drug that has a generic equivalent you will be responsible for the brand drug copayment plus the difference in cost between the brand and generic drugs, unless your physician requests

Hardy, Christopher R.

115

Patterns of prescription medication diversion among drug dealers  

PubMed Central

This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South Florida. In-depth semi-structured interviews (n = 50) were conducted with an ethnically diverse sample of prescription drug dealers from a variety of milieus to assess patterns of diversion. Audiotapes of the interviews were transcribed, coded, and thematically analysed using the NVivo 8 software program. Dealers relied on a wide array of diversion methods including visiting multiple pain clinics, working with pharmacy employees to steal medications from pharmacies, and purchasing medications from indigent patients. The type of medication most commonly sold by dealers was prescription opioid analgesics, and to a lesser extent benzodiazepines such as alprazolam. These findings inform public health policy makers, criminal justice officials, the pharmaceutical industry and government regulatory agencies in their efforts to reduce the availability of diverted prescription drugs in the illicit market. Specifically, these data support the need for statewide prescription drug monitoring programs and increased training for healthcare workers who have access to controlled medications. PMID:22665955

Rigg, Khary K.; Kurtz, Steven P.; Surratt, Hilary L.

2012-01-01

116

Medicare program; Medicare prescription drug benefit. Final rule.  

PubMed

This final rule implements the provisions of the Social Security Act (the Act) establishing and regulating the Medicare Prescription Drug Benefit. The new voluntary prescription drug benefit program was enacted into law on December 8, 2003 in section 101 of Title I of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173). Although this final rule specifies most of the requirements for implementing the new prescription drug program, readers should note that we are also issuing a closely related rule that concerns Medicare Advantage organizations, which, if they offer coordinated care plans, must offer at least one plan that combines medical coverage under Parts A and B with prescription drug coverage. Readers should also note that separate CMS guidance on many operational details appears or will soon appear on the CMS website, such as materials on formulary review criteria, risk plan and fallback plan solicitations, bid instructions, solvency standards and pricing tools, plan benefit packages. The addition of a prescription drug benefit to Medicare represents a landmark change to the Medicare program that will significantly improve the health care coverage available to millions of Medicare beneficiaries. The MMA specifies that the prescription drug benefit program will become available to beneficiaries beginning on January 1, 2006. Generally, coverage for the prescription drug benefit will be provided under private prescription drug plans (PDPs), which will offer only prescription drug coverage, or through Medicare Advantage prescription drug plans (MA PDs), which will offer prescription drug coverage that is integrated with the health care coverage they provide to Medicare beneficiaries under Part C of Medicare. PDPs must offer a basic prescription drug benefit. MA-PDs must offer either a basic benefit or broader coverage for no additional cost. If this required level of coverage is offered, MA-PDs or PDPs, but not fallback PDPs may also offer supplemental benefits through enhanced alternative coverage for an additional premium. All organizations offering drug plans will have flexibility in the design of the prescription drug benefit. Consistent with the MMA, this final rule also provides for subsidy payments to sponsors of qualified retiree prescription drug plans to encourage retention of employer-sponsored benefits. We are implementing the drug benefit in a way that permits and encourages a range of options for Medicare beneficiaries to augment the standard Medicare coverage. These options include facilitating additional coverage through employer plans, MA-PD plans and high-option PDPs, and through charity organizations and State pharmaceutical assistance programs. See sections II.C, II.J, and II.P, and II.R of this preamble for further details on these issues. The proposed rule identified options and alternatives to the provisions we proposed and we strongly encouraged comments and ideas on our approach and on alternatives to help us design the Medicare Prescription Drug Benefit Program to operate as effectively and efficiently as possible in meeting the needs of Medicare beneficiaries. PMID:15678603

2005-01-28

117

The attitudes of consumers toward direct advertising of prescription drugs.  

PubMed Central

Attitudes about prescription drug advertising directed to consumers were assessed in 1,509 persons who had viewed prototypical advertisements for fictitious prescription drug products. Although many subjects were generally favorable toward the concept of drug advertising directed to consumers, strong reservations were also expressed, especially about television advertising. Prescription drug advertising did not appear to undermine the physician's authority, since respondents viewed the physician as the primary drug decision-maker. However, the physician was not perceived as the sole source of prescription drug information. Television advertising appeared to promote greater information-seeking about particular drugs; however, magazine ads were more fully accepted by subjects. Furthermore, magazine ads led to enhanced views of the patient's authority in drug decision-making. The greater information conveyed in magazine ads may have given subjects more confidence in their own ability to evaluate the drug and the ad. Ads that integrated risk information into the body of the advertisement were more positively viewed than ads that gave special emphasis to the risk information. The results suggest that consumer attitudes about prescription drug advertising are not firmly held and are capable of being influenced by the types of ads people view. Regulation of such ads may need to be flexed to adapt to the way different media are used and processed by consumers. PMID:3080797

Morris, L A; Brinberg, D; Klimberg, R; Rivera, C; Millstein, L G

1986-01-01

118

Essays on prescription drug benefits in Medicare managed care  

E-print Network

In this thesis, I estimate a structural demand model for prescription drug benefits by Medicare beneficiaries using data from the Medicare HMO program. I then use the utility parameter estimates to explore other questions ...

Hall, Anne Elizabeth, 1971-

2005-01-01

119

Evaluating Prescription Drugs Used to Treat Overactive Bladder  

MedlinePLUS

... state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin. This brief should ... stores, like Costco, CVS, Kmart, Kroger, Sam’s Club, Target, Walmart, and Walgreens. Some of these stores have ...

120

Media's Positive and Negative Frames in Reporting Celebrity Deaths From Illegal Drug Overdoses Versus Prescription Drug Overdoses  

E-print Network

the majority of participants in that study reported that their idols were a positive influence, an overriding concern in this field is that celebrities can act as advocates for undesirable behaviors (Shaw et al., 2010). Additionally, the International Narcotics... family (Gibson, 2007; Kearl, 2011; Terry, 1999). With increasing media platforms for people to interact with celebrities, fans can now, more than ever before, feel a sense of intimacy with their idols. It is also ironic that, just as audiences come...

Wood, Michelle

2011-12-31

121

Prescription drug advertising trends: A study of oral hypoglycemics  

Microsoft Academic Search

A content analysis of oral hypoglycemic drug advertisemets was performed in selected medical journals published in the United States from 1963 to 1986. The 665 advertisements subsequently examined were studied for certain predetermined parameters in order to indicate trends. The trend results may be summarized as follows. As an extension of prescription drug advertising trends in general, oral hypoglycemic drug

Kumar K. Mehta; Bernard A. Sorofman; Clayton R. Rowland

1989-01-01

122

Impact of legislation and a prescription monitoring program on the prevalence of potentially inappropriate prescriptions for monitored drugs in Ontario: a time series analysis  

PubMed Central

Background The increased use of opioid analgesics, sedative hypnotics and stimulants, coupled with the associated risks of overdose have raised concerns around the inappropriate prescribing of these monitored drugs. We assessed the impact of new legislation, the Narcotics Safety and Awareness Act, and a centralized Narcotics Monitoring System (implemented November 2011 and May 2012, respectively), on the dispensing of prescriptions suggestive of misuse. Methods We conducted a time series analysis of publicly funded prescriptions for opioids, benzodiazepines and stimulants dispensed monthly in Ontario from January 2007 to May 2013, based on information in the Ontario Public Drug Benefit Database. In the primary analysis, a prescription was deemed potentially inappropriate if it was dispensed within 7 days of an earlier prescription and was for at least 30 tablets of a drug in the same class as the earlier prescription, but originated from a different physician and a different pharmacy. Results After enactment of the new legislation, the prevalence of potentially inappropriate opioid prescriptions decreased by 12.5% in 6 months (from 1.6% in October 2011 to 1.4% in April 2012; p = 0.01). No further significant change was observed after the introduction of the narcotic monitoring system (p = 0.8). By May 2013, the prevalence had dropped to 1.0%. Inappropriate benzodiazepine prescribing was significantly influenced by both the legislation (p < 0.001) and the monitoring system (p = 0.05), which together reduced potentially inappropriate prescribing by 50.0% between October 2011 and May 2013 (from 0.4% to 0.2%). The prevalence of potentially inappropriate prescribing of stimulants was significantly influenced by the introduction of the monitoring system in May 2012, falling from 0.7% in April 2012 to 0.3% in May 2013 (p = 0.02). Interpretation For a select group of drugs prone to misuse and diversion, legislation and a prescription monitoring program reduced the prevalence of prescriptions suggestive of misuse. This suggests that regulatory interventions can promote appropriate prescribing which could potentially be applied to other jurisdictions and drugs of concern. PMID:25485251

Juurlink, David; Yao, Zhan; Camacho, Ximena; Paterson, J. Michael; Singh, Samantha; Dhalla, Irfan; Sproule, Beth; Mamdani, Muhammad

2014-01-01

123

Absolute contraindications in relation to potential drug interactions in outpatient prescriptions: analysis of the first five million prescriptions in 1999  

Microsoft Academic Search

Objectives Adverse drug interactions increase morbidity and mortality. To prevent these, situations leading to adverse prescriptions must be clarified. This study quantifies and analyses prescriptions with potential adverse drug interactions in primary health care in the north of France over a 3-month period. Methods All prescriptions administered between 1 January and 31 March 1999 were analysed to identify potential interactions

Laurence Guédon-Moreau; Dominique Ducrocq; Marie-Francoise Duc; Yves Quieureux; Catherine L’Hôte; Jean Deligne; Jacques Caron

2003-01-01

124

Absolute contraindications in relation to potential drug interactions in outpatient prescriptions: analysis of the first five million prescriptions in 1999  

Microsoft Academic Search

Objectives Adverse drug interactions increase morbidity and mortality. To prevent these, situations leading to adverse prescriptions must be clarified. This study quantifies and analyses prescriptions with potential adverse drug interactions in primary health care in the North of France over a 3-month period. Methods All prescriptions administered between 1 January 1999 and 31 March 1999 were analysed to identify potential

Laurence Guédon-Moreau; Dominique Ducrocq; Marie-Francoise Duc; Yves Quieureux; Catherine L’Hôte; Jean Deligne; Jacques Caron

2004-01-01

125

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2014 CFR

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2014-04-01

126

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2010 CFR

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2010-04-01

127

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2012 CFR

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2012-04-01

128

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2013 CFR

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2013-04-01

129

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2011 CFR

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2011-04-01

130

78 FR 8446 - Center for Drug Evaluation and Research; Prescription Drug Labeling Improvement and Enhancement...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Generic drugs approved under an abbreviated new...data show that only 10 percent of generic drug labeling has been converted to...prescriptions today are filled with generic drugs,\\6\\ FDA believes that it...

2013-02-06

131

Law enforcement attitudes toward overdose prevention and response  

PubMed Central

Background Law enforcement is often the first to respond to medical emergencies in the community, including overdose. Due to the nature of their job, officers have also witnessed first-hand the changing demographic of drug users and devastating effects on their community associated with the epidemic of nonmedical prescription opioid use in the United States. Despite this seminal role, little data exist on law enforcement attitudes toward overdose prevention and response. Methods We conducted key informant interviews as part of a 12-week Rapid Assessment and Response (RAR) process that aimed to better understand and prevent nonmedical prescription opioid use and overdose deaths in locations in Connecticut and Rhode Island experiencing overdose “outbreaks.” Interviews with 13 law enforcement officials across three study sites were analyzed to uncover themes on overdose prevention and naloxone. Results Findings indicated support for law enforcement involvement in overdose prevention. Hesitancy around naloxone administration by laypersons was evident. Interview themes highlighted officers’ feelings of futility and frustration with their current overdose response options, the lack of accessible local drug treatment, the cycle of addiction, and the pervasiveness of easily accessible prescription opioid medications in their communities. Overdose prevention and response, which for some officers included law enforcement-administered naloxone, were viewed as components of community policing and good police-community relations. Conclusion Emerging trends, such as existing law enforcement medical interventions and Good Samaritan Laws, suggest the need for broader law enforcement engagement around this pressing public health crisis, even in suburban and small town locations, to promote public safety. PMID:24051061

Green, Traci C.; Zaller, Nickolas; Palacios, Wilson R.; Bowman, Sarah E.; Ray, Madeline; Heimer, Robert; Case, Patricia

2014-01-01

132

Prevalence of the Prescription of Potentially Interacting Drugs  

PubMed Central

The use of multiple medications is becoming more common, with a correspondingly increased risk of untoward effects and drug-related morbidity and mortality. We aimed at estimating the prevalence of prescription of relevant potentially interacting drugs and at evaluating possible predictors of potentially interacting drug exposure. We retrospectively analyzed data on prescriptions dispensed from January 2004 to August 2005 to individuals of two Italian regions with a population of almost 2.1 million individuals. We identified 27 pairs of potentially interacting drugs by examining clinical relevance, documentation, and volume of use in Italy. Subjects who received at least one prescription of both drugs were selected. Co-prescribing denotes “two prescriptions in the same day”, and concomitant medication “the prescription of two drugs with overlapping coverage”. A logistic regression analysis was conducted to examine the predictors of potential Drug-Drug Interaction (pDDIs). 957,553 subjects (45.3% of study population) were exposed to at least one of the drugs/classes of the 27 pairs. Overall, pDDIs occurred 2,465,819 times. The highest rates of concomitant prescription and of co-prescription were for ACE inhibitors+NSAIDs (6,253 and 4,621/100,000 plan participants). Considering concomitance, the male/female ratio was <1 in 17/27 pairs (from 0.31 for NSAIDs-ASA+SSRI to 0.74 for omeprazole+clopidogrel). The mean age was lowest for methotrexate pairs (+omeprazole, 59.9 years; +NSAIDs-ASA, 59.1 years) and highest for digoxin+verapamil (75.4 years). In 13/27 pairs, the mean ages were ?70 years. On average, subjects involved in pDDIs received ?10 drugs. The odds of exposure were more frequently higher for age ?65 years, males, and those taking a large number of drugs. A substantial number of clinically important pDDIs were observed, particularly among warfarin users. Awareness of the most prevalent pDDIs could help practitioners in preventing concomitant use, resulting in a better quality of drug prescription and potentially avoiding unwanted side effects. PMID:24147143

Tragni, Elena; Casula, Manuela; Pieri, Vasco; Favato, Giampiero; Marcobelli, Alberico; Trotta, Maria Giovanna; Catapano, Alberico Luigi

2013-01-01

133

Medicare Beneficiaries and Free Prescription Drug Samples: A National Survey  

Microsoft Academic Search

Background  New policies regulating physician\\/pharmaceutical company relationships propose to eliminate access to free prescription drug\\u000a samples. Little is known about the prevalence of patient activity in requesting or receiving free prescription drug samples,\\u000a or the characteristics of patients who access drug samples.\\u000a \\u000a \\u000a \\u000a Objective  To determine the prevalence of free sample access and to examine demographic, clinical, and insurance characteristics of Medicare\\u000a beneficiaries

Jennifer Tjia; Becky A. Briesacher; Stephen B. Soumerai; Marsha Pierre-Jacques; Fang Zhang; Dennis Ross-Degnan; Jerry H. Gurwitz

2008-01-01

134

Comprehension of Prescription Drug Information: Overview of A Research Program  

Microsoft Academic Search

Both patients and healthcare professionals must understand information about prescription drugs to help them use medications in a safe and effective manner. However drug information materials can be difficult to understand - they can be long, detailed, technical, and complex. Comprehension problems can increase the chances that ineffective treatment or medication errors will occur. This paper presents an overview of

Ruth S. Day

135

Closing the Prescription Drug Coverage Gap  

MedlinePLUS

... participate in this program. How is coverage for generic drugs changing in the coverage gap? In 2015, Medicare ... coverage gap You’ll pay this percentage for generic drugs in the coverage gap 2015 45% 65% 2016 ...

136

Diclofenac sodium overdose  

MedlinePLUS

Donovan JW. Nonsteroidal anti-inflammatory drugs. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; 2007: ...

137

Fenoprofen calcium overdose  

MedlinePLUS

Donovan JW. Nonsteroidal anti-inflammatory drugs. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; 2007: ...

138

A New Prescription for Fighting Drug Abuse  

ERIC Educational Resources Information Center

It's a drug prevention conversation--and program--that was largely missing as recently as a decade ago in most middle and high schools. In those days, the principal concern of health educators and disciplinarians alike was to keep students from misusing alcohol and illegal street drugs such as ecstasy, cocaine and even heroine. But driven by the…

Schachter, Ron

2012-01-01

139

Fatal heroin 'overdose': a review  

Microsoft Academic Search

The current paper examines critically the literature on deaths attributed to heroin overdose, and examines the characteristics and circumstances of such deaths. In particular, the dominance of the widely held belief that heroin-related fatalities are a consequence of overdose is challenged. Deaths attributed to overdose represented in the literature are typically older, heroin-dependent males not in drug treatment at the

SHANE DARKE; DEBORAH ZADOR

1996-01-01

140

Prescription and Over-the-Counter Drug Abuse Prevention. Prevention Update  

ERIC Educational Resources Information Center

According to the White House Office of National Drug Control Policy, "abuse of prescription drugs to get high has become increasingly prevalent among teens and young adults. Past year abuse of prescription pain killers now ranks second--only behind marijuana--as the Nation's most prevalent illegal drug problem." Use of prescription drugs without a…

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2010

2010-01-01

141

Combating Misuse and Abuse of Prescription Drugs  

MedlinePLUS

... for nonmedical purposes at least once. These include drugs prescribed for anxiety or insomnia, such as benzodiazepines—including diazepam (Valium), alprazolam (Xanax) and clonazepam (Klonapin)—and non-benzodiazepines such as zolpidem (Ambien), zaleplon (Sonata) and ...

142

A Political History of Medicare and Prescription Drug Coverage  

PubMed Central

This article examines the history of efforts to add prescription drug coverage to the Medicare program. It identifies several important patterns in policymaking over four decades. First, prescription drug coverage has usually been tied to the fate of broader proposals for Medicare reform. Second, action has been hampered by divided government, federal budget deficits, and ideological conflict between those seeking to expand the traditional Medicare program and those preferring a greater role for private health care companies. Third, the provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 reflect earlier missed opportunities. Policymakers concluded from past episodes that participation in the new program should be voluntary, with Medicare beneficiaries and taxpayers sharing the costs. They ignored lessons from past episodes, however, about the need to match expanded benefits with adequate mechanisms for cost containment. Based on several new circumstances in 2003, the article demonstrates why there was a historic opportunity to add a Medicare prescription drug benefit and identify challenges to implementing an effective policy. PMID:15225331

Oliver, Thomas R; Lee, Philip R; Lipton, Helene L

2004-01-01

143

Rural Adolescents' Nonmedical Prescription Drug Use: Implications for Intervention  

ERIC Educational Resources Information Center

Rural communities often have distinct contextual factors that impact residents' substance abuse behavior. However, most studies to date have focused either exclusively on urban populations or neglected to analyze data in a way that allows any rural/urban comparison. This is especially true for research examining nonmedical prescription drug use…

Young, April M.; Glover, Natalie; Havens, Jennifer R.

2012-01-01

144

OPADE: development of an European computerized drug prescription system.  

PubMed Central

Many computerized drug prescription systems have been developed but they are rarely used in clinical practice because of their lack of integration with the functioning of medical institutions and the difficulty of building and maintaining a complete knowledge base on drugs. We present in this paper a system, called OPADE, which answers these shortcomings and we argue that a system actually used by practitioners may introduce a positive feed back loop in the prescribing process. PMID:8130451

de Zegher, I.; Milstein, C.; Séné, B.; Dhalberg, B.; Harding, N.; Kostrewski, B.; Venot, A.

1993-01-01

145

Adult Prescription Drug Use and Pediatric Medication Exposures and Poisonings  

PubMed Central

BACKGROUND AND OBJECTIVES: Nontherapeutic medication ingestions continue to be a major pediatric health problem, with recent increases in ingestions despite a number of public health interventions. It is unknown how changes in adult prescription drug use relate to pediatric medication poisonings. The objective of the study was to measure the association between changing adult prescription drug patterns and pediatric medication exposures and poisonings and identify high-risk classes of medications and pediatric age groups. METHODS: We measured monthly pediatric exposures and poisonings using the National Poison Data System and prescriptions written for adults using the National Ambulatory Medical Care Surveys for 2000 through 2009. Associations between adult prescriptions for oral hypoglycemics, antihyperlipidemics, ?-blockers, and opioids and exposures and poisonings among children 0 to 5, 6 to 12, and 13 to 19 years were analyzed by using multiple time-series analysis. Emergency department visits, serious injuries, and hospitalizations stemming from these associations were described. RESULTS: Adult medication prescriptions were statistically significantly associated with exposures and poisonings in children of all ages, with the strongest association observed for opioids. Across medications, the greatest risk was among children 0 to 5 years old, followed by 13- to 19-year-olds. Rates of emergency department visits were highest for events related to hypoglycemics (60.1%) and ?-blockers (59.7%), whereas serious injuries and hospitalizations occurred most frequently with opioids (26.8% and 35.2%, respectively) and hypoglycemics (19.5% and 49.4%, respectively). CONCLUSIONS: Increasing adult drug prescriptions are strongly associated with rising pediatric exposures and poisonings, particularly for opioids and among children 0 to 5 years old. These associations have sizable impacts, including high rates of serious injury and health care use. PMID:23733792

Ayers, John W.; Brownstein, John S.; Bronstein, Alvin C.; Ewald, Michele Burns; Bourgeois, Florence T.

2013-01-01

146

Health Outcomes in Patients Using No-Prescription Online Pharmacies to Purchase Prescription Drugs  

PubMed Central

Background Many prescription drugs are freely available for purchase on the Internet without a legitimate prescription from a physician. Objective This study focused on the motivations for using no-prescription online pharmacies (NPOPs) to purchase prescription drugs rather than using the traditional doctor-patient-pharmacy model. We also studied whether users of NPOP-purchased drugs had poorer health outcomes than those who obtain the same drug through legitimate health care channels. Methods We selected tramadol as a representative drug to address our objective because it is widely prescribed as an unscheduled opioid analgesic and can easily be purchased from NPOPs. Using search engine marketing (SEM), we placed advertisements on search result pages stemming from the keyword “tramadol” and related terms and phrases. Participants, who either used the traditional doctor-patient-pharmacy model to obtain tramadol (traditional users, n=349) or purchased it on the Web without a prescription from their local doctor (ie, nontraditional users, n=96), were then asked to complete an online survey. Results Respondents in both groups were primarily white, female, and in their mid-forties (nontraditional users) to upper forties (traditional users). Nearly all nontraditional users indicated that their tramadol use was motivated by a need to treat pain (95%, 91/96) that they perceived was not managed appropriately through legitimate health care channels. A majority of nontraditional users (55%, 41/75) indicated they used NPOPs because they did not have access to sufficient doses of tramadol to relieve pain. In addition, 29% (22/75) of nontraditional users indicated that the NPOPs were a far cheaper alternative than seeing a physician, paying for an office visit, and filling a prescription at a local pharmacy, which is often at noninsured rates for those who lack medical insurance (37%, 35/96, of NPOP users). The remainder of participants (16%, 12/96) cited other motivations (eg, anonymity) for using NPOPs. In terms of health outcomes, nontraditional users experienced a significantly (P<.01) greater number and severity of adverse events, including life-threatening seizures: 7% (7/96) of nontraditional users reported seizures, while none of the traditional users reported seizures. Conclusions Although online pharmacies can offer distinct advantages in terms of convenience and cost, users of these “rogue” pharmacies that offer drugs with no prescription or doctor supervision do so at great risk to their health, as evidenced by much higher rates of adverse events. The most logical explanation for these findings is that the lack of physician oversight of dosage schedules, contraindicated conditions, and concomitant medications, were responsible for the increased intensity and frequency of adverse events in the nontraditional users. Although we only examined tramadol, it is logical to postulate that similar results would be observed with dozens of equally accessible prescription drugs. As such, the geometric growth in the use of online pharmacies around the world should prompt intense medical and regulatory discussion about their role in the provision of medical care. PMID:23220405

2012-01-01

147

Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Drug Expenses  

MedlinePLUS

... Sign Up Sign In Sign Out Percentage of Medicare Beneficiaries with High Out-of-Pocket Prescription Drug Expenses This measure reports the percentage of Medicare beneficiaries with high medical expenses for prescription drugs ...

148

75 FR 81843 - Amendments to Regulations Regarding Eligibility for a Medicare Prescription Drug Subsidy  

Federal Register 2010, 2011, 2012, 2013, 2014

...Eligibility for a Medicare Prescription Drug Subsidy AGENCY: Social Security Administration...prescription drug coverage low-income subsidy (Extra Help) program made by the Affordable...spouse would decrease or eliminate the subsidy provided by the Extra Help program,...

2010-12-29

149

77 FR 2446 - Amendments to Regulations Regarding Eligibility for a Medicare Prescription Drug Subsidy  

Federal Register 2010, 2011, 2012, 2013, 2014

...Eligibility for a Medicare Prescription Drug Subsidy AGENCY: Social Security Administration...prescription drug coverage low-income subsidy (Extra Help) program made by the Patient...spouse would decrease or eliminate the subsidy provided by the Extra Help program,...

2012-01-18

150

21 CFR 14.160 - Establishment of standing technical advisory committees for human prescription drugs.  

Code of Federal Regulations, 2013 CFR

...standing technical advisory committees for human prescription drugs. 14.160 Section...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC HEARING BEFORE...ADVISORY COMMITTEE Advisory Committees for Human Prescription Drugs § 14.160...

2013-04-01

151

21 CFR 14.160 - Establishment of standing technical advisory committees for human prescription drugs.  

Code of Federal Regulations, 2010 CFR

...standing technical advisory committees for human prescription drugs. 14.160 Section...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC HEARING BEFORE...ADVISORY COMMITTEE Advisory Committees for Human Prescription Drugs § 14.160...

2010-04-01

152

21 CFR 14.160 - Establishment of standing technical advisory committees for human prescription drugs.  

Code of Federal Regulations, 2014 CFR

...standing technical advisory committees for human prescription drugs. 14.160 Section...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC HEARING BEFORE...ADVISORY COMMITTEE Advisory Committees for Human Prescription Drugs § 14.160...

2014-04-01

153

21 CFR 14.160 - Establishment of standing technical advisory committees for human prescription drugs.  

Code of Federal Regulations, 2011 CFR

...standing technical advisory committees for human prescription drugs. 14.160 Section...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC HEARING BEFORE...ADVISORY COMMITTEE Advisory Committees for Human Prescription Drugs § 14.160...

2011-04-01

154

Withholding Medicare Prescription Drug Premium from Your 2014 Social Security Payment  

MedlinePLUS

... 2014 Withholding Medicare Prescription Drug Premium from Your 2015 Social Security Payment Each year, Medicare Prescription Drug ... up. 2 I chose a different plan for 2015 with a different premium but the plan is ...

155

Medicare prescription drug coverage: consumer information and preferences.  

PubMed

We investigate prescription drug use, and information and enrollment intentions for the new Medicare Part D drug insurance program, using a sample of Medicare-eligible subjects surveyed before open enrollment began for this program. We find that, despite the complexity of competing plans offered by private insurers under Part D, a majority of the Medicare population had information on this program and a substantial majority planned to enroll. We find that virtually all elderly, even those with no current prescription drug use, can expect to benefit from enrollment in a Part D Standard plan at the low premiums available in the current market. However, there is a significant risk that many eligible seniors, particularly low-income elderly with poor health or cognitive impairment, will make poor enrollment and plan choices. PMID:16682629

Winter, Joachim; Balza, Rowilma; Caro, Frank; Heiss, Florian; Jun, Byung-hill; Matzkin, Rosa; McFadden, Daniel

2006-05-16

156

Assessing the new medicare prescription drug law.  

PubMed

The Medicare Modernization Act (MMA) is the product of a political compromise to attract moderate Republicans and enough Democrats without losing Republican conservatives. The compromise offered more private health plans to beneficiaries while maintaining and improving traditional Medicare's benefits. This compromise did not settle the debate over the legislation, which is a major issue in the 2004 elections. Voters poorly understand the law because of its complexity. In this paper, I explain how the policy decisions made by the U.S. Congress have contributed to the law's complexity and controversy. I examine the new private health plan options that will be offered to beneficiaries, improvements made to traditional Medicare, and the impact of introducing income-based determinations into Medicare. I also discuss the impact of the drug benefit on beneficiaries in different income and assets categories and Congress's decision to prohibit the federal government from directly negotiating prices with drug manufacturers. I conclude by assessing the major claims made by critics and proponents. Both might be more circumspect in their assessments of the law's impact, since it is impossible to predict how a law of such complexity, with so many human variables, will work out in the end. The MMA is a worthwhile but imperfect effort to extend drug coverage to seniors who are most in need. It deserves neither condemnation nor indiscriminate praise but instead a commitment to help it succeed. PMID:15353431

Doherty, Robert B

2004-09-01

157

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2013 CFR

... Fixed-combination prescription drugs for humans. 300.50 Section 300.50 Food and Drugs...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE GENERAL Combination Drugs §...

2013-04-01

158

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2012 CFR

... Fixed-combination prescription drugs for humans. 300.50 Section 300.50 Food and Drugs...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE GENERAL Combination Drugs §...

2012-04-01

159

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2014 CFR

... Fixed-combination prescription drugs for humans. 300.50 Section 300.50 Food and Drugs...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE GENERAL Combination Drugs §...

2014-04-01

160

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2011 CFR

... Fixed-combination prescription drugs for humans. 300.50 Section 300.50 Food and Drugs...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE GENERAL Combination Drugs §...

2011-04-01

161

Income and the use of prescription drugs for near retirement individuals  

Microsoft Academic Search

Understanding how demand for prescription drugs responds to changes in income is important for assessing the welfare consequences of reforms affecting income. This becomes more imminent as age progresses, because the use of prescription drugs and the associated budgetary burden increases dramatically from about age 55. In this paper we estimate how demand for prescription drugs varies with income for

Søren Leth-Petersen; Niels Skipper

2010-01-01

162

77 FR 45639 - Prescription Drug User Fee Rates for Fiscal Year 2013  

Federal Register 2010, 2011, 2012, 2013, 2014

...FDA-2012-N-0007] Prescription Drug User Fee Rates for Fiscal Year 2013 AGENCY: Food...announcing the rates for prescription drug user fees for fiscal year (FY) 2013. The Federal...as amended by the Prescription Drug User Fee Amendments of 2012 (Title 1 of the...

2012-08-01

163

76 FR 45831 - Prescription Drug User Fee Rates for Fiscal Year 2012  

Federal Register 2010, 2011, 2012, 2013, 2014

...FDA-2011-N-0559] Prescription Drug User Fee Rates for Fiscal Year 2012 AGENCY: Food...announcing the rates for prescription drug user fees for fiscal year (FY) 2012. The Federal...as amended by the Prescription Drug User Fee Amendments of 2007 (Title 1 of the...

2011-08-01

164

75 FR 46952 - Prescription Drug User Fee Rates for Fiscal Year 2011  

Federal Register 2010, 2011, 2012, 2013, 2014

...FDA-2010-N-0390] Prescription Drug User Fee Rates for Fiscal Year 2011 AGENCY: Food...announcing the rates for prescription drug user fees for fiscal year (FY) 2011. The Federal...as amended by the Prescription Drug User Fee Amendments of 2007 (Title 1 of the...

2010-08-04

165

Naproxen sodium overdose  

MedlinePLUS

Naproxen sodium is a non-steroidal anti-inflammatory drug (NSAID) used to relieve mild to moderate aches and pains. Naproxen sodium overdose occurs when someone accidentally or intentionally takes ...

166

Adrenergic bronchodilator overdose  

MedlinePLUS

Akhtar J, Rittenberger JC. Clinical neurotoxicology. In: Shannon MW, Borron SW, Burns MJ. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap ...

167

Eucalyptus oil overdose  

MedlinePLUS

Maypole J, Woolf AD. Essential oils. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; 2007: ...

168

Multiple vitamin overdose  

MedlinePLUS

Muller AA, Henretig FM. The vitamins. In: Shannon MW, Borron SW, Burns MJ. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Saunders Elsevier; 2007:chap ...

169

Calcium channel blocker overdose  

MedlinePLUS

Salhanick SD. Calcium channel antagonists. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; ...

170

Mineral oil overdose  

MedlinePLUS

White SR, Hedge MW. Gastrointestinal toxicology. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; 2007: ...

171

Cardiac glycoside overdose  

MedlinePLUS

Lapostolle F, Borron SW. Digitalis. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; ...

172

Peppermint oil overdose  

MedlinePLUS

Maypole J, Woolf AD. Essential oils. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; 2007: ...

173

Petroleum jelly overdose  

MedlinePLUS

Shannon MW. Emergency Management of Poisoning. In: Shannon, MW, Borron, SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007: ...

174

Eugenol oil overdose  

MedlinePLUS

Maypole J, Woolf AD. Essential oils. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Saunders Elsevier; 2007: ...

175

Amitriptyline and perphenazine overdose  

MedlinePLUS

Brush DE, Aaron CK. Tricyclic and other cyclic antidepressants. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: ...

176

Development of a Patient-Centered Bilingual Prescription Drug Label  

PubMed Central

Research shows that prescription drug labels are often difficult for patients to understand, which contributes to medication errors and nonadherence. In this study, the authors developed and qualitatively evaluated an evidence-based bilingual prescription container label designed to improve understanding. The authors developed several prototypes in English only or in English and Spanish. The labels included an image of the drug, an icon to show its purpose, and plain-language instructions presented in a 4-time-of-day table. In 5 focus groups and interviews that included 57 participants, patients and pharmacists critically reviewed the designs and compared them with traditional medication labels and reformatted labels without illustrations. Patients strongly preferred labels that grouped patient-relevant content, highlighted key information, and included drug indication icons. They also preferred having the 4-time-of-day table and plain-language text instructions as opposed to either one alone. Patients preferred having pertinent warnings on the main label instead of auxiliary labels. Pharmacists and Latino patients valued having Spanish and English instructions on the label, so both parties could understand the content. The final label design adheres to the latest national- and state-level recommendations for label format and incorporates additional improvements on the basis of patient and pharmacist input. This design may serve as a prototype for improving prescription drug labeling. PMID:24093345

Mohan, Arun; Riley, M. Brian; Boyington, Dane; Johnston, Phillip; Trochez, Karen; Jennings, Callie; Mashburn, Jennie; Kripalani, Sunil

2013-01-01

177

Nitrosamine formation via non-prescription drugs?  

PubMed

Both carcinogenic and non-carcinogenic nitrosamines can be formed under physiological conditions in the human body by a reaction between nitrite and secondary or tertiary amines. A large number of people are exposed daily through drinking water to high levels of nitrate, which can be reduced to nitrite. Moreover, nitrate and nitrite are present in vegetables and nitrite is used in food preservation. Dietary exposure to amines is normally below 100 mg per day, whereas paracetamol and antazolin, both secondary amines, are used therapeutically at much higher doses. Knowledge about the possible interactions between these widely used drugs and the background exposure to nitrite is presently not available. Therefore, an evaluation of the carcinogenic hazard related to this combination is needed. PMID:7915398

Nielsen, J B; Lings, S

1994-04-01

178

78 FR 15019 - Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for...  

Federal Register 2010, 2011, 2012, 2013, 2014

...PrescriptionDrugUserFee/UCM329758.pdf. DATES: Submit either electronic or written...PrescriptionDrugUserFee/UCM270412.pdf. Section X of the PDUFA Goals Document...PrescriptionDrugUserFee/UCM329758.pdf. The comment period will remain open...

2013-03-08

179

Community Characteristics and Death by Homicide, Suicide and Drug Overdose in Italy: The Role of Civic Engagement  

Microsoft Academic Search

A number of recent theories suggest that high civicness, civic participation and social capital protect a community from deviant\\u000a behavior. Most empirical studies of this hypothesis have been conducted in North America. This paper examines to what extent\\u000a this hypothesis applies to Italy and to three forms of violent death: homicide, suicide, and drug overdose, using the Putnam\\u000a concept of

Uberto Gatti; Richard E. Tremblay; Hans M. A. Schadee

2007-01-01

180

Growing internet use may help explain the rise in prescription drug abuse in the United States  

PubMed Central

The rise in availability of commonly abused prescription drugs through the internet has raised public health concerns. We examined whether U.S. prescription drug abuse growth may be explained by growth in internet use. We find that for every 10 percent increase in high-speed internet use at the state level, associated admissions for prescription drug abuse rose by 1 percent. Non-prescription drug related admissions bore no association with internet use. The results suggest that better surveillance of online prescription drug use is warranted, and aggressive efforts to curb illegitimate online pharmacies may be necessary. PMID:21565838

Goldman, Dana P.; Jena, Anupam B.

2013-01-01

181

Prescription Drug Use and Expenditures Among Dually Eligible Beneficiaries  

PubMed Central

Using Medicaid Analytic eXtract (MAX) claims files for 1999 and 2001, the authors describe patterns of prescription drug use and expenditures among dually eligible Medicare and Medicaid beneficiaries for all Medicaid full dually eligible beneficiaries and three important subgroups: (1) aged, (2) disabled, and (3) full-year nursing home residents. The analyses indicate great variation in use and expenditures across States that cannot be explained through differences in use of cost containment strategies. Further, the findings suggest that Medicare Part D plans may achieve significant savings by providing incentives for greater use of generic drugs. PMID:17722750

Bagchi, Ann D.; Esposito, Dominick; Verdier, James M.

2007-01-01

182

Co-Prescription Trends in a Large Cohort of Subjects Predict Substantial Drug-Drug Interactions  

PubMed Central

Pharmaceutical prescribing and drug-drug interaction data underlie recommendations on drug combinations that should be avoided or closely monitored by prescribers. Because the number of patients taking multiple medications is increasing, a comprehensive view of prescribing patterns in patients is important to better assess real world pharmaceutical response and evaluate the potential for multi-drug interactions. We obtained self-reported prescription data from NHANES surveys between 1999 and 2010, and confirm the previously reported finding of increasing drug use in the elderly. We studied co-prescription drug trends by focusing on the 2009-2010 survey, which contains prescription data on 690 drugs used by 10,537 subjects. We found that medication profiles were unique for individuals aged 65 years or more, with ?98 unique drug regimens encountered per 100 subjects taking 3 or more medications. When drugs were viewed by therapeutic class, it was found that the most commonly prescribed drugs were not the most commonly co-prescribed drugs for any of the 16 drug classes investigated. We cross-referenced these medication lists with drug interaction data from Drugs.com to evaluate the potential for drug interactions. The number of drug alerts rose proportionally with the number of co-prescribed medications, rising from 3.3 alerts for individuals prescribed 5 medications to 11.7 alerts for individuals prescribed 10 medications. We found 22% of elderly subjects taking both a substrate and inhibitor of a given cytochrome P450 enzyme, and 4% taking multiple inhibitors of the same enzyme simultaneously. By examining drug pairs prescribed in 0.1% of the population or more, we found low agreement between co-prescription rate and co-discussion in the literature. These data show that prescribing trends in treatment could drive a large extent of individual variability in drug response, and that current pairwise approaches to assessing drug-drug interactions may be inadequate for predicting real world outcomes. PMID:25739022

Sutherland, Jeffrey J.; Daly, Thomas M.; Liu, Xiong; Goldstein, Keith; Johnston, Joseph A.; Ryan, Timothy P.

2015-01-01

183

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2013 CFR

21 Food and Drugs 4 2013-04-01 2013-04-01 false Amphetamine and methamphetamine inhalers regarded as prescription drugs. 250.101 Section 250.101 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

2013-04-01

184

21 CFR 14.160 - Establishment of standing technical advisory committees for human prescription drugs.  

Code of Federal Regulations, 2012 CFR

21 Food and Drugs 1 2012-04-01 2012-04-01 false Establishment...standing technical advisory committees for human prescription drugs. 14.160 Section 14.160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF...

2012-04-01

185

76 FR 79194 - Agency Information Collection Activities; Proposed Collection; Comment Request; Prescription Drug...  

Federal Register 2010, 2011, 2012, 2013, 2014

...HEALTH AND HUMAN SERVICES Food and Drug Administration...Prescription Drug Product Labeling: Medication Guide Requirements AGENCY: Food and Drug Administration...distribution of patient labeling, called Medications...Management (HFA-305), Food and Drug...

2011-12-21

186

Redressing the Epidemics of Opioid Overdose and HIV among People who Inject Drugs in Central Asia: The Need for a Syndemic Approach  

PubMed Central

Background Accumulating evidence suggests that opioid overdose and HIV infection are burgeoning intertwined epidemics among people who inject drugs (PWID) in Central Asia. To date, however, research on overdose and its associations with HIV risks among PWID in Central Asia remains virtually absent. This paper aims to provide a regional overview of the hidden epidemic of overdose and how it is linked to HIV among PWID in Central Asia, using a syndemic framework that is guided by risk environment research. Methods We conducted a comprehensive literature search of peer-reviewed publications and grey literature on opioid overdose and its associations with HIV in five countries of Central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan) as well as on policies and programs that address these co-occurring epidemics. Results Regional data indicate high rates of fatal and non-fatal overdose among PWID. Evidence suggests mortality rates from overdose exceed HIV/AIDS as the leading cause of death among PWID. The syndemic framework suggests multiple macro-level and micro-level environmental risk factors that drive the co-occurring epidemics of HIV and overdose. This framework identifies several interacting biological and behavioral risks that result in additive effects for HIV and overdose. Conclusion The high rates of overdose and its associations with HIV underscore the need for a syndemic approach that considers overdose on parity with HIV. Such an approach should focus on the biological, behavioral and structural interactions between these epidemics to reduce social suffering, morbidity and mortality among PWID in Central Asia. PMID:23954070

Gilbert, Louisa; Primbetova, Sholpan; Nikitin, Danil; Hunt, Timothy; Terlikbayeva, Assel; Momenghalibaf, Azzi; Ruziev, Murodali; El-Bassel, Nabila

2013-01-01

187

Improving the prescription of folate to women receiving antiepileptic drugs.  

PubMed

In women of childbearing potential (WCP) on antiepileptic drugs (AEDs), there is an increased risk of teratogenicity. This can potentially be reduced with folate supplementation. We evaluated the rate of co-prescription of AEDs and folate to WCP by non-epileptologist Neurology attendings and residents before and after an educational intervention. During the initial 3 month survey, 54 WCP were prescribed ?1 AEDs. Prior to the intervention, the rate of co-prescription of AEDs and folate was 20.4%. This was higher when neurologists were prescribing AEDs for epilepsy (34.4%) versus other disorders (0%, p=0.02). In the 3 months following the intervention, 48 WCP received AEDs. The rate of co-prescribing folate increased to 64.6% (p<0.001). Neurologists treating epilepsy continued to be more likely to prescribe folate (86.4%) than neurologists treating other conditions (46.2%, p=0.006). PMID:25847335

Sharma, Anumeha; Cavitt, Jennifer; Privitera, Michael; Moseley, Brian D

2015-05-01

188

Prescription opioid misuse and its relation to injection drug use and hepatitis C virus infection: protocol for a systematic review and meta-analysis  

PubMed Central

Background The production, prescription, and consumption of opioid analgesics to treat non-cancer pain have increased dramatically in the USA in the past decade. As a result, misuse of these opioids has increased; overdose and transition to riskier forms of drug use have also emerged. Research points to a trend in transition to drug injection among those misusing prescription opioids, where clusters of acute hepatitis C virus (HCV) infection are now being reported. This systematic review and meta-analysis aims to synthesize the prevalence of prescription opioid misuse in the USA and examine the rate of transition to injection drug use and incident HCV in these new people who inject drugs (PWID). Methods/design Eligible studies will include quantitative, empirical data including national survey data. Scientific databases will be searched using a comprehensive search strategy; proceedings of scientific conferences, reference lists, and personal communications will also be searched. Quality ratings will be assigned to each eligible report using the Newcastle-Ottawa Scale. Pooled estimates of incidence rates and measures of association will be calculated using random effects models. Heterogeneity will be assessed at each stage of data synthesis. Discussion A unique typology of drug use is emerging which is characterized by antecedent prescription opioid misuse among PWID. As the epidemic of prescription opioid misuse matures, this will likely serve as a persistent source of new PWID. Persons who report a recent transition to drug injection are characterized by high rates of HCV seroincidence of 40 per 100 person years or higher. Given the potential for the persistence and escalation of the consequences of prescription opioid misuse in the USA, there is a critical need for synthesis of the current state of the epidemic in order to inform future public health interventions and policy. Systematic review registration PROSPERO CRD42014008870. PMID:25178433

2014-01-01

189

Evaluation of an Overdose Prevention and Response Training Programme for Injection Drug Users in the Skid Row Area of Los Angeles, California  

PubMed Central

Background Fatal opioid overdose is a significant cause of mortality among injection drug users (IDUs). Methods We evaluated an overdose prevention and response training programme for IDUs implemented by a community-based organization in Los Angeles, California. During a 1-hour training session participants learned skills to prevent, recognize, and respond to opioid overdoses, including: calling for emergency services, performing rescue breathing, and administering an intramuscular injection of naloxone (an opioid antagonist). Ninety-three IDUs were trained from September 2006 to January 2008. Of those, 66 (71%) enrolled in the evaluation study. In total, 47 of 66 participants (71%) completed both a baseline interview and three-month follow-up interview. Results Participants were 21% female, 42% White, 29% African American, and 18% Latino. Most were homeless and reported living predominantly in the street (44%), temporary housing such as hotels or motels (15%), or shelters (14%). Significant increases were found in overdose knowledge, driven largely by increase in knowledge about the appropriate use of naloxone. Twenty-two participants witnessed and responded to 35 overdoses during the follow-up period. Twenty-six overdose victims were reported to have recovered, four died, and the outcome of five cases was unknown. The most commonly reported response techniques included: staying with the victim (85%), administering naloxone (80%), providing rescue breathing (66%), and calling emergency services (60%). The average number of appropriate response techniques used by participants increased significantly from baseline to follow-up (p<0.05). Half (53%) of programme participants reported that their drug use decreased at follow-up. Conclusion Results suggest that overdose prevention and response training programmes may be associated with improvements in knowledge and overdose response behaviour among IDUs, with few adverse consequences and some unforeseen benefits, such as reductions in drug use. PMID:19268564

Wagner, Karla D.; Valente, Thomas W.; Casanova, Mark; Partovi, Susan M.; Mendenhall, Brett M.; Hundley, James H.; Gonzalez, Mario; Unger, Jennifer B.

2014-01-01

190

Computer-aided auditing of prescription drug claims.  

PubMed

We describe a methodology for identifying and ranking candidate audit targets from a database of prescription drug claims. The relevant audit targets may include various entities such as prescribers, patients and pharmacies, who exhibit certain statistical behavior indicative of potential fraud and abuse over the prescription claims during a specified period of interest. Our overall approach is consistent with related work in statistical methods for detection of fraud and abuse, but has a relative emphasis on three specific aspects: first, based on the assessment of domain experts, certain focus areas are selected and data elements pertinent to the audit analysis in each focus area are identified; second, specialized statistical models are developed to characterize the normalized baseline behavior in each focus area; and third, statistical hypothesis testing is used to identify entities that diverge significantly from their expected behavior according to the relevant baseline model. The application of this overall methodology to a prescription claims database from a large health plan is considered in detail. PMID:23821344

Iyengar, Vijay S; Hermiz, Keith B; Natarajan, Ramesh

2014-09-01

191

The drug cost gap and the diagnosis-prescription connection.  

PubMed

Although the rise in pharmacy benefit costs continues to outpace overall medical cost inflation, the gap is narrowing. Employers can improve cost and employee wellness even further with an innovative technique for drug therapy compliance called the Diagnosis-Prescription (Dx-Rx) approach. This article reports results from a 2007 national employer survey on pharmacy benefits and describes how the Dx-Rx innovation can keep patients and their doctors on track when it comes to controlling disease and driving down overall medical costs. PMID:19048746

Dross, David

2008-01-01

192

78 FR 46980 - Prescription Drug User Fee Rates for Fiscal Year 2014  

Federal Register 2010, 2011, 2012, 2013, 2014

...DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0007] Prescription Drug User Fee Rates for Fiscal Year 2014 AGENCY: Food and Drug Administration, HHS. ACTION:...

2013-08-02

193

Rev 09/09/13 Your 2014 ORNL Prescription Drug Benefit...  

E-print Network

: Generic Drugs 20% coinsurance $10 minimum 20% coinsurance $30 minimum $15 copayment Tier 2: PreferredRev 09/09/13 Your 2014 ORNL Prescription Drug Benefit... ...For Retirees & Spouses over age 65 ...Provides Comprehensive Drug Coverage Your plan combines

194

75 FR 52765 - Development and Distribution of Patient Medication Information for Prescription Drugs; Public...  

Federal Register 2010, 2011, 2012, 2013, 2014

...with quality prescription drug information are as follows...information about the drug, and is accurate, balanced...counting all innovator and generic products). Second...PMI system be applied to generic drugs? (4) What...

2010-08-27

195

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

Code of Federal Regulations, 2011 CFR

...SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG MARKETING Wholesale Distribution § 203.50 Requirements for... (b) The drug origin statement is subject to the record retention requirements of § 203.60 and must be retained by all...

2011-04-01

196

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

Code of Federal Regulations, 2010 CFR

...SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG MARKETING Wholesale Distribution § 203.50 Requirements for... (b) The drug origin statement is subject to the record retention requirements of § 203.60 and must be retained by all...

2010-04-01

197

Has Medicare Part D Reduced Racial/Ethnic Disparities in Prescription Drug Use and Spending?  

PubMed Central

Objective To evaluate whether Medicare Part D has reduced racial/ethnic disparities in prescription drug utilization and spending. Data Nationally representative data on white, African American, and Hispanic Medicare seniors from the 2002–2009 Medical Expenditure Panel Survey are analyzed. Five measures are examined: filling any prescriptions during the year, the number of prescriptions filled, total annual prescription spending, annual out-of-pocket prescription spending, and average copay level. Study Design We apply the Institute of Medicine's definition of a racial/ethnic disparity and adopt a difference-in-difference-in-differences (DDD) estimator using a multivariate regression framework. The treatment group consists of Medicare seniors, the comparison group, adults without Medicare aged 55–63 years. Principal Findings Difference-in-difference-in-differences estimates suggest that for African Americans Part D increased the disparity in annual spending on prescription drugs by $258 (p = .011), yet had no effect on other measures of prescription drug disparities. For Hispanics, DDD estimates suggest that the program reduced the disparities in annual number of prescriptions filled, annual total and out-of-pocket spending on prescription drugs by 2.9 (p = .077), $282 (p = .019) and $143 (p < .001), respectively. Conclusion Medicare Part D had mixed effects. Although it reduced Hispanic/white disparities related to prescription drugs among seniors, it increased the African American/white disparity in total annual spending on prescription drugs. PMID:24102408

Mahmoudi, Elham; Jensen, Gail A

2014-01-01

198

Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations  

PubMed Central

Objective Prescription drug diversion involves the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace, and can occur along all points in the drug delivery process, from the original manufacturing site to the wholesale distributor, the physician's office, the retail pharmacy, or the patient. However, empirical data on diversion are limited. Method In an attempt to develop a better understanding of how specific drug-using populations are diverting prescription opioids and other medications, or obtaining controlled drugs that have already been diverted, qualitative interviews and focus group data were collected on four separate populations of prescription drug abusers in Miami, Florida—club drug users, street-based illicit drug users, methadone maintenance patients, and HIV positive individuals who abuse and/or divert drugs. Results Sources of abused prescription drugs cited by focus group participants were extremely diverse, including their physicians and pharmacists; parents and relatives; “doctor shopping”; leftover supplies following an illness or injury; personal visits to Mexico, South America and the Caribbean; prescriptions intended for the treatment of mental illness; direct sales on the street and in nightclubs; pharmacy and hospital theft; through friends or acquaintances; under-the-door apartment flyers advertising telephone numbers to call; and “stealing from grandma's medicine cabinet.” Conclusion While doctor shoppers, physicians and the Internet receive much of the attention regarding diversion, the data reported in this paper suggest that there are numerous active street markets involving patients, Medicaid recipients and pharmacies as well. In addition, there are other data which suggest that the contributions of residential burglaries, pharmacy robberies and thefts, and “sneak thefts” to the diversion problem may be understated. PMID:17305688

Inciardi, James A.; Surratt, Hilary L.; Kurtz, Steven P.; Cicero, Theodore J.

2010-01-01

199

Nonmedical Prescription Drug Use among Adolescents: The Influence of Bonds to Family and School  

ERIC Educational Resources Information Center

There has been a tremendous increase in the prevalence of nonmedical prescription drug use among adolescents in recent years. Research now indicates that the prevalence of nonmedical prescription drug use is greater than the prevalence of other illicit drug use, excluding marijuana. Despite these recent trends, there is a dearth of research in the…

Ford, Jason A.

2009-01-01

200

HOW CLINICIANS USE PRESCRIPTION DRUG MONITORING PROGRAMS: A QUALITATIVE INQUIRY  

PubMed Central

Objectives Prescription drug monitoring programs (PDMP) are now active in most states to assist clinicians in identifying potential controlled drug misuse, diversion or excessive prescribing. Little is still known about the ways in which they are incorporated into workflow and clinical decision making, what barriers continue to exist, and how clinicians are sharing PDMP results with their patients. Design Qualitative data were collected through online focus groups and telephone interviews Setting Clinicians from pain management, emergency and family medicine, psychiatry/behavioral health, rehabilitation medicine, internal medicine and dentistry. Subjects 35 clinicians from 9 states participated. Methods We conducted two online focus groups and seven telephone interviews. A multidisciplinary team then used a grounded theory approach coupled with an immersion-crystallization strategy for identifying key themes in the resulting transcripts. Results Some participants, mainly from pain clinics, reported checking the PDMP with every patient, every time. Others checked only for new patients, for new opioid prescriptions, or for patients for whom they suspected abuse. Participants described varied approaches to sharing PDMP information with patients, including openly discussing potential addiction or safety concerns; avoiding discussion altogether; and approaching discussion confrontationally. Participants described patient anger or denial as a common response and noted the role of patient satisfaction surveys as an influence on prescribing. Conclusion Routines for accessing PDMP data and how clinicians respond to it vary widely. As PDMP use becomes more widespread, it will be important to understand what approaches are most effective for identifying and addressing unsafe medication use. PMID:24833113

Hildebran, Christi; Cohen, Deborah J.; Irvine, Jessica M.; Foley, Carol; O’Kane, Nicole; Beran, Todd; Deyo, Richard A.

2014-01-01

201

Should the US allow prescription drug reimports from Canada?  

PubMed

As a result of public outrage over lower prescription drug prices in Canada, Congress passed legislation that would allow these drugs to be imported into the US. The lower Canadian prices reflect price regulation. Opponents of allowing these imports have argued that the US will import Canadian price controls and that profits of pharmaceutical companies will be hurt. In this paper, a model is developed in which a good sold in the foreign country is subject to a negotiated price which is determined in a Nash bargaining game. When imports back into the home country are allowed, this negotiated price also becomes the domestic price. This causes the home firm to make fewer price concession in the Nash bargaining game. Home firm profits are found to rise under the reimport regime for both of the demand functions analyzed in this paper. PMID:12146598

Pecorino, Paul

2002-07-01

202

Changing effects of direct-to-consumer broadcast drug advertising information sources on prescription drug requests.  

PubMed

This study tracks the changes of the effects of 4 information sources for direct-to-consumer drug advertising on patients' requests for prescription drugs from physicians since the inception of the "Guidance for Industry about Consumer-directed Broadcast Advertisements." The Guidance advises pharmaceuticals to use four information sources for consumers to seek further information to supplement broadcast drug advertisements: small-print information, the Internet, a toll-free number, and health-care providers (nurses, doctors, and pharmacists). Logistic models were created by using survey data collected by the Food and Drug Administration in 1999 and 2002. Results show that throughout the years, health-care providers remain the most used and strongest means associated with patients' direct requests for nonspecific and specific prescription drugs from doctors. The small-print information source gains power and changes from an indirect means associated with patients' discussing drugs with health-care providers to a direct means associated with patients' asking about nonspecific and specific drugs from their doctors. The Internet is not directly related to drug requests, but the effect of its association with patients seeking information from health-care providers grew 11-fold over the course of the study. The toll-free number lost its power altogether for both direct request for a prescription drug and further discussion with health-care providers. Patient demographics will be considered for specific policy implications. PMID:19499430

Lee, Annisa Lai

2009-06-01

203

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2011 CFR

21 Food and Drugs 4 2011-04-01 2011-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2011-04-01

204

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2012 CFR

21 Food and Drugs 4 2012-04-01 2012-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2012-04-01

205

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2013 CFR

21 Food and Drugs 4 2013-04-01 2013-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2013-04-01

206

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2014 CFR

21 Food and Drugs 4 2014-04-01 2014-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2014-04-01

207

Heroin overdose: Research and evidence-based intervention  

Microsoft Academic Search

Drug overdose is a major cause of premature death and morbidity among heroin users. This article examines recent research\\u000a into heroin overdose to inform interventions that will reduce the rate of overdose death. The demographic characteristics\\u000a of overdose cases are discussed, including factors associated with overdose: polydrug use, drug purity, drug tolerance, routes\\u000a of administration, and suicide. Responses by heroin

Shane Darke; Wayne Hall

2003-01-01

208

Exploring the Etiologic Factors and Dynamics of Prescription Drug Abuse in Southwest Virginia  

PubMed Central

Background: Prescription drug abuse in Southwest Virginia is a serious problem affecting indi-viduals, families, and communities. The aim of this study was to characterize and understand the extent of the prescription drug abuse problem in Southwest, Virginia as well as the dynamics that surround that abuse. More specifically, the study focused on learning the extent of the problem along with which prescription drugs are typically used prior to entering treatment, reasons for prescription drug and methadone abuse, and the sources for prescription drug use, misuse and abuse. Methods: Mixed methodology was employed which included surveying methadone clinic con-sumers at two treatment clinics in Southwest, Virginia and seven focus field interviews of key community stakeholders. Results: The extent of prescription drug abuse is high and that the demographics of prescription drug users are getting younger and now involve more males than females. Oxycodone, hydroco¬done, methadone, and morphine were the most commonly used drugs prior to enrollment in the clinics with over one-half of methadone-maintained consumers reporting that they had abused benzodiazepines along with opioids. Focus groups and clinic consumer data highlighted the key etiological factors in prescription drug abuse: use (due to workforce related injuries) turning to abuse, wanting to get high, overprescribing and physician issues, lack of information, and cultural acceptance of drug taking as problem solving behavior. The two most common sources for the abused prescription drugs were physicians and street dealers. Conclusions: A constellation of conditions have led to the epidemic of prescription drug abuse in Southwest Virginia, including poverty, unemployment and work-related injuries, besides, public health education programs on the dangers of prescription opiate misuse and abuse are urgently needed. PMID:24688929

Redican, Kerry J; Marek, Lydia I; Brock, Donna JP; McCance-Katz, Elinore F

2012-01-01

209

An Exploration of Social Circles and Prescription Drug Abuse Through Twitter  

PubMed Central

Background Prescription drug abuse has become a major public health problem. Relationships and social context are important contributing factors. Social media provides online channels for people to build relationships that may influence attitudes and behaviors. Objective To determine whether people who show signs of prescription drug abuse connect online with others who reinforce this behavior, and to observe the conversation and engagement of these networks with regard to prescription drug abuse. Methods Twitter statuses mentioning prescription drugs were collected from November 2011 to November 2012. From this set, 25 Twitter users were selected who discussed topics indicative of prescription drug abuse. Social circles of 100 people were discovered around each of these Twitter users; the tweets of the Twitter users in these networks were collected and analyzed according to prescription drug abuse discussion and interaction with other users about the topic. Results From November 2011 to November 2012, 3,389,771 mentions of prescription drug terms were observed. For the 25 social circles (n=100 for each circle), on average 53.96% (SD 24.3) of the Twitter users used prescription drug terms at least once in their posts, and 37.76% (SD 20.8) mentioned another Twitter user by name in a post with a prescription drug term. Strong correlation was found between the kinds of drugs mentioned by the index user and his or her network (mean r=0.73), and between the amount of interaction about prescription drugs and a level of abusiveness shown by the network (r=0.85, P<.001). Conclusions Twitter users who discuss prescription drug abuse online are surrounded by others who also discuss it—potentially reinforcing a negative behavior and social norm. PMID:24014109

2013-01-01

210

Perceived Drug Use Functions and Risk Reduction Practices Among High-Risk Nonmedical Users of Prescription Drugs  

PubMed Central

Nonmedical use of prescription drugs has become the fastest growing drug problem in the United States, particularly among young adults. This study examines the reasons young polydrug users misuse prescription drugs, and explores how young users employ risk reduction strategies to minimize adverse consequences. The sample was recruited during 2008 and 2009 in Los Angeles and New York, and comprised 45 nonmedical users of prescription drugs, aged 16 to 25. Data from a semistructured interview were analyzed quantitatively and qualitatively. Participants reported nonmedical use of prescription drugs to change mood, to facilitate activity, and to monitor the intake of other substances. Commonly employed risk reduction strategies included calculating pill timing, dosage, and access, and monitoring frequency of use, particularly when combining different substances. Most study participants often planned drug use to occur within socially acceptable parameters, such that prescription drug misuse was a normalized feature of their everyday lives. PMID:25477621

Silva, Karol; Kecojevic, Aleksandar; Lankenau, Stephen E.

2014-01-01

211

How Does Drug Treatment for Diabetes Compare between Medicare Advantage Prescription Drug Plans (MAPDs) and Stand-Alone Prescription Drug Plans (PDPs)?  

PubMed Central

Objective To compare the use of guideline-recommended prescription medications for diabetes among Medicare beneficiaries enrolled in stand-alone prescription drug plans (PDPs) with Medicare Advantage prescription drug plans (MAPDs) in the presence of potential selection bias. Data Sources/Study Setting Centers for Medicare and Medicaid Services' Chronic Condition Data Warehouse (2006, 2007). Study Design Retrospective cross-sectional comparison of drug use and proportion of days covered (PDC) for oral-antidiabetics, ACE-inhibitors/ARBs, and antihyperlipidemics among PDP and MAPD enrollees with diabetes. We estimated “naïve” regression models assuming exogenous plan choice and two-stage residual inclusion (2SRI) models to study endogeneity in choice of Part D plan type. Data Collection/Extraction Methods We identified 111,290 diabetics based on ICD-9 codes in Medicare claims from a random 5 percent sample of Medicare beneficiaries in 2005 excluding dual eligibles. Principal Findings The naïve regression models indicated lower probability of drug use for oral-antidiabetics (?4 percent; p < .001) and ACE-inhibitors/ARBS (?2 percent; p = .004) among PDP enrollees, but their PDC was higher (3–5 percent) for all drug classes (p < .001). 2SRI models produced no significant differences in any-use equations, but significantly higher PDC values for PDP enrollees for oral-antidiabetics and ACE-inhibitors/ARBs. Conclusions We found similar overall use of recommended drugs in diabetes treatment and no consistent evidence of favorable or adverse selection into PDPs and MAPDs. PMID:23205568

Erten, Mujde Z; Stuart, Bruce; Davidoff, Amy J; Shoemaker, J Samantha; Bryant-Comstock, Lynda; Shenolikar, Rahul

2013-01-01

212

Prescription Drug Misuse among University Staff and Students: A Survey of Motives, Nature and Extent  

ERIC Educational Resources Information Center

Aims: To determine the prevalence and nature of prescription drug misuse among university staff and students in the UK. Methods: In 2009, an online questionnaire regarding non-medical use of prescription drugs was completed by 1614 students and 489 staff registered at a large university in Wales. The sample data were weighted to match the…

Holloway, Katy; Bennett, Trevor

2012-01-01

213

Nonmedical Prescription Drug Use among College Students: A Comparison between Athletes and Nonathletes  

ERIC Educational Resources Information Center

Objective: Given the substantial increase in nonmedical prescription drug use in recent years and a lack of research on the topic, the author analyzed data on nonmedical prescription drug use among college students. Participants and Methods: Using data from the 2001 College Alcohol Study (N = 10,904), the author examined variation in nonmedical…

Ford, Jason A.

2008-01-01

214

An Exploration of the Relationship between the Use of Methamphetamine and Prescription Drugs  

ERIC Educational Resources Information Center

This study examines patterns of use of prescription drugs and methamphetamine. We drew our sample from a study about 130 active and inactive methamphetamine users and focused on 16 participants with a recent history of methamphetamine and prescription drug use. We collected in-depth interviews to explore relationships in use trajectory patterns.…

Lamonica, Aukje K.; Boeri, Miriam

2012-01-01

215

75 FR 69093 - Prescription Drug User Fee Act; Reopening of the Comment Period  

Federal Register 2010, 2011, 2012, 2013, 2014

...FDA-2010-N-0128] Prescription Drug User Fee Act; Reopening of...public meeting to solicit input on the reauthorization of the Prescription Drug User Fee Act (PDUFA) program...longer be able to collect user fees to fund the human...Register requesting public input on the...

2010-11-10

216

Total and Out-of-Pocket Expenditures for Prescription Drugs among Older Persons  

ERIC Educational Resources Information Center

Purpose: The burden of prescription drug costs on Medicare beneficiaries has become a critical policy issue in improving the Medicare program, yet few studies have provided detailed and current information on that burden. The present study estimates total and out-of-pocket expenditures for prescription drugs and the burden of these costs in…

Sambamoorthi, Usha; Shea, Dennis; Crystal, Stephen

2003-01-01

217

Prescription Drug Abuse: A Fast-Growing Problem | NIH MedlinePlus the Magazine  

MedlinePLUS

... turn Javascript on. Feature: Preventing Drug Abuse and Addiction Prescription Drug Abuse: A Fast-Growing Problem Past ... approach do you suggest I take for my addiction or substance abuse? Do I need to see ...

218

Pricing of prescription drugs and its impact on physicians' choice behavior.  

PubMed

This research presents an analysis of Taiwan's health care market with the focus on the pricing of prescription drugs and its impact on physicians' choice behavior. Since the advent of Taiwan's national health insurance, with the competent authority being Bureau of National Health Insurance (BNHI), hospitals are allowed to sell prescription drugs to patients at prices above the purchasing prices, so each prescription drug has two prices: one at which drugs are sold to hospitals; the other which BNHI reimbursement to hospitals. The margin between the different prices is the sales discount that pharmaceutical companies offer to the hospitals. We find that sales discount has a great impact on physicians' choice behavior: i.e., physicians are price-sensitive to prescription drugs. In addition, it is found that too high a sales discount of a prescription drug would result in a too low weighted average price of that drug sold; thus BNHI would be more likely to adjust downward the rate it reimbursement to the hospital. This presents a sales strategy problem to pharmaceutical companies. To solve this, we use the distribution of physicians' evaluations of prescription drugs to establish a profit maximization model in hopes of helping companies to price drugs and find the optimal promotion expending. Ten popular prescription drugs are used in this research as examples. PMID:18826006

Miao-Sheng, Chen; Yu-Ti, Shih

2008-09-01

219

Phenobarbital overdose  

MedlinePLUS

... a medicine used to treat epilepsy , anxiety, and insomnia. Phenobarbital overdose occurs when someone takes too much of this medicine. This is for information only and not for use in the treatment or management of an actual poison exposure. If ...

220

An inevitable wave of prescription drug monitoring programs in the context of prescription opioids: pros, cons and tensions  

PubMed Central

Background In an effort to control non-medical use and/or medical abuse of prescription drugs, particularly prescription opioids, electronic prescription drug monitoring programs (PDMP) have been introduced in North-American countries, Australia and some parts of Europe. Paradoxically, there are simultaneous pressures to increase opioid prescribing for the benefit of individual patients and to reduce it for the sake of public health, and this pressure warrants a delicate balance of appropriate therapeutic uses of these drugs with the risk of developing dependence. This article discusses pros and cons of PDMP in reducing diversion of prescription opioids, without hampering access to those medications for those with genuine needs, and highlights tensions around PDMP implementation. Discussion PDMPs may help alleviate diversion, over-prescription and fraudulent prescribing/dispensing; prompt drug treatment referrals; avoid awkward drug urine test; and inform spatial changes in prescribing practices and help designing tailored interventions. Fear of legal retribution, privacy and data security, potential confusion about addiction and pseudo-addiction, and potential undue pressure of detecting misuse/diversion - are the major problems. There are tensions about unintended consequence of excessive regulatory enforcements, corresponding collateral damages particularly about inadequate prescribing for patients with genuine needs, and mandatory consultation requirements of PDMP. Summary In this era of information technology PDMP is likely to flourish and remain with us for a long time. A clear standard of practice against which physicians’ care will be judged may expedite the utilisation of PDMP. In addition, adequate training on addiction and pain management along with public awareness, point-of-supply data entry from pharmacy, point-of-care real-time access to data, increasing access to addiction treatment and appropriate regulatory enforcement preferably through healthcare administration, together, may help remove barriers to PDMP use. PMID:25127880

2014-01-01

221

Prescription drug insurance coverage and patient health outcomes: a systematic review.  

PubMed

Previous reviews have shown that changes in prescription drug insurance benefits can affect medication use and adherence. We conducted a systematic review of the literature to identify studies addressing the association between prescription drug coverage and health outcomes. Studies were included if they collected empirical data on expansions or restrictions of prescription drug coverage and if they reported clinical outcomes. We found 23 studies demonstrating that broader prescription drug insurance reduces use of other health care services and has a positive impact on patient outcomes. Coverage gaps or caps on drug insurance generally led to worse outcomes. States should consider implementing the Affordable Care Act expansions in drug coverage to improve the health of low-income patients receiving state-based health insurance. PMID:25521879

Kesselheim, Aaron S; Huybrechts, Krista F; Choudhry, Niteesh K; Fulchino, Lisa A; Isaman, Danielle L; Kowal, Mary K; Brennan, Troyen A

2015-02-01

222

A Computational Drug-Target Network for Yuanhu Zhitong Prescription  

PubMed Central

Yuanhu Zhitong prescription (YZP) is a typical and relatively simple traditional Chinese medicine (TCM), widely used in the clinical treatment of headache, gastralgia, and dysmenorrhea. However, the underlying molecular mechanism of action of YZP is not clear. In this study, based on the previous chemical and metabolite analysis, a complex approach including the prediction of the structure of metabolite, high-throughput in silico screening, and network reconstruction and analysis was developed to obtain a computational drug-target network for YZP. This was followed by a functional and pathway analysis by ClueGO to determine some of the pharmacologic activities. Further, two new pharmacologic actions, antidepressant and antianxiety, of YZP were validated by animal experiments using zebrafish and mice models. The forced swimming test and the tail suspension test demonstrated that YZP at the doses of 4?mg/kg and 8?mg/kg had better antidepressive activity when compared with the control group. The anxiolytic activity experiment showed that YZP at the doses of 100?mg/L, 150?mg/L, and 200?mg/L had significant decrease in diving compared to controls. These results not only shed light on the better understanding of the molecular mechanisms of YZP for curing diseases, but also provide some evidence for exploring the classic TCM formulas for new clinical application. PMID:23762151

Lu, Peng; Zhang, Fangbo; Yuan, Yuan; Wang, Songsong

2013-01-01

223

An explanatory model for state Medicaid per capita prescription drug expenditures.  

PubMed

Rising prescription drug expenditure is a growing concern for publicly funded drug benefit programs like Medicaid. To be able to contain drug expenditures in Medicaid, it is important that cause(s) for such increases are identified. This study attempts to establish an explanatory model for Medicaid prescription drugs expenditure based on the impacts of key influencers/predictors identified using a comprehensive framework of drug utilization. A modified Andersen's behavior model of health services utilization is employed to identify potential determinants of pharmaceutical expenditures in state Medicaid programs. Level of federal matching funds, access to primary care, severity of diseases, unemployment, and education levels were found to be key influencers of Medicaid prescription drug expenditure. Increases in all, except education levels, were found to result in increases in drug expenditures. Findings from this study could better inform intervention policies and cost-containment strategies for state Medicaid drug benefit programs. PMID:22963157

Roy, Sanjoy; Madhavan, S Suresh

2012-01-01

224

Understanding Nonprescription and Prescription Drug Misuse in Late Adolescence/Young Adulthood  

PubMed Central

This study explored the extent to which nonprescription and prescription drugs misuse among adolescents/young adults are related to their perception that it is safer than illicit drugs, ease of access, and lower societal stigma. Adolescents/young adults (N = 465; Mage = 18.57, SD = 0.86) completed an online survey about their nonprescription and prescription drug misuse, other substance use, and correlates of use. Perceived risk, societal stigma, and access to nonprescription and prescription drugs were predictive of misuse. Results support program planners working towards targeting perceived risk and societal stigma in reducing misuse and the need to restrict and monitor access to nonprescription and prescription drugs for adolescents/young adults. PMID:24826368

Fleary, Sasha A.; Heffer, Robert W.; McKyer, E. Lisako J.

2013-01-01

225

Non-medical use of prescription drugs and sexual risk behavior in young adults.  

PubMed

In recent years, the non-medical use of prescription drugs (without a doctor's prescription) has increased dramatically, particularly in young adults. Previous work has noted associations between the non-medical use of prescription drugs and the use of illicit drugs, and associations between the use of illicit drugs and sexual risk behavior. Investigations examining associations between the non-medical use of prescription drugs (NMUPD) and sexual risk behavior are sparse. In the present study, undergraduate students (n=435) ages 18-25 completed an instrument assessing these behaviors. Overall, 35.6% of participants reported NMUPD. Individuals who reported NMUPD were more likely to also report the use of alcohol, marijuana, ecstasy, cocaine, methamphetamine, and poppers. Participants who indicated they had used prescription medications without a doctor's consent had significantly higher rates of sexual risk behavior, including more sexual partners and more instances of unprotected sex in the previous 3 months. Results suggest that a significant minority of young adults are using prescription medication recreationally and are risking negative consequences, including the potential for addiction, dangerous interactions between prescription and recreational drugs, and greater risk for contracting sexually transmitted infections. PMID:20863626

Benotsch, Eric G; Koester, Stephen; Luckman, Diana; Martin, Aaron M; Cejka, Anna

2011-01-01

226

Prescription drugs purchased through the internet: Who are the end users?  

PubMed Central

Although prescription drugs are readily available on the Internet, little is known about the prevalence of Internet use for the purchase of medications without a legitimate prescription, and the characteristics of those that obtain non-prescribed drugs through online sources. The scientific literature on this topic is limited to anecdotal reports or studies plagued by small sample sizes. Within this context, the focus of this paper is an examination of five national data sets from the U.S. with the purpose of estimating: (1) how common obtaining prescription medications from the Internet actually is, (2) who are the typical populations of “end users” of these non-prescribed medications, and (3) which drugs are being purchased without a prescription. Three of the data sets are drawn from the RADARS® (Researched Abuse Diversion and Addiction-Related Surveillance) System, a comprehensive series of studies designed to collect timely and geographically specific data on the abuse and diversion of a number of prescription stimulants and opioid analgesics. The remaining data sets include the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) survey. Our analysis yielded uniformly low rates of prescription drug acquisition from online sources across all five data systems we examined. The consistency of this finding across very diverse populations suggests that the Internet is a relatively minor source for illicit purchases of prescription medications by the individual end-users of these drugs. PMID:20227199

Inciardi, James A.; Surratt, Hilary L.; Cicero, Theodore J.; Rosenblum, Andrew; Ahwah, Candice; Bailey, J. Elise; Dart, Richard C.; Burke, John J.

2012-01-01

227

NATIONAL SURVEY OF PRESCRIPTION DRUG INFORMATION PROVIDED TO PATIENTS (NSPDIPP)  

EPA Science Inventory

National telephone surveys were conducted in 1992, 1994, 1996, and 1998 to determine how much prescription medicine information consumers receive and through which sources. Approximately 1,000 U.S. consumers who received a new prescription for themselves or a family member at a r...

228

Quantifying Age-Related Differences in Information Processing Behaviors When Viewing Prescription Drug Labels  

Microsoft Academic Search

Adverse drug events (ADEs) are a significant problem in health care. While effective warnings have the potential to reduce the prevalence of ADEs, little is known about how patients access and use prescription labeling. We investigated the effectiveness of prescription warning labels (PWLs, small, colorful stickers applied at the pharmacy) in conveying warning information to two groups of patients (young

Raghav Prashant Sundar; Mark W. Becker; Nora M. Bello; Laura Bix

2012-01-01

229

Income and the Use of Prescription Drugs by the Elderly: Evidence from the Notch Cohorts  

ERIC Educational Resources Information Center

We use exogenous variation in Social Security payments created by the Social Security benefits notch to estimate how retirees' use of prescription medications responds to changes in their incomes. Using data from the 1993 Wave of the AHEAD, we obtain instrumental variables estimates of the income elasticity of prescription drug use that are…

Moran, John R.; Simon, Kosali Ilayperuma

2006-01-01

230

Prescription drug abuse & addiction: past, present and future: the paradigm for an epidemic.  

PubMed

Prescription drug abuse has reached epidemic proportions in the United States and West Virginia is not immune. It is estimated that in 2009, the number of adolescents and adults with a substance abuse and/or dependence problem has reached 23.2 million in the US. There has been an alarming rate of increased sales of methadone, hydrocodone and oxycodone. This article addresses the scope of the problem of prescription drug abuse in West Virginia and the impact by and on the addicted individual. Addiction is a chronic relapsing neuropsychiatric illness manifested by compulsive drug seeking and use. It has created a substantive socioeconomic burden on our state. Prescription drug abuse and addiction increase medical expenses, drug related crime and unemployment. There are misconceptions regarding the etiology and treatment of addiction based on past clinical experience. The view of addiction as volitional misconduct alone has been disproven scientifically. A more current understanding of neurobiological alterations caused by this disease, current treatment strategies and future directions will be presented. This article provides an understanding of prescription drug abuse and addiction's contribution and impact on society's health and social policy. Addressing the problem of prescription drug abuse requires an understanding of the disease of addiction, thus enhancing the effectiveness in diminishing the associated health and social costs. It is the article's intent to illuminate the mutually symbiotic relationship of prescription drug abuse and the disease of addiction and subsequently provide recommendations toward the resolution of this most important issue. PMID:21932750

Hall, P Bradley; Hawkinberry, Denzil; Moyers-Scott, Pam

2010-01-01

231

How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan  

MedlinePLUS

... Works with a Medicare Advantage Plan or Medicare Cost Plan Revised April 2014 Medicare offers prescription drug ... Medicare, and can be added to a Medicare Cost Plan, a Medical Savings Account (MSA) Plan, and ...

232

Measures Such As Interstate Cooperation Would Improve The Efficacy Of Programs To Track Controlled Drug Prescriptions  

PubMed Central

In response to increasing abuse of prescription drugs, 44 states have implemented -- and five more states will soon adopt -- monitoring programs to track prescriptions of controlled medications. Although these programs are primarily designed to help law enforcement officials and regulatory agencies spot possible illegal activity, health care providers have begun to use data from them to help improve patient safety and quality of care. We reviewed government documents, expert white papers, articles from the peer reviewed medical literature, and reports of the experiences of local health officials. Although we found some evidence that prescription drug monitoring programs are a benefit to both law enforcement and health care delivery, the programs have strengths and weaknesses, and their overall impact on drug abuse and illegal activity remains unclear. We believe that improving the efficacy of prescription drug monitoring programs will require such changes as more standardization and interstate cooperation, better training of providers, more secure funding, and further evaluation. PMID:23406570

Deyo, Richard A.; Irvine, Jessica; Millet, Lisa; Beran, Todd; O'Kane, Nicole; Wright, Dagan; McCarty, Dennis

2013-01-01

233

P: Prescription of anti-glaucoma drugs, patient characteristics and treatment results  

E-print Network

Introduction: For decades there has been a difference in the prescription of anti-glaucoma drugs between different parts of Sweden, despite similar management principles 1. No explanation to this has yet been offered. A possible explanation

Lene Martin Peter Wanger

234

77 FR 16973 - Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in Television and Radio Advertisements in a Clear, Conspicuous, and...DTC) television and radio advertisements relating to the side...

2012-03-23

235

77 FR 4273 - Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in Television and Radio Advertisements in a Clear, Conspicuous, and...DTC) television and radio advertisements relating to the side...

2012-01-27

236

Pricing of prescription drugs and its impact on physicians’ choice behavior  

Microsoft Academic Search

This research presents an analysis of Taiwan’s health care market with the focus on the pricing of prescription drugs and\\u000a its impact on physicians’ choice behavior. Since the advent of Taiwan’s national health insurance, with the competent authority\\u000a being Bureau of National Health Insurance (BNHI), hospitals are allowed to sell prescription drugs to patients at prices above\\u000a the purchasing prices,

Chen Miao-Sheng; Shih Yu-Ti

2008-01-01

237

The impact of Medicare prescription drug coverage on the use of antidementia drugs  

PubMed Central

Background Cholinesterase inhibitors and memantine are prescribed to slow the progression dementia. Although the efficacy of these drugs has been demonstrated, their effectiveness, from the perspective of patients and caregivers, has been questioned. Little is known about whether the demand for cholinesterase inhibitors and memantine are sensitive to out-of-pocket cost. Using the 2006 implementation of Medicare Part D as a natural experiment, this study examines the impact of changes in drug coverage on use of cholinesterase inhibitors and memantine by comparing use before and after Medicare Part D implementation among older adults who did and did not experience a change in coverage. Methods Retrospective analyses of claims data from 35,102 community-dwelling Medicare beneficiaries in Pennsylvania aged 65 or older. Beneficiaries were continuously enrolled in a Medicare Advantage plan from 2004 to 2007. Outcome variables were any use of donepezil (Aricept®), galantamine (Razadyne®), rivastigmine (Exelon®), tacrine (Cognex®), or memantine (Namenda®) each year and the number of 30-day prescriptions filled for these drugs. Independent variables included type of drug benefit pre–Part D (No coverage, $150 cap, $350 cap, and No cap as the reference group), time period, and their interaction. Sensitivity analyses were conducted to test if there are differences in use by drug class or if beneficiaries with a diagnosis of dementia pre–Part D experienced an increase in use post–Part D. Results The No coverage group had a 38% increase in the odds ratio of any use of antidementia medications (P?=?0.0008) post–Part D relative to the No cap group. All four coverage groups had significant increases in number of 30-day prescriptions (P?prescriptions (P?=?0.002) and the $350 cap group had a 15% increase (P?=?0.003) after adjusting for trends in the No cap group. Results from the sensitivity analysis for the sub-sample with a diagnosis of dementia pre–Part D show that each group had significant increases in 30-day prescriptions compared to the No cap control group (P?drug coverage under Medicare Part D. PMID:23621892

2013-01-01

238

Potential drug-drug and drug-disease interactions in prescriptions for ambulatory patients over 50 years of age in family medicine clinics in Mexico City  

Microsoft Academic Search

Background  In Mexico, inappropriate prescription of drugs with potential interactions causing serious risks to patient health has been\\u000a little studied. Work in this area has focused mainly on hospitalized patients, with only specific drug combinations analyzed;\\u000a moreover, the studies have not produced conclusive results. In the present study, we determined the frequency of potential\\u000a drug-drug and drug-disease interactions in prescriptions for

Hortensia Reyes-Morales; Laura del PilarTorres-Arreola; Magdalena Suárez-Ortega

2007-01-01

239

78 FR 28862 - Announcement of Requirements and Registration for “Propose New Ideas For Prescription Drugs Oral...  

Federal Register 2010, 2011, 2012, 2013, 2014

...second-most abused category of drugs in the United States, following marijuana. The most commonly misused prescription drugs fall into three...deadly as illegal drugs when used improperly and for non-medical reasons. The possibility that patients will abuse,...

2013-05-16

240

Prescription of drugs to pregnant women in France: the HIMAGE study.  

PubMed

The HIMAGE study, conducted in partnership with the principal Public Health Insurance Funds of the Loire region, analysed medicinal prescriptions during pregnancy on the basis of a representative sample of 911 pregnant women resident in this region of France. Altogether 93.5% received at least one prescription, with a mean of 10.9 different drugs per woman. The prescriptions were predominantly for drugs of the following Anatomical Therapeutic Chemical (ATC) classes: "alimentary tract and metabolism" (78%); "genito-urinary system and sex hormones" (62%); "nervous system" (62%); and "blood and blood-forming organs" (57%). Iron supplements, paracetamol, folic acid, magnesium, progesterone, oxaceprol, phloroglucinol, amoxicillin, domperidone and diosmine were the most frequently prescribed drugs. In total, 4.6% of the women were exposed to drugs involving a risk during pregnancy: principally nonsteroidal anti-inflammatory drugs (NSAIDs) prescribed from the sixth month onwards. This study revealed a high frequency of prescription of drugs to pregnant women, largely motivated by non-rational and to some extent culture-specific considerations, and it also highlighted the prescription of drugs known to involve risk during pregnancy. These results provide a basis for advising clinicians on the rational and safe use of drugs during pregnancy. PMID:15058494

Beyens, Marie-Noëlle; Guy, Claire; Ratrema, Martine; Ollagnier, Michel

2003-01-01

241

Paediatric drug use with focus on off-label prescriptions at Swedish hospitals – a nationwide study  

PubMed Central

Aim To perform a nationwide investigation of paediatric drug use at Swedish hospitals, including an analysis of off-label drug use. Methods All paediatric hospitals in Sweden were invited to register all prescriptions to children, aged between 0 and 18, during two separate 2-day-periods in 2008. Data were reported and analysed with respect to licence status and proportion of and reasons for off-label drug use. Results Data on 11 294 prescriptions to 2947 paediatric patients were received. Drugs associated with pain relief, infection, prematurity, nutrition and surgery or anaesthesia were most commonly used. Paracetamol was the most frequently used drug on-label and also among the most commonly used off-label drugs. Nearly half (49%) of all administered prescriptions concerned unlicensed drugs, off-label drugs or extemporaneously prepared drugs. The corresponding rate among neonates was 69%. Lack of paediatric information in the Summary of Product Characteristics was the main reason for off-label classification. Conclusions Paediatric off-label drug use is common at Swedish hospitals, and nearly half of all prescriptions were not documented for use in children. The findings emphasize a need for paediatric clinical studies as well as compilation of existing clinical experience and scattered evidence, particularly for drug treatment in infants and neonates. PMID:22404126

Kimland, E; Nydert, P; Odlind, V; Böttiger, Y; Lindemalm, S

2012-01-01

242

77 FR 58849 - Prescription Drug User Fee Act Patient-Focused Drug Development; Public Meeting and Request for...  

Federal Register 2010, 2011, 2012, 2013, 2014

...FDA-2012-N-0967] Prescription Drug User Fee Act Patient-Focused Drug Development; Public Meeting...for public comment related to FDA's patient- focused drug development initiative...systematic approach under PDUFA V for obtaining patient perspective on the disease severity...

2012-09-24

243

76 FR 56201 - Prescription Drug User Fee Act; Public Meeting  

Federal Register 2010, 2011, 2012, 2013, 2014

...Dockets Management (HFA-305), Food and Drug Administration, 5630...INFORMATION CONTACT: Sunanda Bahl, Food and Drug Administration, Center...health, providing patients faster access to over 1,500 new drugs...including implementing the Food and Drug Administration...

2011-09-12

244

Preventing deaths from rising opioid overdose in the US – the promise of naloxone antidote in community-based naloxone take-home programs  

PubMed Central

The opioid overdose epidemic is an alarming and serious public health problem in the United States (US) that has been escalating for 11 years. The 2011 National Survey on Drug Use and Health (NSDUH) demonstrated that 1 in 20 persons in the US aged 12 or older reported nonmedical use of prescription painkillers in the past year. Prescription drug overdose is now the leading cause of accidental death in the United States – surpassing motor vehicle accidents. Great efforts have been initiated to curb the overdose crisis. Notable examples of these efforts are (1) the Drug Enforcement Administration’s (DEA) National Take-Back Initiative instituted in 2010; (2) the Prescription Drug Monitoring Programs (PDMPs) implemented in most US states to provide practitioners with point-of-care information regarding a patient’s controlled substance use; (3) the naloxone rescue programs initiated in the community to avert mortality resulting from overdose. The use of naloxone rescue strategies has gained traction as an effective measure to prevent fatal opioid overdose. Many US federal-government agencies are working to make these strategies more accessible to first responders and community participants. This new approach faces many challenges, such as accessibility to naloxone and the equipment and training needed to administer it, but none is more challenging than the fear of legal repercussions. US federal-government agencies, local governments, health care institutions, and community-based organizations have begun to tackle these barriers, and naloxone take-home programs have gained recognition as a feasible and sensible preventive strategy to avoid a fatal result from opioid overdose. Although many challenges still need to be overcome, it is important for federal government research agencies to initiate and support independent and rigorous evaluation of these programs to inform policymakers how effective these programs can be to save lives and curb the opioid overdose public health crisis. PMID:24273417

Straus, Michele M; Ghitza, Udi E; Tai, Betty

2013-01-01

245

The Drug Facts Box: Improving the communication of prescription drug information.  

PubMed

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label--the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing--may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit benefit data for new drugs in an existing class and for drugs approved on the basis of unfamiliar outcomes (such as depression rating scales). The medical literature is also problematic: there is selective reporting of favorable trials, favorable outcomes within trials, and "spinning" unfavorable results to maximize benefit and minimize harm. In contrast, publicly available FDA reviews always include the phase 3 trial data on benefit and harm, which are the basis of drug approval. However, these reviews are practically inaccessible: lengthy, poorly organized, and weakly summarized. To improve accessibility, we developed the Drug Facts Box: a one-page summary of benefit and harm data for each indication of a drug. A series of studies--including national randomized trials--demonstrates that most consumers understand the Drug Facts Box and that it improves decision-making. Despite calls from their own Risk Communication Advisory Committee and Congress (in the Affordable Care Act) to consider implementing boxes, the FDA announced it needs at least 3-5 y more to make a decision. Given its potential public health impact, physicians and the public should not have to wait that long for better drug information. PMID:23942130

Schwartz, Lisa M; Woloshin, Steven

2013-08-20

246

The Drug Facts Box: Improving the communication of prescription drug information  

PubMed Central

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label—the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing—may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit benefit data for new drugs in an existing class and for drugs approved on the basis of unfamiliar outcomes (such as depression rating scales). The medical literature is also problematic: there is selective reporting of favorable trials, favorable outcomes within trials, and “spinning” unfavorable results to maximize benefit and minimize harm. In contrast, publicly available FDA reviews always include the phase 3 trial data on benefit and harm, which are the basis of drug approval. However, these reviews are practically inaccessible: lengthy, poorly organized, and weakly summarized. To improve accessibility, we developed the Drug Facts Box: a one-page summary of benefit and harm data for each indication of a drug. A series of studies—including national randomized trials—demonstrates that most consumers understand the Drug Facts Box and that it improves decision-making. Despite calls from their own Risk Communication Advisory Committee and Congress (in the Affordable Care Act) to consider implementing boxes, the FDA announced it needs at least 3–5 y more to make a decision. Given its potential public health impact, physicians and the public should not have to wait that long for better drug information. PMID:23942130

Schwartz, Lisa M.; Woloshin, Steven

2013-01-01

247

Management of human resources associated with misuse of prescription drugs: analysis of a national survey.  

PubMed

Nonmedical use of prescription drugs is increasingly prevalent in the United States, but limited research is available on prescription drugs misuse in the workforce. We investigated whether absenteeism and turnover are associated with having problems linked to prescription drug misuse among employees. We also further explored the moderating effects of employee drug policy and testing on the relation between having problems linked to misuse of prescription pain relievers (PPRs) and absenteeism and turnover. This is a cross-sectional study (n = 2,249) using the 2007 U.S. national survey data ("National Survey on Drug Use and Health"). The multivariate logistic analysis results illustrate, after controlling confounding factors (gender, age, tobacco use, and heroin use), absenteeism and turnover linked to having problems of PPRs misuse. Our findings suggest the moderating effects of employee drug policy on the association between absenteeism and turnover and having problems linked to misuse of PPRs. Also, drug testing was found to moderate the link between having negative outcomes of misuse of PPRs and absenteeism. Having problems associated with misuse of PPRs is linked to absenteeism and turnover. A drug policy program including drug testing may play a significant role in reducing absenteeism and turnover in relation to having problems linked to misuse of PPRs. PMID:22106546

Lee, Doohee; Ross, Michael W

2011-01-01

248

Medical Use, Illicit Use, and Diversion of Abusable Prescription Drugs  

ERIC Educational Resources Information Center

The authors investigated the medical use, illicit use, and diversion of 4 distinct classes of abusable prescription medication (sleeping medication, sedative or anxiety medication, stimulant medication, and pain medication) in a random sample of undergraduate students. In spring 2003, 9,161 undergraduate students attending a large, public,…

McCabe, Sean Esteban; Teter, Christian J.; Boyd, Carol J.

2006-01-01

249

Medical and Nonmedical Users of Prescription Drugs among College Students  

ERIC Educational Resources Information Center

Objectives: To examine medical and nonmedical users of prescription opioids, central nervous system depressants, and stimulants taken individually and in combination. Participants: Undergraduates at an urban mid-Atlantic university with 12,000 students. Methods: A questionnaire administered in classes provided 413 responses, with a usable response…

Rozenbroek, Katelyn; Rothstein, William G.

2011-01-01

250

Variability in the quality of overdose advice in Summary of Product Characteristics (SPC) documents: gut decontamination recommendations for CNS drugs  

PubMed Central

AIMS Deliberate self-poisoning is a major cause of morbidity and mortality. The Summary of Product Characteristics (SPC) document is a legal requirement for all drugs, and Section 4.9 addresses the features of toxicity and clinical advice on management of overdose. The quality and appropriateness of this advice have received comparatively little attention. METHODS Section 4.9 of the SPC was examined for all drugs in the central nervous system (CNS) category of the British National Formulary. Advice concerning gut decontamination was examined with respect to specific interventions: induced vomiting, oral activated charcoal, gastric lavage, and other interventions. Data were compared with standard reference sources for clinical management advice in poisoning. These were graded ‘A’ if no important differences existed, ‘B’ if differences were noted but not thought clinically important, and ‘C’ if differences were thought to be clinically significant. RESULTS SPC documents were examined for 258 medications from 67 manufacturers. The overall agreement was ‘A’ in 23 (8.9%), ‘B’ in 28 (10.9%) and ‘C’ in 207 (80.2%). Discrepancies were due to inappropriate recommendation of induced emesis in 21.7% (95% confidence interval 17.1, 27.1), gastric lavage in 38.4% (32.7, 44.4), other gut decontamination in 5.8% (3.6, 9.4) and failure to recommend oral activated charcoal in 57.4% (51.1, 63.4). CONCLUSIONS Gut decontamination advice in SPC documents with respect to CNS drugs was inadequate. Possible reasons for the observed discrepancies and ways of improving the consistency of advice are proposed. PMID:19076155

Wall, Andrew J B; Bateman, D N; Waring, W S

2009-01-01

251

Dose finding with drug combinations in cancer phase I clinical trials using conditional escalation with overdose control.  

PubMed

We present a Bayesian adaptive design for dose finding of a combination of two drugs in cancer phase I clinical trials. The goal is to estimate the maximum tolerated dose (MTD) as a curve in the two-dimensional Cartesian plane. We use a logistic model to describe the relationship between the doses of the two agents and the probability of dose limiting toxicity. The model is re-parameterized in terms of parameters clinicians can easily interpret. Trial design proceeds using univariate escalation with overdose control, where at each stage of the trial, we seek a dose of one agent using the current posterior distribution of the MTD of this agent given the current dose of the other agent. At the end of the trial, an estimate of the MTD curve is proposed as a function of Bayes estimates of the model parameters. We evaluate design operating characteristics in terms of safety of the trial design and percent of dose recommendation at dose combination neighborhoods around the true MTD curve. We also examine the performance of the approach under model misspecifications for the true dose-toxicity relationship. PMID:24825779

Tighiouart, Mourad; Piantadosi, Steven; Rogatko, André

2014-09-28

252

A decade of controversy: balancing policy with evidence in the regulation of prescription drug advertising.  

PubMed

Direct-to-consumer advertising (DTCA) of prescription drugs has remained controversial since regulations were liberalized by the Food and Drug Administration in 1997. We reviewed empirical evidence addressing the claims made in the policy debate for and against DTCA. This advertising has some benefits, but significant risks are evident as well, magnified by the prominence of DTCA in population-level health communications. To minimize potential harm and maximize the benefits of DTCA for population health, the quality and quantity of information should be improved to enable consumers to better self-identify whether treatment is indicated, more realistically appraise the benefits, and better attend to the risks associated with prescription drugs. We propose guidelines for improving the utility of prescription drug advertising. PMID:19910354

Frosch, Dominick L; Grande, David; Tarn, Derjung M; Kravitz, Richard L

2010-01-01

253

A Decade of Controversy: Balancing Policy With Evidence in the Regulation of Prescription Drug Advertising  

PubMed Central

Direct-to-consumer advertising (DTCA) of prescription drugs has remained controversial since regulations were liberalized by the Food and Drug Administration in 1997. We reviewed empirical evidence addressing the claims made in the policy debate for and against DTCA. This advertising has some benefits, but significant risks are evident as well, magnified by the prominence of DTCA in population-level health communications. To minimize potential harm and maximize the benefits of DTCA for population health, the quality and quantity of information should be improved to enable consumers to better self-identify whether treatment is indicated, more realistically appraise the benefits, and better attend to the risks associated with prescription drugs. We propose guidelines for improving the utility of prescription drug advertising. PMID:19910354

Grande, David; Tarn, Derjung M.; Kravitz, Richard L.

2010-01-01

254

75 FR 61621 - Charges Billed to Third Parties for Prescription Drugs Furnished by VA to a Veteran for a...  

Federal Register 2010, 2011, 2012, 2013, 2014

...to pay for the same prescription drugs. The commenter also indicated that...minimum. In most cases VA purchases drugs in bulk at discounted prices. Also, insofar as possible, VA prescribes generic drugs. Further, the $1.50 to...

2010-10-06

255

Structure-based discovery of prescription drugs that interact with the norepinephrine transporter, NET  

E-print Network

, including antidepressants and psychosti- mulants, and may mediate off-target effects of other prescription with major depression (4). NET is a target of drugs treating a variety of mood and beha- vioral disorders, such as depression, anxiety, and ADHD (4). Many of these drugs inhibit the uptake of norepinephrine into the pre

Sali, Andrej

256

Prescription Drug Use Trends Among Israeli School Dropouts: An Analysis of Gender and Country of Origin  

Microsoft Academic Search

Widespread international concern exists about the nonmedical use of prescription drugs (NPD), especially among adolescents. This article examines NPD use trends of school dropouts in Israel from 2004 to 2009 based on gender and country of origin status. A cohort of 470 youths completed a self-report questionnaire prior to receiving drug treatment. Females reported NPD at a younger age than

Richard Isralowitz; Alexander Reznik; Shulamith Lala A. Straussner

2011-01-01

257

Preventing drug interactions by online prescription screening in community pharmacies and medical practices  

Microsoft Academic Search

Background: Drug interactions have been shown to be preventable by computerized prescription entry and screening only in hospitals and not in community-based practice.Methods: We retrospectively evaluated the effect of online prescription screening in community pharmacies and physician offices of one health maintenance organization, phased in during 3 consecutive 6-month periods in 1998 to 1999 (period I, system active only in

Hillel Halkin; Itzhak Katzir; Irena Kurman; Joseph Jan; Becky Ben-Oz Malkin

2001-01-01

258

Comparative study of paediatric prescription drug utilization between the spanish and immigrant population  

PubMed Central

Background The immigrant population has increased greatly in Spain in recent years to the point where immigrants made up 12% of the infant population in 2008. There is little information available on the profile of this group with regard to prescription drug utilization in universal public health care systems such as that operating in Spain. This work studies the overall and specific differences in prescription drug utilization between the immigrant and Spanish population. Methods Use was made of the Aragonese Health Service databases for 2006. The studied population comprises 159,908 children aged 0-14 years, 13.6% of whom are foreign nationals. Different utilization variables were calculated for each group. Prescription-drug consumption is measured in Defined Daily Doses (DDD) and DDD/1000 persons/day/(DID). Results A total of 833,223 prescriptions were studied. Utilization is lower for immigrant children than in Spanish children for both DID (66.27 v. 113.67) and average annual expense (€21.55 v. €41.14). Immigrant children consume fewer prescription drugs than Spanish children in all of the therapy groups, with the most prescribed (in DID) being: respiratory system, anti-infectives for systemic use, nervous system, sensory organs. Significant differences were observed in relation to the type of drugs and the geographical background of immigrants. Conclusion Prescription drug utilization is much greater in Spanish children than in immigrant children, particularly with reference to bronchodilators (montelukast and terbutaline) and attention-disorder hyperactivity drugs such as methylphenidate. There are important differences regarding drug type and depending on immigrants' geographical backgrounds that suggest there are social, cultural and access factors underlying these disparities. PMID:19995453

2009-01-01

259

Prescription Drug List --To be used by members  

E-print Network

of these are generic versions of brand-name drugs. Tier 2 ­ Medium copayment ­ Brand- name drugs that are generally Tier 3 drugs may have generic versions in Tier 1 and may cost more than the generic versions on lower)-approved brand-name and generic drugs that have been reviewed and recommended for their quality and how well

Mullins, Dyche

260

Calcium carbonate overdose  

MedlinePLUS

Tums overdose; Calcium overdose ... Calcium ... Products containing calcium carbonate, including Certain antacids (Tums, Chooz) Certain mineral supplements Certain hand lotions Certain vitamin and mineral supplements Note: ...

261

77 FR 58848 - Prescription Drug User Fee Act V Patient-Focused Drug Development; Consultation Meetings; Request...  

Federal Register 2010, 2011, 2012, 2013, 2014

...FDA-2012-N-0966] Prescription Drug User Fee Act V Patient-Focused Drug Development; Consultation Meetings; Request for Notification of Patient Stakeholder Intention To Participate AGENCY...is issuing this notice to request that patient stakeholders notify FDA of their...

2012-09-24

262

Comparing employer-sponsored and federal exchange plans: wide variations in cost sharing for prescription drugs.  

PubMed

Just under seven million Americans acquired private insurance through the new health insurance exchanges, or Marketplaces, in 2014. The exchange plans are required to cover essential health benefits, including prescription drugs. However, the generosity of prescription drug coverage in the plans has not been well described. Our primary objective was to examine the variability in drug coverage in the exchanges across plan types (health maintenance organization or preferred provider organization) and metal tiers (bronze, silver, gold, and platinum). Our secondary objective was to compare the exchange coverage to employer-sponsored coverage. Analyzing prescription drug benefit design data for the federally facilitated exchanges, we found wide variation in enrollees' out-of-pocket costs for generic, preferred brand-name, nonpreferred brand-name, and specialty drugs, not only across metal tiers but also within those tiers across plan types. Compared to employer-sponsored plans, exchange plans generally had lower premiums but provided less generous drug coverage. However, for low-income enrollees who are eligible for cost-sharing subsidies, the exchange plans may be more comparable to employer-based coverage. Policies and programs to assist consumers in matching their prescription drug needs with a plan's benefit design may improve the financial protection for the newly insured. PMID:25732498

Buttorff, Christine; Andersen, Martin S; Riggs, Kevin R; Alexander, G Caleb

2015-03-01

263

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2012 CFR

...means information regarding eligibility for drug benefits, medication history, or related health or drug information for Part D...with applicable Federal and State laws related to fraud and abuse, including the physician self-referral prohibition...

2012-10-01

264

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2013 CFR

...means information regarding eligibility for drug benefits, medication history, or related health or drug information for Part D...with applicable Federal and State laws related to fraud and abuse, including the physician self-referral prohibition...

2013-10-01

265

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2014 CFR

...means information regarding eligibility for drug benefits, medication history, or related health or drug information for Part D...with applicable Federal and State laws related to fraud and abuse, including the physician self-referral prohibition...

2014-10-01

266

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2010 CFR

...means information regarding eligibility for drug benefits, medication history, or related health or drug information for Part D...with applicable Federal and State laws related to fraud and abuse, including the physician self-referral prohibition...

2010-10-01

267

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2011 CFR

...means information regarding eligibility for drug benefits, medication history, or related health or drug information for Part D...with applicable Federal and State laws related to fraud and abuse, including the physician self-referral prohibition...

2011-10-01

268

Branded prescription drug fee. Final regulations, temporary regulations, and removal of temporary regulations.  

PubMed

This document contains final regulations that provide guidance on the annual fee imposed on covered entities engaged in the business of manufacturing or importing branded prescription drugs. This fee was enacted by section 9008 of the Patient Protection and Affordable Care Act, as amended by section 1404 of the Health Care and Education Reconciliation Act of 2010. This document also withdraws the Branded Prescription Drug Fee temporary regulations and contains new temporary regulations regarding the definition of controlled group that apply beginning on January 1, 2015. The final regulations and the new temporary regulations affect persons engaged in the business of manufacturing or importing certain branded prescription drugs. The text of the temporary regulations in this document also serves as the text of proposed regulations set forth in a notice of proposed rulemaking (REG-123286-14) on this subject in the Proposed Rules section in this issue of the Federal Register. PMID:25118373

2014-07-28

269

Prescription Drug Abuse: Epidemiology, Regulatory Issues, Chronic Pain Management with Narcotic Analgesics  

PubMed Central

Synopsis The epidemic of prescription drug abuse has reached a critical level, which has received national attention. Physicians must learn strategies to effectively treat chronic pain, and help reduce the rates of prescription drug abuse. This chapter will provide insight into the epidemiology of prescription drug abuse, explain regulatory issues, and provide guidelines for the assessment and management of pain, particularly with chronic opioid therapy. The use of informed consent forms, treatment agreements, risk documentation tools, and regular monitoring of the 4 “A's” helps to educate patients, as well as guide management based on treatment goals. By using universal precautions, and being aware of aberrant behaviors, physicians may feel more confident in identifying and addressing problematic behaviors. PMID:21356422

Manubay, Jeanne M.; Muchow, Carrie; Sullivan, Maria A.

2012-01-01

270

Fetal exposure to prescription drugs and adult sexual orientation  

Microsoft Academic Search

This study was undertaken to determine if prenatal exposure to therapeutic drugs contributes to variations in sexual orientation. Especially suspect were drugs that could affect the delicate balance of sex hormone levels that appear to guide the sexual differentiation of the fetal brain. The recollections of 5102 mothers concerning their use of therapeutic drugs during pregnancy were linked to reports

Lee Ellis; Jill Hellberg

2005-01-01

271

Prescription Drugs Associated with Reports of Violence Towards Others  

PubMed Central

Context Violence towards others is a seldom-studied adverse drug event and an atypical one because the risk of injury extends to others. Objective To identify the primary suspects in adverse drug event reports describing thoughts or acts of violence towards others, and assess the strength of the association. Methodology From the Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) data, we extracted all serious adverse event reports for drugs with 200 or more cases received from 2004 through September 2009. We identified any case report indicating homicide, homicidal ideation, physical assault, physical abuse or violence related symptoms. Main Outcome Measures Disproportionality in reporting was defined as a) 5 or more violence case reports, b) at least twice the number of reports expected given the volume of overall reports for that drug, c) a ?2 statistic indicating the violence cases were unlikely to have occurred by chance (p<0.01). Results We identified 1527 cases of violence disproportionally reported for 31 drugs. Primary suspect drugs included varenicline (an aid to smoking cessation), 11 antidepressants, 6 sedative/hypnotics and 3 drugs for attention deficit hyperactivity disorder. The evidence of an association was weaker and mixed for antipsychotic drugs and absent for all but 1 anticonvulsant/mood stabilizer. Two or fewer violence cases were reported for 435/484 (84.7%) of all evaluable drugs suggesting that an association with this adverse event is unlikely for these drugs. Conclusions Acts of violence towards others are a genuine and serious adverse drug event associated with a relatively small group of drugs. Varenicline, which increases the availability of dopamine, and antidepressants with serotonergic effects were the most strongly and consistently implicated drugs. Prospective studies to evaluate systematically this side effect are needed to establish the incidence, confirm differences among drugs and identify additional common features. PMID:21179515

Moore, Thomas J.; Glenmullen, Joseph; Furberg, Curt D.

2010-01-01

272

An Exploration of the Relationship between the Use of Methamphetamine and Prescription Drugs  

PubMed Central

This study examines patterns of use of prescription drugs and methamphetamine. We drew our sample from a study about 130 active and inactive methamphetamine users and focused on 16 participants with a recent history of methamphetamine and prescription drug use. We collected in-depth interviews to explore relationships in use trajectory patterns. The qualitative methods we used in this study followed the constant comparison process developed by grounded theory methods and analytical ethnography, which is based on familiarity with the social setting and developing propositions while conducting a research study. We used a triangulation of methods and analysis and included qualitative data, such as participant observation notes and in-depth interviews, as well as quantitative data that we collected in drug history matrices. Five themes emerged from the coding of the interview transcripts: (1) sequential polydrug use; (2) concurrent polydrug use (3) temporary substitution of preferred drug; (4) consequential-based use; and (5) switching from using methamphetamine to using prescription drugs. The trajectory patterns of methamphetamine and prescription drug use complicates treatment significantly. PMID:23285312

Lamonica, Aukje K.; Boeri, Miriam

2012-01-01

273

Non-medical prescription drug and illicit street drug use among young Swiss men and associated mental health issues.  

PubMed

Non-medical use of prescription drugs (NMUPD) is increasing among the general population, particularly among teenagers and young adults. Although prescription drugs are considered safer than illicit street drugs, NMUPD can lead to detrimental consequences. The aim of the present study was to investigate the relationship between drug use (NMUPD on the one side, illicit street drugs on the other side) with mental health issues and then compare these associations. A representative sample of 5719 young Swiss men aged around 20 years filled in a questionnaire as part of the ongoing baseline Cohort Study on Substance Use Risk Factors (C-SURF). Drug use (16 illicit street drugs and 5 NMUPDs, including sleeping pills, sedatives, pain killers, antidepressants, stimulants) and mental health issues (depression, SF12) were assessed. Simple and multiple linear regressions were employed. In simple regressions, all illicit and prescription drugs were associated with poorer mental health. In multiple regressions, most of the NMUPDs, except for stimulants, were significantly associated with poorer mental health and with depression. On the contrary, the only associations that remained significant between illicit street drugs and mental health involved cannabis. NMUPD is of growing concern not only because of its increasing occurrence, but also because of its association with depression and mental health problems, which is stronger than the association observed between these problems and illicit street drug use, excepted for cannabis. Therefore, NMUPD must be considered in screening for substance use prevention purposes. PMID:24447983

Baggio, Stéphanie; Studer, Joseph; Mohler-Kuo, Meichun; Daeppen, Jean-Bernard; Gmel, Gerhard

2014-01-01

274

Direct-to-consumer promotion of prescription drugs. Economic implications for patients, payers and providers.  

PubMed

Spending on outpatient prescription drugs in the US is accelerating rapidly. Although numerous factors are driving this trend, attention has recently focused on the role played by the marketing, promotion and advertising of pharmaceuticals, in particular direct-to-consumer (DTC) advertising. In 1997, the US Food and Drug Administration (FDA) issued a 'guidance' on such mass media promotion. The guidance altered existing FDA rules and effectively permitted pharmaceutical companies to promote prescription drugs on television and radio without giving detailed or even summary information on indications, efficacy or potential adverse effects. Since then, television commercials, in particular, and print advertisements in consumer magazines and newspapers have proliferated rapidly. Pharmaceutical companies spent $US1.8 billion on DTC advertising in 1999, a 40% increase over 1998. This spending in 1999 was heavily concentrated on about 50 drugs. Evidence is growing that DTC promotion of prescription drugs is: (i) alerting consumers to the existence of new drugs and the conditions they treat; (ii) increasing consumer demand for many drugs; (iii) contributing increasingly to the recent sharp increase in the number of prescriptions being dispensed; (iv) raising sales revenues; and, thus, (v) contributing to the higher pharmaceutical costs of health insurers, government and consumers. The public policy issues surrounding DTC advertisements centre on the following questions: (i) are the advertisements leading to the inappropriate clinical use of some drugs? (ii) are the advertisements inducing both consumers and physicians to choose more costly new brand-name drugs over less expensive, but equally effective, older brand or generic drugs? (iii) do television advertisements for prescription drugs contain a balanced amount of information on benefits versus potential adverse effects? and (iv) will the revenue benefits generated by DTC advertising cause pharmaceutical companies to focus more on developing products to treat prevalent but not life-threatening conditions, such as baldness, sexual dysfunction or memory loss? These questions are just beginning to be probed despite prescription drug spending, insurance coverage and payment policies having become major political issues in the US. PMID:11284378

Findlay, S D

2001-01-01

275

Can Increases in CHIP Copayments Reduce Program Expenditures on Prescription Drugs?  

PubMed Central

Objective The primary aim is to explore whether prescription drug expenditures by enrollees changed in Alabama’s CHIP program, ALL Kids, after copayment increases in fiscal year 2004. The subsidiary aim is to explore whether non-pharmaceutical expenditures also changed. Data Sources Data on ALL Kids enrollees between 1999–2007, obtained from claims files and the state’s administrative database. Study Design We used data on children who were enrolled between one and three years both before and after the changes to the copayment schedule, and estimate regression models with individual-level fixed effects to control for time-invariant heterogeneity at the child level. This allows an accurate estimate of how program expenditures change for the same individual following copayment changes. Primary outcomes of interest are expenditures for prescription drugs by class and brand-name and generic versions. We estimate models for the likelihood of any use of prescription drugs and expenditure level conditional on use. Principal Findings Following the copayment increase, the probability of any expenditure decline by 5.8%, brand name drugs by 6.9%, generic drugs by 7.4%. Conditional on any use, program expenditures decline by 7.9% for all drugs, by 9.6% for brand name drugs, and 6.2% for generic drugs. The largest declines are for antihistamine drugs; the least declines are for Central Nervous System agents. Declines are smaller and statistically weaker for children with chronic health conditions. Concurrent declines are also seen for non-pharmaceutical medical expenditures. Conclusions Copayment increases appear to reduce program expenditures on prescription drugs per enrollee and may be a useful tool for controlling program costs. PMID:24967148

Sen, Bisakha; Blackburn, Justin; Morrisey, Michael; Becker, David; Kilgore, Meredith; Caldwell, Cathy; Menachemi, Nir

2014-01-01

276

Using classification tree modelling to investigate drug prescription practices at health facilities in rural Tanzania  

PubMed Central

Background Drug prescription practices depend on several factors related to the patient, health worker and health facilities. A better understanding of the factors influencing prescription patterns is essential to develop strategies to mitigate the negative consequences associated with poor practices in both the public and private sectors. Methods A cross-sectional study was conducted in rural Tanzania among patients attending health facilities, and health workers. Patients, health workers and health facilities-related factors with the potential to influence drug prescription patterns were used to build a model of key predictors. Standard data mining methodology of classification tree analysis was used to define the importance of the different factors on prescription patterns. Results This analysis included 1,470 patients and 71 health workers practicing in 30 health facilities. Patients were mostly treated in dispensaries. Twenty two variables were used to construct two classification tree models: one for polypharmacy (prescription of ?3 drugs) on a single clinic visit and one for co-prescription of artemether-lumefantrine (AL) with antibiotics. The most important predictor of polypharmacy was the diagnosis of several illnesses. Polypharmacy was also associated with little or no supervision of the health workers, administration of AL and private facilities. Co-prescription of AL with antibiotics was more frequent in children under five years of age and the other important predictors were transmission season, mode of diagnosis and the location of the health facility. Conclusion Standard data mining methodology is an easy-to-implement analytical approach that can be useful for decision-making. Polypharmacy is mainly due to the diagnosis of multiple illnesses. PMID:22950486

2012-01-01

277

21 CFR 201.100 - Prescription drugs for human use.  

Code of Federal Regulations, 2010 CFR

...statement of their effect; and if the vehicle is water for injection it need not be named. (6) An...labeling claims for the drug by the National Academy of Sciences/National Research Council (NAS/NRC), Drug Efficacy Study...

2010-04-01

278

Prescription for Drug Abuse Education: Managing the Mood Changers  

ERIC Educational Resources Information Center

This article emphasizes the need to prepare youth to make decisions about drug use. To do this it is essential to eliminate hypocrisy about the use of marihuana, to "infuse" the curriculum with drug information and to provide students with realistic learning experiences. (Author)

Yolles, Stanley F.

1971-01-01

279

Abuse of Prescription (Rx) Drugs Affects Young Adults Most  

MedlinePLUS

... updated June 2013 Related Topics Addiction Science Comorbidity Criminal Justice Drugged Driving Drug Testing Global Health Hepatitis (Viral) HIV/AIDS Medical Consequences Mental Health Pain Prevention Substance Abuse in Military ... viewer . Flash content requires the free Adobe Flash Player . NIH...Turning Discovery Into Health ®

280

Utility of the Electrocardiogram in Drug Overdose and Poisoning: Theoretical Considerations and Clinical Implications  

PubMed Central

The ECG is a rapidly available clinical tool that can help clinicians manage poisoned patients. Specific myocardial effects of cardiotoxic drugs have well-described electrocardiographic manifestations. In the practice of clinical toxicology, classic ECG changes may hint at blockade of ion channels, alterations of adrenergic tone, or dysfunctional metabolic activity of the myocardium. This review will offer a structured approach to ECG interpretation in poisoned patients with a focus on clinical implications and ECG-based management recommendations in the initial evaluation of patients with acute cardiotoxicity. PMID:22708912

Yates, Christopher; Manini, Alex F

2012-01-01

281

An Exploratory Study of Rape Survivors' Prescription Drug Use as a Means of Coping with Sexual Assault  

ERIC Educational Resources Information Center

In this study we examined rape survivors' post assault use of prescription drugs, including sedatives, tranquilizers, and antidepressants. In a community-based sample of 102 sexual assault survivors, 44% had used prescription drugs post rape. Consistent with prior research on alcohol as a postassault coping mechanism, the current study found…

Sturza, Marisa L.; Campbell, Rebecca

2005-01-01

282

Use of Antipsychotic Drugs in Individuals with Intellectual Disability (ID) in the Netherlands: Prevalence and Reasons for Prescription  

ERIC Educational Resources Information Center

Background: We investigated antipsychotic drug prescription practice of Dutch ID physicians, studying prevalence of antipsychotic drug use, reasons for prescription and the relationship between these reasons and patient characteristics. Methods: A cross-sectional study of medical and pharmaceutical records in a population living in residential…

de Kuijper, G.; Hoekstra, P.; Visser, F.; Scholte, F. A.; Penning, C.; Evenhuis, H.

2010-01-01

283

The Medicare Prescription Drug, Improvement, & Modernization Act of 2003: Are We Playing the Lottery With Healthcare Reform?  

Microsoft Academic Search

With millions of Americans unable to cope with the rising costs of prescription drugs, and many even forced to go without health insurance, the mounting pressure on Congress to enact major healthcare reform culminated in the Medicare Prescription Drug, Improvement, & Modernization Act of 2003. This iBrief examines this legislation, and concludes that it provides elusive benefits for seniors and

Melissa Ganz

2004-01-01

284

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2010 CFR

...prescription drugs are stored, warehoused...Be free from infestation by insects, rodents, birds...drugs shall be stored at appropriate...has been held, stored, or shipped before...and (iii) The dates of receipt...

2010-04-01

285

What to Do If You No Longer Automatically Qualify for Extra Help with Medicare Prescription Drug Costs  

MedlinePLUS

... qualify for Extra Help with Medicare prescription drug costs Revised April 2014 What’s Extra Help? Getting “Extra ... you may be able to save on drug costs. 2 If I no longer automatically qualify, what ...

286

Variability in prescription drug utilization: issues for research.  

PubMed Central

The authors report the results of a literature review to identify research issues relating to physician prescribing practices and evaluate the potential for existing Canadian databases to support initiatives to improve prescribing practices. Methodologies such as small-area variation analysis and drug utilization reviews are discussed, and Canadian data sources relating to drug prescribing are assessed. The authors conclude that small-area variation analysis can be used to identify differences in drug utilization rates. A ranking method to identify drugs with the greatest variability in utilization can then be used to establish priorities for further analysis. After statistically significant factors associated with prescribing patterns are identified, intervention and policy formation will be possible. This will involve a more sophisticated integration of existing provincial information sources and the adoption of uniform guidelines to promote rational prescribing practices. PMID:8603319

Anis, A H; Carruthers, S G; Carter, A O; Kierulf, J

1996-01-01

287

How Can I End a Prescription Drug Habit Safely?  

MedlinePLUS

TeensHealth from Nemours for Parents for Kids for Teens Teens Home Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Q&A School & Jobs Drugs & Alcohol Staying Safe Recipes En Español Making a change - Use this tool ...

288

Imprecise Frequency Descriptors and the Miscomprehension of Prescription Drug Advertising: Public Policy and Regulatory Implications.  

ERIC Educational Resources Information Center

Explores the communicative effectiveness of imprecise frequency descriptors within the context of consumer prescription drug advertising. Conducts two separate studies using a total sample of 147 adults. Finds that consumers are unable to accurately estimate the relative likelihood of side effect occurrence when a list of side effects are preceded…

Davis, Joel J.

1999-01-01

289

Utilizing Business, University, and Community Resources to Target Adolescent Prescription Drug Abuse  

ERIC Educational Resources Information Center

"Generation Rx" is a prescription drug abuse prevention strategy which includes a "toolkit" designed to be used with youth. Developed by Cardinal Health Foundation and the Ohio State University, it provides health care providers (especially pharmacists), parents, teachers, youth workers, and other community leaders with interactive tools and…

Wade-Mdivanian, R.; Anderson-Butcher, D.; Hale, K.; Kwiek, N.; Smock, J.; Radigan, D.; Lineberger, J.

2012-01-01

290

PLAN HOSPITAL SERVICES PHYSICIAN VISITS OTHER BENEFITS PRESCRIPTION DRUGS BEHAVIORAL HEALTH4 Inpatient Surgeon/Assistant  

E-print Network

PLAN HOSPITAL SERVICES PHYSICIAN VISITS OTHER BENEFITS PRESCRIPTION DRUGS BEHAVIORAL HEALTH4 program available) Generic: $5 Brand: $255 Non-Formulary: $40 Generic: $10 Brand: $505 Non-Formulary: $80 No charge if part of a routine physical exam Not covered $20 (medically necessary) 30-day supply--Generic

Mills, Allen P.

291

The Relationship between Health Professionals and the Elderly Patient Facing Drug Prescription: A Qualitative Approach  

ERIC Educational Resources Information Center

Aiming at identifying the relationship between the elderly patient facing drug prescription and health professionals, an exploratory and descriptive study of a qualitative cut was carried out using semi-structured interviews. To this end, the Collective Subject Discourse analysis technique was employed. Thirty elderly patients living in the urban…

Lefevre, Fernando; Teixeira, Jorge Juarez Vieira; Lefevre, Ana Maria Cavalcanti; de Castro, Lia Lusitana Cardozo; Spinola, Aracy Witt de Pinho

2004-01-01

292

[Drugs used for cognitive impairment. Analysis of 1.5 million prescriptions in Argentina].  

PubMed

Cognitive impairment and dementia treatment costs are significant for health systems. According to national and international guidelines, recommended drugs for treatment of dementias are cholinesterase inhibitors (donepezil, galantamine, rivastigmine) and memantine. Despite these guidelines recommendations, other nootropics, vasodilators and antioxidants are often used in Argentina. The purpose of this study was to describe and compare the prescription pattern of commonly used drugs for the treatment of cognitive disorders and dementia in different regions of Argentina. An observational, retrospective study of 1814108 recipes prescribed to National Institute of Social Services for Retired and Pensioners outpatients during the during the second half of 2008 and the first and second half of 2009 was performed, taking in count the whole country and also different Argentina's regions. Demographic variables, quantity and rate of prescriptions, dosage forms and strengths were analyzed. Considering the entire country, memantine was the most prescribed drug in these periods (570893 packages). An increase in the memantine, donepezil, rivastigmine and idebenone rates of prescription was observed. Prescription rate of memantine increased in the North-West and North-East regions, that of idebenone in the North-East region and Patagonia and donepezil in the North-East region. Non recommended drugs were highly prescribed in all the analyzed regions. Some of them were indicated to young and middle-aged patients. PMID:23732196

Rojas, Galeno; Demey, Ignacio; Arizaga, Raúl L

2013-01-01

293

A Typology of Prescription Drug Misuse: A Latent Class Approach to Differences and Harms  

PubMed Central

Introduction and Aims Prescription drug misuse is a considerable problem among young adults, and the identification of types of misuse among this population remains important for prevention and intervention efforts. We use Latent Class Analysis (LCA) to identify possible distinct latent groups of prescription drug misusers across multiple prescription drug types (pain killers, sedatives, and stimulants). Design and Methods Our data is comprised of a sample of 404 young adults recruited from nightlife scenes via time-space sampling. Through the specification of a zero-inflated Poisson Latent Class Analysis, we evaluate differences in class membership by various demographic factors as well as assess the relationship between class membership and health outcomes, including indications of dependence, problems associated with substance use, and mental health. Results Our assessment of fit indices led to a 4 class solution (dabblers, primary stimulant users, primary downers users, and extensive regulars). No demographic differences existed between latent classes. The extensive regular class report the greatest number of symptoms related to dependence, greatest number of problems related to misuse, and the greatest mental health problems. The dabblers report the fewest problems and symptoms, while the other two classes experiences problems and symptoms in between the classes on the extremes. Discussion and Conclusions Prevention efforts should take into account that young adults who misuse prescription drug have different profiles of misuse, and there may be a need for varied interventions to target these different types of misuse. PMID:25196636

Kelly, Brian C.; Rendina, H. Jonathon; Vuolo, Mike; Wells, Brooke E.; Parsons, Jeffrey T.

2014-01-01

294

Misuse of Prescription and Illicit Drugs Among High-risk Young Adults in Los Angeles and New York  

PubMed Central

Background Prescription drug misuse among young adults is increasingly viewed as a public health concern, yet most research has focused on student populations and excluded high-risk groups. Furthermore, research on populations who report recent prescription drug misuse is limited. This study examined patterns of prescription drug misuse among high-risk young adults in Los Angeles (LA) and New York (NY), which represent different local markets for illicit and prescription drugs. Design and Methods Between 2009 and 2011, 596 young adults (16 to 25 years old) who had misused prescription drugs within the past 90 days were interviewed in Los Angeles and New York. Sampling was stratified to enroll three groups of high-risk young adults: injection drug users (IDUs); homeless persons; and polydrug users. Results In both sites, lifetime history of receiving a prescription for an opioid, tranquilizer, or stimulant was high and commonly preceded misuse. Moreover, initiation of opioids occurred before heroin and initiation of prescription stimulants happened prior to illicit stimulants. NY participants more frequently misused oxycodone, heroin, and cocaine, and LA participants more frequently misused codeine, marijuana, and methamphetamine. Combining prescription and illicit drugs during drug using events was commonly reported in both sites. Opioids and tranquilizers were used as substitutes for other drugs, e.g., heroin, when these drugs were not available. Conclusion Patterns of drug use among high-risk young adults in Los Angeles and New York appear to be linked to differences in local markets in each city for illicit drugs and diverted prescription drugs. PMID:22798990

Lankenau, Stephen E.; Schrager, Sheree M.; Silva, Karol; Kecojevic, Alex; Bloom, Jennifer Jackson; Wong, Carolyn; Iverson, Ellen

2012-01-01

295

Whom do older adults trust most to provide information about prescription drugs?  

Microsoft Academic Search

Background: Cost-related nonadherence to medieations is common among older adults, yet physician-patient communication about medication cost concerns is infrequent. One factor affecting communication and adherence may be older adults' confidence in the information about prescription drugs provided by physicians and other sources.Objectives: This study was conducted to identify which source older adults most trust to provide information on drugs and

Julie M. Donohue; Haiden A. Huskamp; Ira B. Wilson; Joel Weissman

2009-01-01

296

Off the prescription pad and over the counter: the trend toward drug deregulation grows.  

PubMed Central

In the future, regulatory agencies may authorize the switch of more drugs from prescription-only to over-the-counter status. This could have the double effect of reducing the number of doctor visits and cutting drug costs. Although some physicians worry about the escape of reasonably potent drugs from medical surveillance, pharmacists are assuming a more significant counselling and medication-tracking role. This article looks at the negative and positive sides of drug deregulation from the perspectives of the physician, pharmacist and patient. PMID:7828102

Morgan, P P; Cohen, L

1995-01-01

297

EMS runs for suspected opioid overdose: Implications for surveillance and prevention  

PubMed Central

Objective Opioid (including prescription opiate) abuse and overdose rates in the US have surged in the past decade. The dearth and limitations of opioid abuse and overdose surveillance systems impede the development of interventions to address this epidemic. We explored evidence to support the validity of emergency medical services (EMS) data on naloxone administration as a possible proxy for estimating incidence of opioid overdose. Methods We reviewed data from Baltimore City Fire Department EMS patient records matched with dispatch records over a thirteen month time period (2008-2009), and census 2008 data. We calculated incidence rates and patient demographic and temporal patterns of naloxone administration, and examined patient evaluation data associated with naloxone administration. Results were compared to the demographic distributions of the EMS patient and city population and to prior study findings. Results Of 116,910 EMS incidents during the study period for patients 15 years and older, EMS providers administered naloxone 1,297 times (1.1% of incidents), an average of 100 administrations per month. Overall incidence was 1.87 administrations per 1,000 population per year. Findings indicated naloxone administration peaked in summer months (31% of administrations), weekends (32%), and late afternoon (4-5:00pm [8%]); and there was a trend toward peaking in the first week of the month. The incidence of suspected opioid overdose was highest among males, whites, and those in the 45-54 year age group. Findings on temporal patterns were comparable to findings from prior studies. Demographic patterns of suspected opioid overdose were similar to medical examiner reports of demographic patterns of fatal drug or alcohol related overdoses in Baltimore in 2008-9 (88% of which involved opioids). The findings on patient evaluation data suggest some inconsistencies with previously recommended clinical indications of opioid overdose. Conclusions While our findings suggest limitations of EMS naloxone administration data as a proxy indicator of opioid overdose, the results provide partial support of the data for estimating opioid overdose incidence and suggest ways to improve such data. The study findings have implications for an EMS role in conducting real-time surveillance and treatment and prevention of opioid abuse and overdose. PMID:23734988

Knowlton, Amy; Weir, Brian; Hazzard, Frank; Olsen, Yngvild; McWilliams, Junette; Fields, Julie; Gaasch, Wade

2013-01-01

298

Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards: retrospective cohort study  

PubMed Central

Objective To test the hypothesis that people taking anxiolytic and hypnotic drugs are at increased risk of premature mortality, using primary care prescription records and after adjusting for a wide range of potential confounders. Design Retrospective cohort study. Setting 273 UK primary care practices contributing data to the General Practice Research Database. Participants 34?727 patients aged 16 years and older first prescribed anxiolytic or hypnotic drugs, or both, between 1998 and 2001, and 69?418 patients with no prescriptions for such drugs (controls) matched by age, sex, and practice. Patients were followed-up for a mean of 7.6 years (range 0.1-13.4 years). Main outcome All cause mortality ascertained from practice records. Results Physical and psychiatric comorbidities and prescribing of non-study drugs were significantly more prevalent among those prescribed study drugs than among controls. The age adjusted hazard ratio for mortality during the whole follow-up period for use of any study drug in the first year after recruitment was 3.46 (95% confidence interval 3.34 to 3.59) and 3.32 (3.19 to 3.45) after adjusting for other potential confounders. Dose-response associations were found for all three classes of study drugs (benzodiazepines, Z drugs (zaleplon, zolpidem, and zopiclone), and other drugs). After excluding deaths in the first year, there were approximately four excess deaths linked to drug use per 100 people followed for an average of 7.6 years after their first prescription. Conclusions In this large cohort of patients attending UK primary care, anxiolytic and hypnotic drugs were associated with significantly increased risk of mortality over a seven year period, after adjusting for a range of potential confounders. As with all observational findings, however, these results are prone to bias arising from unmeasured and residual confounding. PMID:24647164

2014-01-01

299

Direct-to-consumer prescription drug advertising and the public  

Microsoft Academic Search

OBJECTIVE: Drug manufacturers are intensely promoting their products directly to consumers, but the impact has not been widely studied.\\u000a Consumers’ awareness and understanding of, attitudes toward, and susceptibility to direct-to-consumer (DTC) drug advertising\\u000a were examined.\\u000a \\u000a \\u000a DESIGN: Random-digit dialing telephone survey with a random household member selection procedure (completion and response rates,\\u000a 58% and 69%, respectively).\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: Respondents were interviewed while

Robert A. Bell; Richard L. Kravitz; Michael S. Wilkes

1999-01-01

300

21 CFR 202.1 - Prescription-drug advertisements.  

Code of Federal Regulations, 2010 CFR

...section. (ii) In the case of an advertisement for a...is generally recognized as safe and effective among...consisting of adequate and well-controlled investigations...clinical investigations (as used in this section “clinical investigations...significance” mean in the case of drugs intended for...

2010-04-01

301

Forces Pushing Prescription Psychotropic Drugs in College Mental Health  

ERIC Educational Resources Information Center

A complex of forceful influences is greatly accelerating the use of what are usually referred to as "psychiatric drugs," although most prescribing is not done by psychiatrists. Many other clinicians, including other kinds of physicians, and recently psychologists, prescribe these medications. The influences contributing to this dramatic surge…

Whitaker, Leighton C.

2007-01-01

302

OxyContin: Prescription Drug Abuse. CSAT Advisory.  

ERIC Educational Resources Information Center

Recently, the media have issued numerous reports about the apparent increase in OxyContin abuse and addiction. OxyContin has been heralded as a miracle drug that allows patients with chronic pain to resume a normal life. It has also been called pharmaceutical heroin and is thought to have been responsible for a number of deaths and robberies in…

Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

303

77 FR 43337 - Drugs for Human Use; Drug Efficacy Study Implementation; Certain Prescription Drugs Offered for...  

Federal Register 2010, 2011, 2012, 2013, 2014

...adjunctive therapy in peptic ulcer and in the irritable bowel syndrome, functional diarrhea, drug- induced diarrhea, ulcerative colitis, urinary bladder spasm, and urethral spasm (36 FR 11875, June 22, 1971). In 1981, FDA reclassified...

2012-07-24

304

What impact do prescription drug charges have on efficiency and equity? Evidence from high-income countries  

PubMed Central

As pharmaceutical expenditure continues to rise, third-party payers in most high-income countries have increasingly shifted the burden of payment for prescription drugs to patients. A large body of literature has examined the relationship between prescription charges and outcomes such as expenditure, use, and health, but few reviews explicitly link cost sharing for prescription drugs to efficiency and equity. This article reviews 173 studies from 15 high-income countries and discusses their implications for important issues sometimes ignored in the literature; in particular, the extent to which prescription charges contain health care costs and enhance efficiency without lowering equity of access to care. PMID:18454849

Gemmill, Marin C; Thomson, Sarah; Mossialos, Elias

2008-01-01

305

Prescription drug use among older adults in Italy: a country-wide perspective.  

PubMed

In Italy, prescription drug costs represent approximately 17% of total public health expenditures. Older adults commonly use multiple drugs and, for this reason, this population is responsible for a large portion of drug-related costs. In 2012, public expenditure for pharmaceuticals in primary care exceeded 11 billion Euros (approximately 15.2 billion US $), and older adults aged 65 or older accounted for more than 60% of these costs. Recently, increased attention has been focused on studies aimed at monitoring drug use and evaluating the appropriateness of drug prescribing in older adults. In this article, we examined studies that assessed these issues in different settings at a national level. Specifically, results of surveys of prescription drug use in primary care (OsMED), hospital (GIFA, CRIME, and REPOSI) and long-term care (ULISSE and SHELTER) settings are reviewed. Overall, these studies showed that the quality of drug prescribing in older patients is far from optimal. This leads to an increased risk of negative health outcomes and increased health care costs. Data from these studies are valuable, not only to monitor drug use, but also to target interventions aimed at improving the quality of prescribing. Translating the findings of clinical research and monitoring programs will be challenging, but it will lead to quantifiable improvements in the quality of drug prescribing at a national level. PMID:24878216

Onder, Graziano; Vetrano, Davide Liborio; Cherubini, Antonio; Fini, Massimo; Mannucci, Pier Mannuccio; Marengoni, Alessandra; Monaco, Alessandro; Nobili, Alessandro; Pecorelli, Sergio; Russo, Pierluigi; Vitale, Cristiana; Bernabei, Roberto

2014-07-01

306

Prescription Drug Marketing Act of 1987; Prescription Drug Amendments of 1992; policies, requirements, and administrative procedures; delay of effective date. Final rule; delay of effective date.  

PubMed

The Food and Drug Administration (FDA) is further delaying, until December 1, 2006, the effective date of certain requirements of a final rule published in the Federal Register of December 3, 1999 (64 FR 67720). In the Federal Register of May 3, 2000 (65 FR 25639), the agency delayed until October 1, 2001, the effective date of certain requirements in the final rule relating to wholesale distribution of prescription drugs by distributors that are not authorized distributors of record, and distribution of blood derivatives by entities that meet the definition of a "health care entity" in the final rule. The agency further delayed the effective date of these requirements in three subsequent Federal Register notices. Most recently, in the Federal Register of January 31, 2003 (68 FR 4912), FDA delayed the effective date until April 1, 2004. This action further delays the effective date of these requirements until December 1, 2006. The final rule implements the Prescription Drug Marketing Act of 1987 (PDMA), as modified by the Prescription Drug Amendments of 1992 (PDA), and the Food and Drug Administration Modernization Act of 1997 (the Modernization Act). The agency is taking this action to address concerns about the requirements in the final rule raised by affected parties. As explained in the SUPPLEMENTARY INFORMATION section, FDA is working with stakeholders through its counterfeit drug initiative to facilitate widespread, voluntary adoption of track and trace technologies that will generate a de facto electronic pedigree, including prior transaction history back to the original manufacturer, as a routine course of business. If this technology is widely adopted, it is expected to help fulfill the pedigree requirements of the PDMA and obviate or resolve many of the concerns that have been raised with respect to the final rule by ensuring that an electronic pedigree travels with a drug product at all times. Therefore, it is necessary to delay the effective date of Sec. Sec. 203.3(u) and 203.50 (21 CFR 203.3(u) and 203.50) until December 1, 2007 to allow stakeholders time to continue to move toward this goal. In addition, the further delay of the applicability of Sec. 203.3(q) to wholesale distribution of blood derivatives by health care entities is necessary to give the agency additional time to consider whether regulatory changes are appropriate and, if so, to initiate such changes. PMID:14997866

2004-02-23

307

Relationship of consumers' perceptions of drugs to drug use.  

PubMed Central

To examine consumers' perceptions of nonprescription and prescription drugs and the relationship of these perceptions to drug use, a sample of 200 adult residents of a northern midwestern area who were similar in age and education to the national population was surveyed. Respondents who rated nonprescription drugs as safe and somewhat effective used nearly 90 percent less nonprescription drugs than respondents rating these drugs as safe and ineffective. Respondents who rated prescription drugs as unsafe used approximately 60 percent less of them than respondents rating them as somewhat safe or safe. Data for the study were collected from March 15 to May 15, 1978. The respondents' perceptions of nonprescription and prescription drugs in respect to safety, efficacy, side effects, and overdose effects were measured on a thermometer scale, with anchors at three points (100 degrees for the most positive perception, 50 degrees for the midpoint, and 0 degrees for the most negative perception). Drug use, based on the respondents' recollections, was measured for 2 days before the interview. The respondents rated prescription drugs as safer and more effective than nonprescription drugs, but as having more dangerous overdose effects. Two-way analysis of variance showed that perceptions of the safety and effectiveness of nonprescription drugs and the interaction between these two variables were related to the use of these drugs. Perceptions of the safety of prescription drugs were related to their use. PMID:6828642

Grahn, J L

1983-01-01

308

National health spending in 2006: a year of change for prescription drugs.  

PubMed

In 2006, U.S. health care spending increased 6.7 percent to $2.1 trillion, or $7,026 per person. The health care portion of gross domestic product (GDP) was 16.0 percent, slightly higher than in 2005. Prescription drug spending growth accelerated in 2006 to 8.5 percent, partly as a result of Medicare Part D's impact. Most of the other major health care services and public payers experienced slower growth in 2006 than in prior years. The implementation of Medicare Part D caused a major shift in the distribution of payers for prescription drugs, as Medicare played a larger role in drug purchases than it had before. PMID:18180476

Catlin, Aaron; Cowan, Cathy; Hartman, Micah; Heffler, Stephen

2008-01-01

309

Prescription of nonsteroidal anti-inflammatory drugs for elderly people in Alberta.  

PubMed Central

OBJECTIVE: To examine the extent prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) are used by elderly people in Alberta as well as the degree of concurrent use of multiple NSAIDs, of peptic ulcer medications and of certain medications known to have clinically significant adverse interactions with NSAIDs. DESIGN: Retrospective analysis of the Alberta Blue Cross database. SETTING: Alberta. PATIENTS: All people 65 years of age and older using the subsidized drug benefit plan for whom prescription claims were submitted for reimbursement between Jan. 1 and June 30, 1991. OUTCOME MEASURES: Number of people who received one or more prescriptions for NSAIDs, rates of prescribing peptic ulcer medications and drugs with the potential for clinically significant interactions with NSAIDs among NSAID users and non-NSAID users, and rate of prescribing more than one NSAID concurrently. RESULTS: Of the Albertan population 65 years of age and over 61,601 (26.7%) received at least one prescription for an NSAID during the study period. In decreasing order, the five most commonly prescribed NSAIDs were acetylsalicylic acid, diclofenac, naproxen, indomethacin and ibuprofen. The total cost of NSAID therapy was $5,415,974. Of the people prescribed an NSAID 25.8% were also prescribed a peptic ulcer medication, as compared with 10.5% of the non-NSAID users. There was a significant relation between the increasing number of NSAID prescriptions and the likelihood of receiving a peptic ulcer medication. Those who received a prescription for an NSAID were more likely than non-NSAID users to have been prescribed coumarin anticoagulants, diuretics, angiotensin-converting-enzyme inhibitors, beta-blockers, oral corticosteroids, methotrexate and lithium, all of which are known to have possible adverse interactions with NSAIDs. A total of 2,631 people had two or more prescriptions for NSAIDs filled on the same day. CONCLUSIONS: NSAIDs are prescribed frequently for elderly people and are associated with an increased likelihood of concurrent prescription of peptic ulcer medication and medications that could have adverse drug interactions with NSAIDs. Additional study is required to evaluate the appropriateness of NSAID use in elderly patients, to determine the degree of actual patient consumption of these medications, to document the true prevalence of clinically significant drug interactions and to formulate educational strategies to reach physicians with this information. PMID:8039085

Hogan, D B; Campbell, N R; Crutcher, R; Jennett, P; MacLeod, N

1994-01-01

310

Quality of Online Pharmacies and Websites Selling Prescription Drugs: A Systematic Review  

PubMed Central

Background Online pharmacies are companies that sell pharmaceutical preparations, including prescription-only drugs, on the Internet. Very little is known about this phenomenon because many online pharmacies operate from remote countries, where legal bases and business practices are largely inaccessible to international research. Objective The aim of the study was to perform an up-to-date and comprehensive review of the scientific literature focusing on the broader picture of online pharmacies by scanning several scientific and institutional databases, with no publication time limits. Methods We searched 4 electronic databases up to January 2011 and the gray literature on the Internet using the Google search engine and its tool Google Scholar. We also investigated the official websites of institutional agencies (World Health Organization, and US and European centers for disease control and drug regulation authorities). We focused specifically on online pharmacies offering prescription-only drugs. We decided to analyze and report only articles with original data, in order to review all the available data regarding online pharmacies and their usage. Results We selected 193 relevant articles: 76 articles with original data, and 117 articles without original data (editorials, regulation articles, or the like) including 5 reviews. The articles with original data cover samples of online pharmacies in 47 cases, online drug purchases in 13, consumer characteristics in 15, and case reports on adverse effects of online drugs in 12. The studies show that random samples with no specific limits to prescription requirements found that at least some websites sold drugs without a prescription and that an online questionnaire was a frequent tool to replace prescription. Data about geographical characteristics show that this information can be concealed in many websites. The analysis of drug offer showed that online a consumer can get virtually everything. Regarding quality of drugs, researchers very often found inappropriate packaging and labeling, whereas the chemical composition usually was not as expected in a minority of the studies’ samples. Regarding consumers, the majority of studies found that not more than 6% of the samples had bought drugs online. Conclusions Online pharmacies are an important phenomenon that is continuing to spread, despite partial regulation, due to intrinsic difficulties linked to the impalpable and evanescent nature of the Web and its global dimension. To enhance the benefits and minimize the risks of online pharmacies, a 2-level approach could be adopted. The first level should focus on policy, with laws regulating the phenomenon at an international level. The second level needs to focus on the individual. This approach should aim to increase health literacy, required for making appropriate health choices, recognizing risks and making the most of the multitude of opportunities offered by the world of medicine 2.0. PMID:21965220

Merla, Anna; Schulz, Peter J; Gelatti, Umberto

2011-01-01

311

Medicare Part D and Its Effect on the Use of Prescription Drugs and Use of Other Health Care Services of the Elderly  

ERIC Educational Resources Information Center

We examine the effect of gaining prescription drug insurance, as a result of Medicare Part D, on use of prescription drugs and other medical services for a nationally representative sample of Medicare beneficiaries. Given the heightened importance of prescription drugs for those with chronic illness, we provide separate estimates for elderly in…

Kaestner, Robert; Nasreen Khan,

2012-01-01

312

Quantifying age-related differences in information processing behaviors when viewing prescription drug labels.  

PubMed

Adverse drug events (ADEs) are a significant problem in health care. While effective warnings have the potential to reduce the prevalence of ADEs, little is known about how patients access and use prescription labeling. We investigated the effectiveness of prescription warning labels (PWLs, small, colorful stickers applied at the pharmacy) in conveying warning information to two groups of patients (young adults and those 50+). We evaluated the early stages of information processing by tracking eye movements while participants interacted with prescription vials that had PWLs affixed to them. We later tested participants' recognition memory for the PWLs. During viewing, participants often failed to attend to the PWLs; this effect was more pronounced for older than younger participants. Older participants also performed worse on the subsequent memory test. However, when memory performance was conditionalized on whether or not the participant had fixated the PWL, these age-related differences in memory were no longer significant, suggesting that the difference in memory performance between groups was attributable to differences in attention rather than differences in memory encoding or recall. This is important because older adults are recognized to be at greater risk for ADEs. These data provide a compelling case that understanding consumers' attentive behavior is crucial to developing an effective labeling standard for prescription drugs. PMID:22719955

Sundar, Raghav Prashant; Becker, Mark W; Bello, Nora M; Bix, Laura

2012-01-01

313

Researching Prescription Drug Misuse among First Nations in Canada: Starting from a Health Promotion Framework  

PubMed Central

The intentional misuse of psychotropic drugs is recognized as a significant public health concern in Canada, although there is a lack of empirical research detailing this. Even less research has been documented on the misuse of prescription drugs among First Nations in Canada. In the past, Western biomedical and individual-based approaches to researching Indigenous health have been applied, whereas First Nations’ understandings of health are founded on a holistic view of wellbeing. Recognition of this disjuncture, alongside the protective influence of First Nations traditional culture, is foundational to establishing an empirical understanding of and comprehensive response to prescription drug misuse. We propose health promotion as a framework from which to begin to explore this. Our work with a health promotion framework has conveyed its potential to support the consideration of Western and Indigenous worldviews together in an ‘ethical space’, with illustrations provided. Health promotion also allots for the consideration of Canada’s colonial history of knowledge production in public health and supports First Nations’ self-determination. Based on this, we recommend three immediate ways in which a health promotion framework can advance research on prescription drug misuse among First Nations in Canada. PMID:22879752

Dell, Colleen Anne; Roberts, Gary; Kilty, Jennifer; Taylor, Kelli; Daschuk, Mitch; Hopkins, Carol; Dell, Debra

2012-01-01

314

To Dope or Not to Dope: Neuroenhancement with Prescription Drugs and Drugs of Abuse among Swiss University Students  

PubMed Central

Background Neuroenhancement is the use of substances by healthy subjects to enhance mood or cognitive function. The prevalence of neuroenhancement among Swiss university students is unknown. Investigating the prevalence of neuroenhancement among students is important to monitor problematic use and evaluate the necessity of prevention programs. Study aim To describe the prevalence of the use of prescription medications and drugs of abuse for neuroenhancement among Swiss university students. Method In this cross-sectional study, students at the University of Zurich, University of Basel, and Swiss Federal Institute of Technology Zurich were invited via e-mail to participate in an online survey. Results A total of 28,118 students were contacted, and 6,275 students completed the survey. Across all of the institutions, 13.8% of the respondents indicated that they had used prescription drugs (7.6%) or drugs of abuse including alcohol (7.8%) at least once specifically for neuroenhancement. The most frequently used prescription drugs for neuroenhancement were methylphenidate (4.1%), sedatives (2.7%), and beta-blockers (1.2%). Alcohol was used for this purpose by 5.6% of the participants, followed by cannabis (2.5%), amphetamines (0.4%), and cocaine (0.2%). Arguments for neuroenhancement included increased learning (66.2%), relaxation or sleep improvement (51.2%), reduced nervousness (39.1%), coping with performance pressure (34.9%), increased performance (32.2%), and experimentation (20%). Neuroenhancement was significantly more prevalent among more senior students, students who reported higher levels of stress, and students who had previously used illicit drugs. Although “soft enhancers”, including coffee, energy drinks, vitamins, and tonics, were used daily in the month prior to an exam, prescription drugs or drugs of abuse were used much less frequently. Conclusions A significant proportion of Swiss university students across most academic disciplines reported neuroenhancement with prescription drugs and drugs of abuse. However, these substances are rarely used on a daily basis and more sporadically used prior to exams. PMID:24236008

Maier, Larissa J.; Liechti, Matthias E.; Herzig, Fiona; Schaub, Michael P.

2013-01-01

315

Characteristics of inmates witnessing overdose events in prison: implications for prevention in the correctional setting  

Microsoft Academic Search

BACKGROUND: Although prevention of opiate overdose has been gaining attention as a harm reduction measure with community drug users, there is scarce information about drug overdose in prison. In correctional institutions without a drug free environment, awareness of overdose events is an important public health concern. This study explores the frequency with which inmates in a state penitentiary system report

Carmen E Albizu-García; Adriana Hernández-Viver; Jacqueline Feal; José F Rodríguez-Orengo

2009-01-01

316

Doping in gymnasiums in Amman: the other side of prescription and nonprescription drug abuse.  

PubMed

This study investigated the abuse of over-the-counter (OTC) products (e.g., proteins, dietary supplements) and prescription drugs (e.g., hormones) in gymnasiums in Amman by random distribution of a structured questionnaire to 375 gym clients (November 2012-February 2013). Data were analyzed using SPSS for Windows (version 17.0). A total of 31 (8.8%) clients admitted to using 21 products (mentioned 71 times) of anabolic steroids and other hormones (e.g., growth hormone and thyroxine) to increase muscular power at the gym or build muscle mass. Abuse of different prescription and OTC drugs among gymnasium clients is present in Jordan, but current methods for controlling the problem are ineffective. Better methods should be developed. The study's limitations are noted. PMID:24611822

Wazaify, Mayyada; Bdair, Ahmad; Al-Hadidi, Kamal; Scott, Jenny

2014-08-01

317

College on Problems of Drug Dependence taskforce on prescription opioid non-medical use and abuse: position statement  

Microsoft Academic Search

This position paper from the College on Problems of Drug Dependence addresses the issues related to non-medical use and abuse of prescription opioids. A central theme throughout is the need to strike a balance between risk management strategies to prevent and deter prescription opioid abuse and the need for physicians and patients to have appropriate access to opioid pharmaceuticals for

James Zacny; George Bigelow; Peggy Compton; Kathleen Foley; Martin Iguchi; Christine Sannerud

2003-01-01

318

Analysis of the Movement of Prescription Drugs to Over-the-Counter Status  

Microsoft Academic Search

BACKGROUND: The transition of prescription drugs (Rx) to over-the-counter (OTC) status is a very complex and multifaceted process involving many parties and many issues. This article examines the regulatory history and process and presents a review of the issues involved, using recent Rx-to-OTC conversions as examples. FINDINGS: Data are presented on the growth of the OTC market and the impact

PATRICIA HARRINGTON; CLIN Pharm; MARVIN D. SHEPHERD

319

What kind of patients and physicians value direct-to-consumer advertising of prescription drugs  

Microsoft Academic Search

Direct-to-consumer (DTC) advertising of prescription drugs can enhance the physician–patient relationship, as well as benefiting\\u000a its sponsor. However, overall benefits can only occur if the patients value the information enough to discuss it with their\\u000a physicians and the physicians are not predisposed against the DTC information. We investigate the impact of demographics and\\u000a exposure to marketing on consumers' and physicians'

Füsun F. Gönül; Franklin Carter; Jerry Wind

2000-01-01

320

Textual Cues in Direct-to-Consumer Prescription Drug Advertising: Motivators to Communicate with Physicians  

Microsoft Academic Search

Growth of direct-to-consumer advertising (DTCA) of prescription drugs heightens concerns about its effects on the patient–physician relationship. Based on social cognitive theory, this study examines textual features of DTCA that may motivate patients to alter communication with physicians. Results of analyses of 225 unique advertisements found in 18 consumer magazines indicate that DTCA's textual messages associate instrumental and identity motivators

Henry N. Young; Rebecca J. Welch Cline

2005-01-01

321

Prescription Drugs, Alcohol, and Illicit Substance Use and Their Correlations Among Medical Sciences Students in Iran  

PubMed Central

Background: Substance use among young people is a major public health problem in Iran. Objectives: The aims of the present study were to determine the prevalence of substance misuse and its determinants in medical sciences students in Tehran, Iran. Patients and Methods: A cross-sectional study was performed on a randomly selected sample of 1992 medical sciences students during 2012-2013. Anonymous, structured questionnaires were distributed among the students in each selected class. Substance misuse was defined according to cultural and epidemiological features. Data analysis was performed using chi-squared test, Fisher’s exact test, and binary logistic regression. Results: The prevalence of prescription drug misuse, last year alcohol use, and ever illicit substance use was 4.9%, 6.9%, and 2.9%, respectively. The result of multiple logistic regression model showed that being a male (OR = 4.0), hookah use in the last year (OR = 3.2), prescription drug misuse (OR = 3.2), and alcohol use in the last year (OR = 3.3) were associated with the students’ illicit substance use. Last year alcohol use (OR = 5.3), ever illicit substance use (OR = 3.2), and illicit substance use in friends (OR = 2.6) were associated with prescription drug misuse. Conclusions: Our results suggested that the prevalence of prescription drugs, alcohol and illicit substance use was relatively low, though still significant, among Iranian students, which was strongly associated with family and friends’ use. The findings of this research can be used for planning and evaluating interventions by considering the risk factors and protective factors in Universities.

Abbasi-Ghahramanloo, Abbas; Fotouhi, Akbar; Zeraati, Hojjat; Rahimi-Movaghar, Afarin

2015-01-01

322

The past, present, and future of direct-to-consumer prescription drug advertising  

Microsoft Academic Search

Since the first experiences with direct-toconsumer c(DTC) prescription drug advertising in the early 1980s, pharmaceutical marketers, government regulators, researchers, health practitioners, and consumers have been both perplexed and intrigued by this practice. As experience with DTC advertising has expanded, so has knowledge and understanding of its risks and rewards. This article discusses important issues in DTC advertising, such as the

Matthew Perri; Shashank Shinde; Reshma Banavali

1999-01-01

323

Evaluation, Use, and Usefulness of Prescription Drug Information Sources Among Anglo and Hispanic Americans  

Microsoft Academic Search

This survey was conducted to determine and compare how Anglo and Hispanic Americans evaluate and use interpersonal, advertising, and mediated sources of prescription drug information. Findings suggest the following: (1) Hispanics rely on doctors, Internet advertising sources, and direct-to-consumer advertising (DTCA), while Anglos frequently use health-related websites and health care professionals; (2) Anglos are more likely to use health-related websites

Denise E. DeLorme; Jisu Huh; Leonard N. Reid

2010-01-01

324

Literacy demands of product information intended to supplement television direct-to-consumer prescription drug advertisements.  

PubMed

The US Food and Drug Administration (FDA) allows television direct-to-consumer (DTC) prescription drug advertisements that do not fully disclose drug risks if the ads include "adequate provision" for dissemination of the drug's approved labeling. This requirement can be met in part by referring consumers to multiple text sources of product labeling. This study was designed to assess the materials to which consumers were referred in 23 DTC television advertisements. SMOG assessments showed that the average reading grade levels were in the high school range for the main body sections of the materials and college-level range for the brief summary sections. The Suitability Assessment of Materials (SAM) instrument identified specific difficulties with the materials, including content, graphics, layout, and typography features. Stronger plain language requirements are recommended. Health care providers should be aware that patients who ask about an advertised drug might not have the full information required to make an informed decision. PMID:15530767

Kaphingst, Kimberly A; Rudd, Rima E; DeJong, William; Daltroy, Lawren H

2004-11-01

325

Impact of celebrity pitch in direct-to-consumer advertising of prescription drugs.  

PubMed

Online surveys were conducted to determine the impact of endorser credibility, endorser effectiveness, and consumers' involvement in direct-to-consumer advertising. In a randomized posttest only study, using the elaboration likelihood model, survey participants (U.S. adults) were either exposed to a fictitious prescription drug ad with a celebrity or a noncelebrity endorser. There was no significant difference in credibility and effectiveness between the celebrity and the noncelebrity endorser. High involvement consumers viewed the ad more favorably and exhibited significantly stronger drug inquiry intentions during their next doctor visit. Further, consumers' involvement did not moderate the effect of celebrity endorser. PMID:22416924

Bhutada, Nilesh S; Menon, Ajit M; Deshpande, Aparna D; Perri, Matthew

2012-01-01

326

Tort reform by regulation: FDA prescription drug labeling rules and preemption of state tort claims.  

PubMed

In 2006, the Food and Drug Administration (FDA) asserted in the preamble to a revised physician labeling rule for prescription drugs that FDA labeling requirements preempt state common law failure to warn claims. The FDA's action reflects a wider effort of administrative agencies to preempt conflicting state law requirements. The debate over preemption raises a set of difficult issues, including the sufficiency of agency safety review, the scope of administrative deference, and federalism. This article surveys the background to the 2006 FDA labeling rule and the Supreme Court's recent preemption jurisprudence in leading cases such as Cippollone v. Liggett Group, Inc., and Geier v. American Honda Motor Corp. PMID:18610730

Moreland, Michael P

2007-01-01

327

An assessment of direct-to-consumer advertising of prescription drugs.  

PubMed

Advertising is widely seen by economists and regulators as beneficial to markets and consumers. The prescription drug market offers exceptional opportunities for direct-to-consumer advertising (DTCA) to provide new-product information, improve compliance, alleviate widespread underdiagnosis and undertreatment, and motivate new-product development.5 DTCA can also induce excess or even dangerous prescribing, however, partly because patients are poorly informed and usually pay far less than the full cost of drugs. Empirical research can help resolve these issues. PMID:17851572

Calfee, J E

2007-10-01

328

[The message of the heroin overdoses].  

PubMed

Drug use can be defined as a kind of self destruction, and it is directly linked to attitudes toward death and suicide occurring in a significant number of users of different narcotics. The aim of the authors was to look for the background of this relationship between drug and death and examine the origin, development, and motives behind heroin overdose based on an analysis of previous studies. It seems clear that pure heroin overdose increased gradually over the years. The fear of the police is the inhibitory factor of the overdose prevention and notification of emergency health care service. Signs of suicide could be the own home as the chosen location for heroin overdose and the presence of partners ("moment of death companion"). Interventions should include simple techniques such as first aid, naloxone administration, resuscitation, prevention of relapse of prisoners and social network extension involving maintenance programs. Orv. Hetil., 2015, 156(9), 352-357. PMID:25702255

Pap, Ágota; Heged?s, Katalin

2015-03-01

329

Direct-to-consumer advertising of prescription drugs: European Commission persists in putting industry's interests first.  

PubMed

In late September 2010, Members of the European Parliament (MEPs) issued their verdict on European Commission proposals aimed at lifting the ban on pharmaceutical companies communicating directly with the general public about prescription drugs. The MEPs were able to limit the scope of some of the more harmful aspects of these proposals, in particular by proposing that drug regulatory agencies should pre-screen the "information" produced by drug companies before it is made available to the public. In December 2010, faced with ongoing opposition from European Member States, the Commission appeared to back down, announcing that it was drawing up "amended proposals". They were publicly released in February 2012 but still leave the door open to direct-to-consumer advertising of prescription drugs, particularly "reminder advertising". As of 4 July 2012, the amended proposals had not yet been examined by Member States, thus obstructing the legislative process. Public health and management of the costs of social services for Member States are at stake. The Medicines in Europe Forum (MiEF) and the International Society of Drug Bulletins (ISDB) urge Member States to continue to refuse to examine the Commission's proposals, and have drawn up concrete counterproposals that would enable the general public to obtain relevant health information. PMID:23373084

2013-01-01

330

Teens and the Misuse of Prescription Drugs: Evidence-Based Recommendations to Curb a Growing Societal Problem  

Microsoft Academic Search

The misuse of prescription drugs by teens in the United States is a growing public health problem. This article provides a\\u000a systematic synthesis of multiple strands of literature to recommend effective prevention methods. Using a social-ecological\\u000a framework, we review the scope of the problem of prescription drug use among teens. Then, we analyze the multiple factors\\u000a that may influence teen

Eric C. Twombly; Kristen D. Holtz

2008-01-01

331

Innocent parties or devious drug users: the views of primary healthcare practitioners with respect to those who misuse prescription drugs  

PubMed Central

Background Many health professionals engage in providing health services for drug users; however, there is evidence of stigmatisation by some health professionals. Prescription drug misusers as a specific group, may also be subject to such judgment. This study aimed to understand issues for primary care health practitioners in relation to prescription drug misuse (PDM), by exploring the attitudes and experiences of healthcare professionals with respect to PDM. Methods Tape-recorded interviews were conducted with a purposive sample of general practitioners (17), community pharmacists (16) and 'key experts' (18) in New Zealand. Interviews were transcribed verbatim and a thematic analysis undertaken. Participants were offered vouchers to the value of NZ$30 for their participation. Results A major theme that was identified was that of two different types of patients involved in PDM, as described by participants - the 'abuser' and the 'overuser'. The 'abuser' was believed to acquire prescription medicines through deception for their own use or for selling on to the illicit market, to use the drugs recreationally, for a 'high' or to stave off withdrawal from illicit drugs. 'Overusers' were characterised as having become 'addicted' through inadvertent overuse and over prescribing, and were generally viewed more sympathetically by practitioners. It also emerged that practitioners' attitudes may have impacted on whether any harm reduction interventions might be offered. Furthermore, whilst practitioners might be more willing to offer help to the 'over-user', it seemed that there is a lack of appropriate services for this group, who may also lack a peer support network. Conclusions A binary view of PDM may not be helpful in understanding the issues surrounding PDM, nor in providing appropriate interventions. There is a need for further exploration of 'over users’ whose needs may not be being met by mainstream drug services, and issues of stigma in relation to ‘abusers’. PMID:20868516

2010-01-01

332

Adequacy of FDA'S Prescription to over-the-Counter Switch Criteria in Physician Evaluation of Proposed Switches of Drug Products  

Microsoft Academic Search

Futurists have forecast that, by the turn of the century, a majority of today's prescription drugs will be switched to over-the-counter (OTC) status. Currently, the Food and Drug Administration (FDA) evaluates potential switch candidates primarily using safety, effectiveness, and labeling criteria. These criteria may not be adequate because of the reported mishaps associated with OTC drug use. The criteria implicitly

Suresh Madhavan

1994-01-01

333

'He was like a zombie': off-label prescription of antipsychotic drugs in dementia.  

PubMed

This paper explores the legal position of the off-label prescription of antipsychotic medications to people with dementia who experience behavioural and psychological symptoms of dementia (BPSD). Dementia is a challenging illness, and BPSD can be very difficult for carers to manage, with evidence that this contributes to carer strain and can result in the early institutionalisation of people with dementia. As a result, the prescription of antipsychotic and other neuroleptic medications to treat BPSD has become commonplace, in spite of these drugs being untested and unlicensed for use to treat older people with dementia. In recent years, it has become apparent through clinical trials that antipsychotic drugs increase the risk of cerebrovascular accident (stroke) and death in people with dementia. In addition, these types of medication also have other risk factors for people with dementia, including over-sedation and worsening of cognitive function. Drawing on recent questionnaire (n = 185), focus group (n = 15), and interview (n = 11) data with carers of people with dementia, this paper explores the law relating to off-label prescription, and the applicability of medical negligence law to cases where adverse events follow the use of antipsychotic medication. It is argued that the practice of off-label prescribing requires regulatory intervention in order to protect vulnerable patients. PMID:23047844

Harding, Rosie; Peel, Elizabeth

2013-03-01

334

Prediction and Prevention of Prescription Drug Abuse: Role of Preclinical Assessment of Substance Abuse Liability  

PubMed Central

In 2011, the prevalence of prescription drug abuse exceeded that of any other illicit drug except marijuana. Consequently, efforts to curtail abuse of new medications should begin during the drug development process, where abuse liability can be identified and addressed before a candidate medication has widespread use. The first step in this process is scheduling with the Drug Enforcement Agency so that legal access is appropriately restricted, dependent upon levels of abuse risk and medical benefit. To facilitate scheduling, the Food and Drug Administration (FDA) has published guidance for industry that describes assessment of abuse liability. The purpose of this paper is to review methods that may be used to satisfy the FDA’s regulatory requirements for animal behavioral and dependence pharmacology. Methods include psychomotor activity, self-administration (an animal model of the rewarding effects of a drug), drug discrimination (an animal model of the subjective effects of a drug), and evaluation of tolerance and dependence. Data from tests conducted at RTI with known drugs of abuse illustrate typical results, and demonstrate that RTI is capable of performing these tests. While using preclinical data to predict abuse liability is an imperfect process, it has substantial predictive validity. The ultimate goal is to increase consumer safety through appropriate scheduling of new medications. PMID:24008590

Marusich, Julie A.; Lefever, Timothy W.; Novak, Scott P.; Blough, Bruce E.; Wiley, Jenny L.

2013-01-01

335

Prescription Opioid Use, Misuse, and Diversion among Street Drug Users in New York City  

PubMed Central

Objective The use of heroin, cocaine, and other drugs is well researched in New York City, but prescription opioids (POs) have been overlooked. This study documents patterns of PO use, misuse, and diversion among street drug users, and begins to indicate how drug culture practices interact with the legitimate therapeutic goals of PO prescriptions (e.g. pain management). Methods Staff completed interviews inquiring about the reasons for use of POs and illicit drugs with 586 street drug users. Ethnographers wrote extensive field notes about subjects’ complex patterns of PO use. Results Methadone was used (71.9%) and sold (64.7%) at a higher level than OxyContin, Vicodin, and Percocet, used by between 34% and 38% of the users and sold by between 28% and 41% of the sellers. Recent PO use is associated with the recency of using heroin and cocaine (p<.001). Half of the heroin/cocaine sellers sold POs, and one quarter of the PO sellers only sold POs. Subjects were classified into four groups by whether they diverted POs or used POs to relieve pain or withdrawal rather than for euphoria. This classification was associated with frequency of PO use, whether POs were obtained from doctors/pharmacies or from drug dealers and family members, and those mostly likely to use POs for pain and withdrawal. Conclusions POs are an important component of street drug users’ drug-taking regimes, especially those who are Physically III Chemical Abusers (PICA). Future research is needed to model PO use, misuse, and diversion among this population. PMID:17913395

Rees Davis, W.; Johnson, Bruce D.

2008-01-01

336

Physicians' decision process for drug prescription and the impact of pharmaceutical marketing mix instruments.  

PubMed

This paper provides an in-depth, qualitative analysis of the physicians' decision process for drug prescription. Drugs in the considered therapeutic classes are mainly prescribed by specialists, treating patients with obligatory medical insurance, for a prolonged period of time. The research approach is specifically designed to capture the full complexity and sensitive nature of the physician's choice behavior, which appears to be more hybrid and less rational in nature than is often assumed in quantitative, model-based analyses of prescription behavior. Several interesting findings emerge from the analysis: (i) non-compensatory decision rules seem to dominate the decision process, (ii) consideration sets are typically small and change-resistant, (iii) drug cost is not a major issue for most physicians, (iv) detailing remains one of the most powerful pharmaceutical marketing instruments and is highly appreciated as a valuable and quick source of information, and (v) certain types of non-medical marketing incentives (such as free conference participation) may in some situations also influence drug choices. PMID:16597584

Campo, Katia; De Staebel, Odette; Gijsbrechts, Els; van Waterschoot, Walter

2005-01-01

337

Use of illicit and prescription drugs for cognitive or mood enhancement among surgeons  

PubMed Central

Background Surgeons are usually exposed to high workloads leading to fatigue and stress. This not only increases the likelihood of mistakes during surgery but also puts pressure on surgeons to use drugs to counteract fatigue, distress, concentration deficits, burnout or symptoms of depression. The prevalence of surgeons taking pharmacological cognitive enhancement (CE) or mood enhancement (ME) drugs has not been systematically assessed so far. Methods Surgeons who attended five international conferences in 2011 were surveyed with an anonymous self-report questionnaire (AQ) regarding the use of prescription or illicit drugs for CE and ME and factors associated with their use. The Randomized Response Technique (RRT) was used in addition. The RRT guarantees a high degree of anonymity and confidentiality when a person is asked about stigmatizing issues, such as drug abuse. Results A total of 3,306 questionnaires were distributed and 1,145 entered statistical analysis (response rate: 36.4%). According to the AQ, 8.9% of all surveyed surgeons confessed to having used a prescription or illicit drug exclusively for CE at least once during lifetime. As one would expect, the prevalence rate assessed by RRT was approximately 2.5-fold higher than that of the AQ (19.9%; 95% confidence interval (CI), 15.9% to 23.9%, N = 1,105). An even larger discrepancy between the RRT and AQ was observed for the use of antidepressants with a 6-fold higher prevalence (15.1%; 95% CI, 11.3% to 19.0%, N = 1,099) as compared to 2.4% with the AQ. Finally, logistic regression analysis revealed that pressure to perform at work (odds ratio (OR): 1.290; 95% CI, 1.000 to 1.666; P = 0.05) or in private life (OR: 1.266; 95% CI, 1.038 to 1.543; P = 0.02), and gross income (OR: 1.337; 95% CI, 1.091 to 1.640; P = 0.005), were positively associated with the use of drugs for CE or ME. Conclusions The use of illicit and prescription drugs for CE or ME is an underestimated phenomenon among surgeons which is generally attributable to high workload, perceived workload, and private stress. Such intake of drugs is associated with attempts to counteract fatigue and loss of concentration. However, drug use for CE may lead to addiction and to overestimation of one’s own capabilities, which can put patients at risk. Coping strategies should be taught during medical education. PMID:23570256

2013-01-01

338

Medicare Part D and the Federal Employees Health Benefits Program: A Comparison of Prescription Drug Coverage  

PubMed Central

Background There is much debate currently about how to restructure the Medicare program to achieve better value for the money. Many have cited the Federal Employees Health Benefits Program (FEHBP) as a model for reform. Objective To compare drug coverage and cost-sharing between Medicare Part D and the FEHBP plans. Methods A cross-sectional comparison was conducted of January 2009 data obtained from the Centers for Medicare & Medicaid Services, the Office of Personnel Management, and 3 health plan websites. Regression analysis and t-tests were used to examine drug coverage, copayment, and coinsurance amounts among Medicare Part D and FEHBP plans. The final study sample of Medicare Part D plans consisted of 19 formularies, covering 63% of total Part D enrollment. These 19 formularies represented 232 stand-alone prescription drug plans. In addition, 5 prescription drug plans or formularies in the FEHBP plans were included, which represents 70% of total FEHBP enrollment. Results The results of this study reveal that formulary coverage of the top drugs dispensed and sold in the United States in 2009 ranged from 72% to 94% (average, 84%) in Medicare Part D plans and from 85% to 99% (average, 94%) in the FEHBP plans (P <.01). The mean copayment for generic drugs in Medicare Part D plans was $4.53 compared with a mean of $7.67 (P <.05) in the FEHBP plans. The difference between the 2 programs in mean copayment for brand-name drugs was nonsignificant. For generic drugs, the mean coinsurance rate was 17% for Medicare Part D plans and a mean of 20% for the FEHBP plans (P <.05). Conclusions This analysis shows that there are differences in prescription drug coverage and cost-sharing among plans within Medicare Part D and the FEHBP. To avoid extreme increases in payroll taxes and other revenues or major cutbacks in services, Medicare must explore ways to change the healthcare system to achieve better value for the money. The experience of the FEHBP suggests a possible means of accomplishing this objective. PMID:24991346

Lovett, Annesha

2013-01-01

339

The effects of involvement and ad type on attitudes toward direct-to-consumer advertising of prescription drugs.  

PubMed

This article examines consumers' attitudes toward Direct-to-Consumer (DTC) advertising of prescription drugs that are influenced by the use different types of DTC ads and product involvement. Our findings suggest that product involvement and the type of DTC ad are significant predictors of consumers' attitudinal responses toward DTC advertising. High involvement consumers have more favorable attitudes toward the drug's price, DTC ad and brand name, and a higher intention to ask a doctor about the advertised drug than low involvement consumers. In contrast to Informational and Reminder DTC ads, Persuasive ads have more favorable effects on consumers' reactions to DTC prescription drug advertising. PMID:19558035

Limbu, Yam; Torres, Ivonne M

2009-01-01

340

Prescription of psychoactive drugs in patients attended by the SUS at Manhuaçu - MG (Brazil)  

PubMed Central

Objective In this study we present the development of a database of psychoactive drugs dispensed to patients attended by the Brazilian Public Health System (SUS) in the city of Manhuaçu, Minas Gerais and the pattern of drug prescription in this city. Methods 827 patients under psychoactive treatment and attended by SUS were surveyed and information such as gender, degree of education, age, marital status were collected. The collected data were analyzed in order to outline patients' profile and the dispensing and information was used to the access the pattern of psychoactive drug use in the city. Results Women accounted for 67.2% of the population and age seemed to influence positively the use of psychoactive drugs. Benzodiazepines and antidepressants were among the most prescribed drugs especially after 20 years of age, while in the younger population the antipsychotics and antiepileptics were the mainly prescribed drugs. Antiepileptics/mood stabilizers seemed to be prescribed mainly to single men and women. Conclusions Personal data concerning gender, age and marital status are related with psychoactive drug dispensing. The collected data will serve as a support for the performance of pharmacists responsible for dispensing psychoactive drugs in the municipality. PMID:24198857

Gonçalves, Daniel P.; Silva, Ian V.; Rangel, Letícia B.; Rezende, Lucas C.

341

Medicare Beneficiaries and the Impact of Gaining Prescription Drug Coverage on Inpatient and Physician Spending  

PubMed Central

Objective To assess whether gaining prescription drug coverage produces cost offsets in Medicare spending on inpatient and physician services. Data Source Two-year panels constructed from 1995 to 2000 Medicare Current Beneficiary Survey, a dataset of Medicare claims and health care surveys from the Medicare population. Study Design We estimated a series of fixed-effects panel models to calculate adjusted changes in Medicare spending as drug coverage was acquired (Gainers) relative to the spending of beneficiaries who never had drug coverage (Nevers). Explanatory variables in the model include age, calendar year, income, and health status. Principal Findings Assessments of inpatient and physician services spending provided no evidence of overt selection behavior prior to the acquisition of drug coverage (i.e., there were no preswitch spikes in Medicare spending for Gainers). After enrollment, the medical spending of Gainers resembled those of beneficiaries who never had drug coverage. Overall, the multivariate models showed no systematic postenrollment changes in either inpatient or physician spending that could be attributed to the acquisition of drug coverage. Conclusions We found no consistent evidence that drug coverage either increases or reduces spending for hospital and physician services. This does not necessarily mean that drug therapy does not substitute for or complement other medical treatments, but rather that neither effect predominates across the Medicare population as a whole. PMID:16174134

Briesacher, Becky A; Stuart, Bruce; Ren, Xiaoqang; Doshi, Jalpa A; Wrobel, Marian V

2005-01-01

342

Public/Private Partnerships for Prescription Drug Coverage: Policy Formulation and Outcomes in Quebec's Universal Drug Insurance Program, with Comparisons to the Medicare Prescription Drug Program in the United States  

PubMed Central

In January 1997, the government of Quebec, Canada, implemented a public/private prescription drug program that covered the entire population of the province. Under this program, the public sector collaborates with private insurers to protect all Quebecers from the high cost of drugs. This article outlines the principal features and history of the Quebec plan and draws parallels between the factors that led to its emergence and those that led to the passage of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) in the United States. It also discusses the challenges and similarities of both programs and analyzes Quebec's ten years of experience to identify adjustments that may help U.S. policymakers optimize the MMA. PMID:17718665

Pomey, Marie-Pascale; Forest, Pierre-Gerlier; Palley, Howard A; Martin, Elisabeth

2007-01-01

343

Riskier than we think? The relationship between risk statement completeness and perceptions of direct to consumer advertised prescription drugs.  

PubMed

Direct to consumer (DTC) prescription drug advertising is one of the fastest growing categories of advertising. Expenditures have increased from about $25 million in 1992 to nearly $2 billion in 1999. Given strong evidence of consumer-driven demand for advertised prescription drugs, research was conducted to assess the extent to which DTC prescription drug advertising provides consumers with the information they need to make an informed evaluation of an advertised drug's relative benefits and risks. Two studies explored the relationship between the completeness of the statement describing drug-associated side effects (the "risk statement") and consumers' perceptions of a drug's safety and appeal. The research manipulated risk statement completeness with regard to the incidence levels of side effects mentioned in the statement (which in turn affected the number of side effects mentioned) and the presence or absence of a numeric indicator of side effect incidence. The research strongly suggests a direct relationship between risk statement completeness and consumers' perceptions of drug safety and appeal. Consumers rate the safety and appeal of drugs described with an incomplete risk statement significantly more positively than comparable drugs described with a more complete risk statement. Implications of the research for the regulation and presentation of DTC prescription drug advertising and advertiser communication practices are discussed. PMID:11191018

Davis, J J

2000-01-01

344

Antihypertensive drug prescription patterns, rationality, and adherence to Joint National Committee-7 hypertension treatment guidelines among Indian postmenopausal women  

PubMed Central

Aim of Study: The aim of this study is to evaluate antihypertensive drug prescription patterns, rationality and adherence to Joint National Committee (JNC-7) hypertension (HT) treatment recommendations among Indian postmenopausal women (PMW). Materials and Methods: An observational and cross-sectional prospective prescription audit study was carried over a period of 1 year. A total of 500 prescriptions prescribed to PMW for diagnosed HT, were identified for one point analysis. Drug prescription patterns/trends, and their adherence to JNC-7 report as well as rationality using WHO guide to good prescribing was assessed. Results: In the monotherapy, category angiotensin receptor blockers (ARBs) accounted (24.8%), calcium channel blockers (CCBs) (19.4%), angiotensin converting enzyme inhibitors (ACEIs) (11%), beta blockers (BBs) (2.8%), and diuretics (2%) of the total prescription. Individually, amlodipine was maximally prescribed in 16.4%. 31.6% had double combination, whereas 2.2% and 1% had triple and four drug combinations, respectively. About 3.6% of the prescription contained antihypertensive combination along with other class of drug. ARBs + diuretic were observed in 11%, CCBs + BB 10% and ACEI + diuretic in 2.6% of the total prescriptions. Among the combination therapy amlodipine + atenolol (8.4%), telmisartan + hydrochlorothiazide (6%) and losartan + hydrochlorothiazide (4.4%) were maximally prescribed. 84.21% (P < 0.001) of the prescription showed nonadherence as per recommendations for pre-HT. 100% and 43.25% adherence rates were noticed for Stage 1 HT (P < 0.001) and Stage 2 HT (P > 0.05) patients. Conclusion: Antihypertensive prescription trends largely adhere to existing guidelines and are rational except polypharmacy, generic and fixed dose combinations prescribing, were some of the common pharmacologically considered irrationality noticed. PMID:24970986

Tandon, Vishal R.; Sharma, Sudhaa; Mahajan, Shagun; Mahajan, Annil; Khajuria, Vijay; Mahajan, Vivek; Prakash, Chander

2014-01-01

345

How Might the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Affect the Financial Viability of Rural Pharmacies? An Analysis of Preimplementation Prescription Volume and Payment Sources in Rural and Urban Areas  

ERIC Educational Resources Information Center

Passage of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) has created interest in how the legislation will affect access to prescription drugs among rural beneficiaries. Policy attention has focused to a much lesser degree on the implications of the MMA for the financial viability of rural pharmacies. This article…

Fraher, Erin P.; Slifkin, Rebecca T.; Smith, Laura; Randolph, Randy; Rudolf, Matthew; Holmes, George M.

2005-01-01

346

Korean Americans' prescription drug information seeking and evaluation and use of different information sources.  

PubMed

This study examined Korean Americans' prescription drug information seeking, evaluation and use of different information sources, and communication with physicians, and compared the findings with those from the White American population. The results suggest that although Korean and White Americans were similar in extent of drug information seeking, Korean Americans tended to experience relatively greater difficulty finding information. Regarding perceived source usefulness, Korean Americans were significantly more likely to perceive higher usefulness in mass media and direct-to-consumer advertising sources than were Whites. Korean Americans were also more likely to use fewer sources, and less likely to use mass media and printed materials in drug information seeking. However, the hypothesized in-group source preference by Korean Americans was not found. PMID:23472746

Huh, Jisu; Delorme, Denise E; Reid, Leonard N; Kim, Junga

2013-01-01

347

Prescription drug coupons: evolution and need for regulation in direct-to-consumer advertising.  

PubMed

Pharmaceutical marketing in the United States had undergone a shift from largely exclusively targeting physicians to considerable efforts in targeting patients through various forms of direct-to-consumer advertising ("DTCA"). This includes the use of DTCA in prescription drug coupons ("PDCs"), a new form of DTCA that offers discounts and rebates directly to consumers to lower costs of drug purchasing. Our examination of PDCs reveals that the use and types of PDC programs is expanding and includes promotion of the vast majority of top grossing pharmaceuticals. However, controversy regarding this emerging form of DTCA has given rise to health policy concerns about their overall impact on prescription drug expenditures for consumers, payers, and the health care system, and whether they lead to optimal long-term utilization of pharmaceuticals. In response to these concerns and the growing popularity of PDCs, what we propose here are clearer regulation and regulatory guidance for PDC DTCA use. This would include review for appropriate disclosure of marketing claims, increased transparency in PDC use for pharmaceutical pricing, and leveraging potential positive benefits of PDC use for vulnerable or underserved patient populations. PMID:24120330

Mackey, Tim K; Yagi, Nozomi; Liang, Bryan A

2014-01-01

348

Effect of presentation modality in direct-to-consumer (DTC) prescription drug television advertisements.  

PubMed

Direct-to-consumer (DTC) drug advertising markets medications requiring a physician's script to the general public. In television advertising, risk disclosures (such as side effects and contraindications) may be communicated in either auditory (voice) or visual (text) or both in the commercials. This research examines presentation modality factors affecting the communication of the risk disclosures in DTC prescription drug television commercials. The results showed that risk disclosures presented either visually only or both visually and auditorily increased recall and recognition compared to no presentation. Risk disclosures presented redundantly in both the visual and auditory modalities produced the highest recall and recognition. Visual only produced better performance than auditory only. Simultaneous presentation of non-risk information together with risk disclosures produced lower recall and recognition compared to risk disclosures alone-without concurrent non-risk information. Implications for the design of DTC prescription drug television commercials and other audio-visual presentations of risk information including on the Internet, are discussed. PMID:24377979

Wogalter, Michael S; Shaver, Eric F; Kalsher, Michael J

2014-09-01

349

Effectiveness and costs of implementation strategies to reduce acid suppressive drug prescriptions: a systematic review  

PubMed Central

Background Evaluation of evidence for the effectiveness of implementation strategies aimed at reducing prescriptions for the use of acid suppressive drugs (ASD). Methods A systematic review of intervention studies with a design according to research quality criteria and outcomes related to the effect of reduction of ASD medication retrieved from Medline, Embase and the Cochrane Library. Outcome measures were the strategy of intervention, quality of methodology and results of treatment to differences of ASD prescriptions and costs. Results The intervention varied from a single passive method to multiple active interactions with GPs. Reports of study quality had shortcomings on subjects of data-analysis. Not all outcomes were calculated but if so rction of prescriptions varied from 8% up to 40% and the cost effectiveness was in some cases negative and in others positive. Few studies demonstrated good effects from the interventions to reduce ASD. Conclusion Poor quality of some studies is limiting the evidence for effective interventions. Also it is difficult to compare cost-effectiveness between studies. However, RCT studies demonstrate that active interventions are required to reduce ASD volume. Larger multi-intervention studies are necessary to evaluate the most successful intervention instruments. PMID:17983477

Smeets, Hugo M; Hoes, Arno W; de Wit, Niek J

2007-01-01

350

National health spending in 2004: recent slowdown led by prescription drug spending.  

PubMed

U.S. health care spending rose 7.9 percent to $1.9 trillion in 2004, or $6,280 per person. Health spending accounted for 16 percent of gross domestic product (GDP), nearly the same as in 2003. The pace of health spending growth has slowed, compared with the 2000-2002 period, for both public and private payers. Hospital spending accounted for 30 percent of the aggregate increase between 2002 and 2004, and prescription drugs accounted for an 11 percent share-smaller than its share of the increase in recent years and much slower in absolute terms. PMID:16403753

Smith, Cynthia; Cowan, Cathy; Heffler, Stephen; Catlin, Aaron

2006-01-01

351

Relationships Between Self-Reported Unfair Treatment and Prescription Medication Use, Illicit Drug Use, and Alcohol Dependence Among Filipino Americans  

PubMed Central

Objectives. We examined associations between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence. Methods. We used data from the Filipino American Community Epidemiological Survey, a cross-sectional investigation involving 2217 Filipino Americans interviewed in 1998–1999. Multinomial logistic and negative binomial regression analyses were used in assessing associations between unfair treatment and the substance use categories. Results. Reports of unfair treatment were associated with prescription drug use, illicit drug use, and alcohol dependence after control for age, gender, location of residence, employment status, educational level, ethnic identity level, nativity, language spoken, marital status, and several health conditions. Conclusions. Unfair treatment may contribute to illness and subsequent use of prescription medications. Furthermore, some individuals may use illicit drugs and alcohol to cope with the stress associated with such treatment. Addressing the antecedents of unfair treatment may be a potential intervention route. PMID:16809581

Gee, Gilbert C.; Delva, Jorge; Takeuchi, David T.

2007-01-01

352

Association between prescription drug misuse and injection among runaway and homeless youth  

PubMed Central

Background The nonmedical use of prescription drugs is the fastest growing drug problem in the United States, disproportionately impacting youth. Furthermore, the population prevalence of injection drug use among youth is also on the rise. This short communication examines the association between current prescription drug misuse (PDM) and injection among runaway and homeless youth. Methods Homeless youth were surveyed between October, 2011 and February, 2012 at two drop-in service agencies in Los Angeles, CA. Prevalence ratios (PR) and 95% confidence intervals (CI) for the association between current PDM and injection behavior were estimated. The outcome of interest was use of a needle to inject any illegal drug into the body during the past 30 days. Results Of 380 homeless youth (median age, 21; IQR, 17-25; 72% male), 84 (22%) reported current PDM and 48 (13%) reported currently injecting. PDM during the past 30 days was associated with a 7.7 (95% CI: 4.4, 13.5) fold increase in the risk of injecting during that same time. Among those reporting current PDM with concurrent heroin, cocaine, and methamphetamine use, the PR with injection was 15.1 (95% CI: 8.5, 26.8). Conclusions Runaway and homeless youth are at increased risk for a myriad of negative outcomes. Our preliminary findings are among the first to show the strong association between current PDM and injection in this population. Our findings provide the basis for additional research to delineate specific patterns of PDM and factors that enable or inhibit transition to injection among homeless and runaway youth. PMID:24300900

Al-Tayyib, Alia A; Rice, Eric; Rhoades, Harmony; Riggs, Paula

2013-01-01

353

A review of studies of adherence with antihypertensive drugs using prescription databases  

PubMed Central

Poor adherence with antihypertensive therapies is a major factor in the low rates of blood pressure control among people with hypertension. Patient adherence is influenced by a large number of interacting factors but their exact impact is not well understood, partly because it is difficult to measure adherence. Longitudinal prescription data can be used as a measure of drug supply and are particularly useful to identify interruptions and changes of treatment. Obtaining a medicine does not ensure its use; however, it has been established that continuous collection of prescription medications is a useful marker of adherence. We found 20 studies published in the last 10 years that used large prescription databases to investigate adherence with antihypertensive therapies. These were assessed in terms of patient selection, the definition of the adherence outcome(s), and statistical modeling. There was large variation between studies, limiting their comparability. Particular methodological problems included: the failure to identify an inception cohort, which ensures baseline comparability, in four studies; the exclusion of patients who could not be followed up, which results in a selection bias, in 17 studies; failure to validate outcome definitions; and failure to model the discrete-time structure of the data in all the studies we examined. Although the data give repeated measurements on patients, none of the studies attempted to model patient-level variability. Studies of such observational data have inherent limitations, but their potential has not been fully realized in the modeling of adherence with antihypertensive drugs. Many of the studies we reviewed found high rates of nonadherence to antihypertensive therapies despite differences in populations and methods used. Adherence rates from one database ranged from 34% to 78% at 1 year. Some studies found women had better adherence than men, while others found the reverse. Novel approaches to analyzing data from such databases are required to use the information available appropriately and avoid the problems of bias. PMID:18360549

Fitz-Simon, Nicola; Bennett, Kathleen; Feely, John

2005-01-01

354

Increases in heroin overdose deaths - 28 States, 2010 to 2012.  

PubMed

Nationally, death rates from prescription opioid pain reliever (OPR) overdoses quadrupled during 1999-2010, whereas rates from heroin overdoses increased by <50%. Individual states and cities have reported substantial increases in deaths from heroin overdose since 2010. CDC analyzed recent mortality data from 28 states to determine the scope of the heroin overdose death increase and to determine whether increases were associated with changes in OPR overdose death rates since 2010. This report summarizes the results of that analysis, which found that, from 2010 to 2012, the death rate from heroin overdose for the 28 states increased from 1.0 to 2.1 per 100,000, whereas the death rate from OPR overdose declined from 6.0 per 100,000 in 2010 to 5.6 per 100,000 in 2012. Heroin overdose death rates increased significantly for both sexes, all age groups, all census regions, and all racial/ethnic groups other than American Indians/Alaska Natives. OPR overdose mortality declined significantly among males, persons aged <45 years, persons in the South, and non-Hispanic whites. Five states had increases in the OPR death rate, seven states had decreases, and 16 states had no change. Of the 18 states with statistically reliable heroin overdose death rates (i.e., rates based on at least 20 deaths), 15 states reported increases. Decreases in OPR death rates were not associated with increases in heroin death rates. The findings indicate a need for intensified prevention efforts aimed at reducing overdose deaths from all types of opioids while recognizing the demographic differences between the heroin and OPR-using populations. Efforts to prevent expansion of the number of OPR users who might use heroin when it is available should continue. PMID:25275328

Rudd, Rose A; Paulozzi, Len J; Bauer, Michael J; Burleson, Richard W; Carlson, Rick E; Dao, Dan; Davis, James W; Dudek, Jennifer; Eichler, Beth Ann; Fernandes, Jessie C; Fondario, Anna; Gabella, Barbara; Hume, Beth; Huntamer, Theron; Kariisa, Mbabazi; Largo, Thomas W; Miles, JoAnne; Newmyer, Ashley; Nitcheva, Daniela; Perez, Beatriz E; Proescholdbell, Scott K; Sabel, Jennifer C; Skiba, Jessica; Slavova, Svetla; Stone, Kathy; Tharp, John M; Wendling, Tracy; Wright, Dagan; Zehner, Anne M

2014-10-01

355

Utilisation and Off-Label Prescriptions of Respiratory Drugs in Children  

PubMed Central

Respiratory drugs are widely used in children to treat labeled and non-labeled indications but only some data are available quantifying comprehensively off-label usage. Thus, we aim to analyse drug utilisation and off-label prescribing of respiratory drugs focusing on age- and indication-related off-label use. Patients aged ?18 years documented in the Bavarian Association of Statutory Health Insurance Physicians database (approx. 2 million children) between 2004 and 2008 were included in our study. Annual period prevalence rates (PPRs) per 10,000 children and the proportion of age- and indication-related off-label prescriptions were calculated and stratified by age and gender. Within the study period, highest PPRs were found for the fixed combination of clenbuterol/ambroxol (between 374–575 per 10,000 children) and the inhaled short acting beta-2-agonist salbutamol (between 378–527 per 10,000 children). Highest relative PPR increase was found for oral salbutamol (approx. 39-fold) whereas the most distinct decrease was found for oral long-acting beta-2-agonist clenbuterol (?97%). Compound classes most frequently involved in off-label prescribing were inhaled bronchodilative compounds (91,402; 37.3%) and oral beta-2-agonists (26,850; 22.5%). The highest absolute number of off-label prescriptions were found for inhaled salbutamol (n?=?67,084; 42.0%) and oral clenbuterol/ambroxol (fixed combination, n?=?18,897; 20.7%). Off-label prescribing due to indication was of much greater relevance than age-related off-label use. Most frequently, bronchodilative compounds were used off-label to treat respiratory tract infections. Highest off-label prescription rates were found in the youngest patients without relevant gender-related differences. Off-label prescribing of respiratory drugs is common especially in young children. Bronchodilative drugs were most frequently used off-label for treating acute bronchitis or upper respiratory tract infections underlining the essential need for a more rational prescribing in this area. PMID:25180704

Schmiedl, Sven; Fischer, Rainald; Ibáñez, Luisa; Fortuny, Joan; Klungel, Olaf H.; Reynolds, Robert; Gerlach, Roman; Tauscher, Martin; Thürmann, Petra; Hasford, Joerg; Rottenkolber, Marietta

2014-01-01

356

Age and the purchase of prescription drug insurance by older adults.  

PubMed

The Medicare Part D Prescription Drug Program places an unprecedented degree of choice in the hands of older adults despite concerns over their ability to make effective decisions and desire to have extensive choice in this context. While previous research has compared older adults to younger adults along these dimensions, our study, in contrast, examines how likelihood to delay decision making and preferences for choice differ by age among older age cohorts. Our analysis is based on responses of older adults to a simulation of enrollment in Medicare Part D. We examine how age, numeracy, cognitive reflection, and the interaction between age and performance on these instruments are related to the decision to enroll in a Medicare prescription drug plan and preference for choice in this context. We find that numeracy and cognitive reflection are positively associated with enrollment likelihood and that they are more important determinants of enrollment than age. We also find that greater numeracy is associated with a lower willingness to pay for choice. Hence, our findings raise concern that older adults, and, in particular, those with poorer numerical processing skills, may need extra support in enrolling in the program: they are less likely to enroll than those with stronger numerical processing skills, even though they show greater willingness to pay for choice. PMID:21534689

Szrek, Helena; Bundorf, M Kate

2011-06-01

357

Studying Prescription Drug Use and Outcomes With Medicaid Claims Data Strengths, Limitations, and Strategies  

PubMed Central

Medicaid claims and eligibility data, particularly when linked to other sources of patient-level and contextual information, represent a powerful and under-used resource for health services research on the use and outcomes of prescription drugs. However, their effective use poses many methodological and inferential challenges. This article reviews strengths, limitations, challenges, and recommended strategies in using Medicaid data for research on the initiation, continuation, and outcomes of prescription drug therapies. Drawing from published research using Medicaid data by the investigators and other groups, we review several key validity and methodological issues. We discuss strategies for claims-based identification of diagnostic subgroups and procedures, measuring and modeling initiation and persistence of regimens, analysis of treatment disparities, and examination of comorbidity patterns. Based on this review, we discuss “best practices” for appropriate data use and validity checking, approaches to statistical modeling of longitudinal patterns in the presence of typical challenges, and strategies for strengthening the power and potential of Medicaid datasets. Finally, we discuss policy implications, including the potential for the research use of Medicare Part D data and the need for further initiatives to systematically develop and optimally use research datasets that link Medicaid and other sources of clinical and outcome information. PMID:17909385

Crystal, Stephen; Akincigil, Ayse; Bilder, Scott; Walkup, James T.

2008-01-01

358

Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access.  

PubMed

Opioid overdose and mortality have increased at an alarming rate prompting new public health initiatives to reduce drug poisoning. One initiative is to expand access to the opioid antidote naloxone. Naloxone has a long history of safe and effective use by organized healthcare systems and providers in the treatment of opioid overdose by paramedics/emergency medicine technicians, emergency medicine physicians and anesthesiologists. The safety of naloxone in a prehospital setting administered by nonhealthcare professionals has not been formally established but will likely parallel medically supervised experiences. Naloxone dose and route of administration can produce variable intensity of potential adverse reactions and opioid withdrawal symptoms: intravenous administration and higher doses produce more adverse events and more severe withdrawal symptoms in those individuals who are opioid dependent. More serious adverse reactions after naloxone administration occur rarely and may be confounded by the effects of other co-intoxicants and the effects of prolonged hypoxia. One component of the new opioid harm reduction initiative is to expand naloxone access to high-risk individuals (addicts, abusers, or patients taking high-dose or extended-release opioids for pain) and their close family or household contacts. Patients or their close contacts receive a naloxone prescription to have the medication on their person or in the home for use during an emergency. Contacts are trained on overdose recognition, rescue breathing and administration of naloxone by intramuscular injection or nasal spraying of the injection prior to the arrival of emergency medical personnel. The safety profile of naloxone in traditional medical use must be considered in this new context of outpatient prescribing, dispensing and treatment of overdose prior to paramedic arrival. New naloxone delivery products are being developed for this prehospital application of naloxone in treatment of opioid overdose and prevention of opioid-induced mortality. PMID:25642320

Wermeling, Daniel P

2015-02-01

359

Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access  

PubMed Central

Opioid overdose and mortality have increased at an alarming rate prompting new public health initiatives to reduce drug poisoning. One initiative is to expand access to the opioid antidote naloxone. Naloxone has a long history of safe and effective use by organized healthcare systems and providers in the treatment of opioid overdose by paramedics/emergency medicine technicians, emergency medicine physicians and anesthesiologists. The safety of naloxone in a prehospital setting administered by nonhealthcare professionals has not been formally established but will likely parallel medically supervised experiences. Naloxone dose and route of administration can produce variable intensity of potential adverse reactions and opioid withdrawal symptoms: intravenous administration and higher doses produce more adverse events and more severe withdrawal symptoms in those individuals who are opioid dependent. More serious adverse reactions after naloxone administration occur rarely and may be confounded by the effects of other co-intoxicants and the effects of prolonged hypoxia. One component of the new opioid harm reduction initiative is to expand naloxone access to high-risk individuals (addicts, abusers, or patients taking high-dose or extended-release opioids for pain) and their close family or household contacts. Patients or their close contacts receive a naloxone prescription to have the medication on their person or in the home for use during an emergency. Contacts are trained on overdose recognition, rescue breathing and administration of naloxone by intramuscular injection or nasal spraying of the injection prior to the arrival of emergency medical personnel. The safety profile of naloxone in traditional medical use must be considered in this new context of outpatient prescribing, dispensing and treatment of overdose prior to paramedic arrival. New naloxone delivery products are being developed for this prehospital application of naloxone in treatment of opioid overdose and prevention of opioid-induced mortality. PMID:25642320

2015-01-01

360

Prescription drug use during pregnancy and risk of childhood cancer - is there an association?  

PubMed

In economically developed countries up to 90% of women are prescribed medications, including vitamins and supplements, during pregnancy. Whilst a number of adverse health outcomes in their offspring have been related to prescription drug use, associations with childhood cancer are less clear and most investigations have been reliant on maternal self-report. With a view to providing new insight we investigated maternal prescription drug use and risk of childhood cancer primary care medical records collected as part of the United Kingdom Childhood Cancer Study, a national population-based case-control study conducted between 1991 and 1996. There was evidence that mothers of children with acute lymphoblastic leukaemia (OR 1.36, 95% CI 1.14-1.63), medulloblastoma (OR 1.79, 95% CI 1.00-3.22) and Wilms tumour (OR 1.79; 95% CI 1.05-3.04) were more likely to have been prescribed iron when compared to mothers of controls. In addition, systemic anti-infectives were positively associated with acute myeloid leukaemia (OR 1.58, 95% CI: 1.05-2.38) and rhabdomyosarcoma (OR 1.80, 95% CI 1.03-3.16), and analgesic use (NO2B) was positively associated with Hodgkin lymphoma (OR 5.02, 95% CI 2.16-11.82) and neuroblastoma (OR 1.99, 95% CI 1.07-3.69). Whilst our findings suggest that maternal use of antibiotics, iron, and nervous system drugs during pregnancy may be associated with some childhood cancer subtypes these associations need to be confirmed elsewhere. Unravelling the mechanisms that may underpin these associations is complex and research is needed to determine whether they are directly related to the drugs themselves, or the illnesses for which they were prescribed. PMID:25544150

Bonaventure, A; Simpson, J; Ansell, P; Roman, E; Lightfoot, T

2015-02-01

361

Associations between prescription opioid injection and Hepatitis C virus among young injection drug users  

PubMed Central

Objective Hepatitis C virus (HCV) incidence has been increasing among young injection drug users (IDUs). This analysis examined whether the emerging practice of prescription opioid (PO) injection is associated with self-reported HCV among young IDUs. Methods Young IDUs (n = 162) aged 18–25-years-old who indicated recent misuse of prescription drugs were sampled in New York and Los Angeles during 2009–2011. Participants reported lifetime PO injection history and results from their most recent HCV test as well as demographic characteristics and lifetime drug use. Bivariate analyses examined relationships between covariates and both lifetime PO injection and HCV positivity. Poisson regression examined the associations between lifetime PO injection, HCV positivity, and significant covariates. Results A majority reported lifetime PO injection (72.2%) and 30.9% self-reported being HCV positive. Lifetime PO injectors were nearly three times more likely to report being HCV positive than non-PO injectors (adjusted incidence rate ratio (AIRR): 2.69, p<0.05) after controlling for socio-demographic and other drug use variable. Additionally, substituting POs for heroin (AIRR: 2.27, p<0.05), growing up in a lower social class (AIRR: 1.67, p<0.05), age (AIRR: 1.12, p<0.05), age of injection initiation (AIRR: 0.87, p<0.001), and history of being prescribed stimulants (AIRR: 0.64, p<0.05) were independently associated with HCV positivity. Conclusions Findings suggest that PO injection should be given further consideration as a contributing factor to rising HCV infection among young adults in the US. PMID:25598589

Lankenau, Stephen E.; Kecojevic, Aleksandar; Silva, Karol

2014-01-01

362

The economics of direct-to-consumer advertising of prescription-only drugs: prescribed to improve consumer welfare?  

PubMed

According to economic theory, one might expect that the informational content of direct-to-consumer advertising of prescription-only drugs would improve consumers' welfare. However, contrasting the models of consumer and market behaviour underlying this theory with the realities of the prescription-only drug market reveals that this market is distinct in ways that render it unlikely that advertising will serve an unbiased and strictly informative function. A review of qualitative evidence regarding the informational content of drug advertising supports this conclusion. Direct-to-consumer prescription drug advertising concentrates on particular products, and features of those products, to the exclusion of others, and the information provided has frequently been found to be biased or misleading in regulatory and academic evaluations. Governments that have so far resisted direct-to-consumer advertising should invest in independent sources of evidence that could help consumers and professionals to better understand the risks and benefits of treating disease with alternative drug and non-drug therapies, rather than permitting direct-to-consumer prescription drug advertising. PMID:14596759

Morgan, Steven; Mintzes, Barbara; Barer, Morris

2003-10-01

363

Content and format of labeling for human prescription drug and biological products; requirements for pregnancy and lactation labeling. Final rule.  

PubMed

The Food and Drug Administration (FDA) is amending its regulations governing the content and format of the "Pregnancy," "Labor and delivery," and "Nursing mothers" subsections of the "Use in Specific Populations" section of the labeling for human prescription drug and biological products. The final rule requires the removal of the pregnancy categories A, B, C, D, and X from all human prescription drug and biological product labeling. For human prescription drug and biological products subject to the Agency's 2006 Physician Labeling Rule, the final rule requires that the labeling include a summary of the risks of using a drug during pregnancy and lactation, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy and lactation. The final rule eliminates the "Labor and delivery" subsection because information about labor and delivery is included in the "Pregnancy" subsection. The final rule requires that the labeling include relevant information about pregnancy testing, contraception, and infertility for health care providers prescribing for females and males of reproductive potential. The final rule creates a consistent format for providing information about the risks and benefits of prescription drug and/or biological product use during pregnancy and lactation and by females and males of reproductive potential. These revisions will facilitate prescriber counseling for these populations. PMID:25509060

2014-12-01

364

Characterization of Adolescent Prescription Drug Abuse and Misuse Using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS®) System  

PubMed Central

Objective To describe the characteristics and health effects of adolescent (age 13–19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS®) System. Method Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all intentional exposures from 2007 through 2009 were used to describe adolescent prescription opioid (oxycodone, fentanyl, hydrocodone, hydromorphone, morphine, methadone, buprenorphine, and tramadol) and stimulant (methylphenidate and amphetamines) exposures. Results A total of 16,209 intentional adolescent exposures to prescription drugs were identified, 68% to opioids and 32% to stimulants. The mean age was 16.6 years (SD ± 1.7 years). Slightly more than half (52.4%) of drug mentions involved females. The five most frequently misused or abused drugs were hydrocodone (32%), amphetamines (18%), oxycodone (15%), methylphenidate (14%), and tramadol (11%). Of all exposures, 38%were classified as suspected suicidal. Of adolescents who intentionally exposed themselves to prescription drugs, 30% were treated in a health care facility, 2,792 of whom were admitted to the hospital, including 1,293 to the intensive care unit. A total of 17.2% of intentional exposures were associated with no effect, 38.9% minor effects, 23.3% moderate effects, 3.6% major effects, and 0.1% were associated with death. Oxycodone and methadone were associated with the most deaths. No deaths were associated with exposures to stimulants. Conclusions Prescription drug misuse and abuse poses an important health problem and results in thousands of hospitalizations of adolescents per year. Further work is needed to develop focused interventions and educational programs to prevent prescription drug abuse and misuse by adolescents. PMID:23357446

Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick

2013-01-01

365

Characteristics of Recipients of Free Prescription Drug Samples: A Nationally Representative Analysis  

PubMed Central

Objectives. Free prescription drug samples are used widely in the United States. We sought to examine characteristics of free drug sample recipients nationwide. Methods. We analyzed data on 32681 US residents from the 2003 Medical Expenditure Panel Survey (MEPS), a nationally representative survey. Results. In 2003, 12% of Americans received at least 1 free sample. A higher proportion of persons who had continuous health insurance received a free sample (12.9%) than did persons who were uninsured for part or all of the year (9.9%; P<.001). The poorest third of respondents were less likely to receive free samples than were those with incomes at 400% of the federal poverty level or higher. After we controlled for demographic factors, we found that neither insurance status nor income were predictors of the receipt of drug samples. Persons who were uninsured all or part of the year were no more likely to receive free samples (odds ratio [OR]=0.98; 95% confidence interval [CI]=0.087, 1.11) than those who were continuously insured. Conclusions. Poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples. Our findings suggest that free drug samples serve as a marketing tool, not as a safety net. PMID:18172135

Cutrona, Sarah L.; Woolhandler, Steffie; Lasser, Karen E.; Bor, David H.; McCormick, Danny; Himmelstein, David U.

2008-01-01

366

Strategic options for brand-name prescription drugs when patents expire.  

PubMed

Pharmaceutical companies face a very hostile competitive environment from generic drugs once the patents on their brand name drugs expire. Depending on the country, such patents usually last 10-15 years but no sooner do the patents expire then copies of off-patent brand name drugs, called generics, are introduced, generally by smaller-size and lesser known companies, at significantly lower prices. As health care costs escalate all over the world, efforts to control medication costs have created a major market for generic prescription drugs, particularly in government funded hospitals and in dispensing general practitioner markets of the Asia Pacific and the third world. The world market for generics is estimated at US$20 billion, doubling in only five years and capturing over 30% of the market share. Because of adverse effects on sales and profitability due to the launching of generics, most research based companies that produce original brand-name patented drugs are forced to take counter measures to overcome this problem, particularly when R&D costs for new patents are skyrocketing. This paper develops a brief perspective on this problem and then examines the experiences of many multinational companies in the Singapore market in dealing with the problem. While several different approaches are identified, only one company experience appeared to work successfully and this is discussed in relative detail. PMID:10167309

Mehta, S C; Mehta, S S

1997-01-01

367

Acute opiate overdose in Tehran: The forgotten role of opium  

Microsoft Academic Search

IntroductionThe global epidemic of opiate use continues to spread and is an increasing burden especially in developing countries. Acute opiate overdose (AOO) is one of the most dramatic complications of drug abuse. The purpose of this study is to examine the epidemiology of acute opiate overdose in a poisoning center in Tehran.

Mojgan Karbakhsh; Negar Salehian Zandi

2007-01-01

368

Extracorporeal circulation in the management of massive propranolol overdose.  

PubMed

A case of refractory hypotension following propranolol overdose is reported. Management included isoprenaline, glucagon and extracorporeal circulatory support using femoral vein-femoral artery bypass. The unreliability of neurological observations, especially unreactive pupils, in the presence of drug overdose is reiterated. PMID:1928675

McVey, F K; Corke, C F

1991-09-01

369

Women Who Abuse Prescription Opioids: Findings from the Addiction Severity Index-Multimedia Version® Connect Prescription Opioid Database  

PubMed Central

Background Evidence suggests gender differences in abuse of prescription opioids. This study aimed to describe characteristics of women who abuse prescription opioids in a treatment-seeking sample and to contrast gender differences among prescription opioid abusers. Methods Data collected November 2005 to April 2008 derived from the Addiction Severity Index Multimedia Version Connect (ASI-MV® Connect) database. Bivariate and multivariable logistic regression examined correlates of prescription opioid abuse stratified by gender. Results 29,906 assessments from 220 treatment centers were included, of which 12.8% (N=3,821) reported past month prescription opioid abuse. Women were more likely than men to report use of any prescription opioid (29.8% females vs. 21.1% males, p< 0.001) and abuse of any prescription opioid (15.4% females vs. 11.1% males, p < 0.001) in the past month. Route of administration and source of prescription opioids displayed gender-specific tendencies. Women-specific correlates of recent prescription opioid abuse were problem drinking, age <54, inhalant use, residence outside of West US Census region, and history of drug overdose. Men-specific correlates were age <34, currently living with their children, residence in the South and Midwest, hallucinogen use, and recent depression. Women prescription opioid abusers were less likely to report a pain problem although they were more likely to report medical problems than women who abused other drugs. Conclusions Gender-specific factors should be taken into account in efforts to screen and identify those at highest risk of prescription opioid abuse. Prevention and intervention efforts with a gender-specific approach are warranted. PMID:19409735

Green, Traci C.; Grimes Serrano, Jill M.; Licari, Andrea; Budman, Simon H.; Butler, Stephen F.

2009-01-01

370

Direct-to-consumer advertising skepticism and the use and perceived usefulness of prescription drug information sources.  

PubMed

This study investigates advertising skepticism in the context of consumers' prescription drug information seeking behavior. Results of a telephone survey found that: (a) the overall level of direct-to-consumer advertising (DTCA) skepticism among consumers was neutral; (b) DTCA skepticism was unrelated to age, positively related to education and income, and varied by race; (c) however, when all the antecedent variables were considered concurrently, only education emerged as a significant predictor (consumers with higher education were more skeptical of DTCA); (d) DTCA skepticism was not significantly related to perceived importance of prescription drug information; (e) DTCA skepticism was not associated with use of advertising and interpersonal sources of prescription drug information; and (f) DTCA skepticism was negatively related to perceived usefulness of advertising sources but unrelated to perceived usefulness of professional interpersonal sources (i.e., physicians and pharmacists). The article concludes with a discussion of findings and directions for future research. PMID:19916096

DeLorme, Denise E; Huh, Jisu; Reid, Leonard N

2009-01-01

371

[Thinking about evaluation of proprietary Chinese medicines containing toxic herbs during switch process of non-prescription drugs].  

PubMed

To enhance the scientific and fair evaluation about proprietary Chinese medicines containing toxic herbs during the switch process of non-prescription drugs, and to ensure those medicines to be used safely by the public in their self-medication. Combined with current research status of toxic herbs, the experience and knowledge accumulated in the practical work of selection and switch of OTC Chinese medicines for years, thinking about the feasible standards about evaluation and management of proprietary Chinese medicines containing toxic herbs at this stage. Initially established ideas and methods about evaluation of proprietary Chinese medicines containing toxic herbs during the switch process of non-prescription drugs. Basically solved the main problem currently faced by toxic herbs during the OTC switch process of proprietary Chinese medicines, effectively promoted the work on OTC switch, and had the important significance in making consumers use non-prescription drugs conveniently and safely. PMID:21438414

Xia, Dongsheng; Cheng, Gang; Li, Xinling; Zhou, Jieming; Xiao, Aili; Zhang, Chengxu; Du, Xiaoxi

2010-12-01

372

Ischaemic cardiovascular risk and prescription of non-steroidal anti-inflammatory drugs for musculoskeletal complaints  

PubMed Central

Abstract Objective. To determine the influence of ischaemic cardiovascular (CV) risk on prescription of non-steroidal anti-inflammatory drugs (NSAIDs) by general practitioners (GPs) in patients with musculoskeletal complaints. Design. Cohort study. Setting. A healthcare database containing the electronic GP medical records of over one million patients throughout the Netherlands. Patients. A total of 474 201 adults consulting their GP with a new musculoskeletal complaint between 2000 and 2010. Patients were considered at high CV risk if they had a history of myocardial infarction, angina pectoris, stroke, transient ischaemic attack, or peripheral arterial disease, and at low CV risk if they had no CV risk factors. Main outcome measures. Frequency of prescription of non-selective (ns)NSAIDs and selective cyclooxygenase-2 inhibitors (coxibs). Results. Overall, 24.4% of patients were prescribed an nsNSAID and 1.4% a coxib. Of the 41,483 patients with a high CV risk, 19.9% received an nsNSAID and 2.2% a coxib. These patients were more likely to be prescribed a coxib than patients with a low CV risk (OR 1.9, 95% CI 1.8–2.0). Prescription of nsNSAIDs decreased over time in all risk groups and was lower in patients with a high CV risk than in patients with a low CV risk (OR 0.8, 95% CI 0.7–0.8). Conclusion. Overall, patients with a high CV risk were less likely to be prescribed an NSAID for musculoskeletal complaints than patients with a low CV risk. Nevertheless, one in five high CV risk patients received an NSAID, indicating that there is still room for improvement. PMID:24931511

Valkhoff, Vera E; Jong, Geert W't; Warlé-van Herwaarden, Margreet F; Bindels, Patrick Je; Sturkenboom, Miriam Cjm; Luijsterburg, Pim Aj; Bierma-Zeinstra, Sita Ma

2014-01-01

373

Risk factors of ?-hydroxybutyrate overdosing.  

PubMed

The aim of this study was to identify in recreational drug users the factors which increase the risk of overdosing (OD) with ?-hydroxybutyrate (GHB). A purposive sample of 45 experienced GHB users was interviewed, equally divided into three groups (never OD, occasional OD, and repeat OD). The repeat OD group scored highest on many risk factors regarding GHB use, the occasional OD group scored intermediate, and the never OD group scored lowest. Participants, whether or not they had overdosed on GHB, most often perceived GHB use (e.g. using more GHB than usual, using GHB doses too closely together) as the main reason for GHB OD, and many participants who had overdosed on GHB reported that they had taken more GHB than usual at their most recent occasion of GHB OD. No significant differences in co-use of GHB with other substances were found between the three groups. Our findings indicate that using GHB in the company of groups of friends probably reduces, but does not eliminate, the risk of OD. PMID:24080792

Korf, Dirk J; Nabben, Ton; Benschop, Annemieke; Ribbink, Kim; van Amsterdam, Jan G C

2014-01-01

374

Recurrent overdose: patient characteristics, habits, and outcomes.  

PubMed Central

OBJECTIVES: Patients who overdose repeatedly on drugs and poisons (repeaters) are of major concern. This study aimed to examine the demographics, types of drugs ingested, associated self inflicted trauma, and medium term outcome of repeaters and to compare these patients with those who overdosed on one occasion only (single presenters) during the study period. METHODS: The study was undertaken in the emergency department of a large, provincial Australian hospital. A retrospective case note examination was made for all patients who presented, after drug overdose, during the two year study period. These patients were also followed up for a further 12 months after the study period. RESULTS: The study identified 335 single presenters and 46 repeaters. Females formed about two thirds of each group but repeaters tended to be older (p > 0.05) and to present more frequently before midnight (p > 0.05). Significantly more repeat presentations were triaged to the low priority categories 4 or 5 (odds ratio (OR) 0.48; 95% confidence interval (CI) 0.26 to 0.90, p = 0.023) and this group required fewer admissions to the hospital (OR 1.85; 95% CI 1.16 to 2.93, p = 0.009). Repeaters tended to take single drug overdoses. There were significantly more paracetamol only overdoses (OR 0.54; 95% CI 0.32 to 0.92, p = 0.024) and neuroleptic only overdoses (OR 0.27; 95% CI 0.11 to 0.67, p = 0.005) in the repeater group. More repeaters caused self inflicted trauma during the study period (OR 0.20; 95% CI 0.06 to 0.64, p = 0.007). No repeater completed suicide during the study or the 12 month follow up periods but repeaters presented more frequently, after overdose, during follow up (OR 0.38; 95% CI 0.13 to 1.11, p = 0.078). CONCLUSIONS: The study concludes that there are some significant differences between patients who overdose repeatedly and those who overdose on one occasion only. The study findings suggest that the medium term suicidal risk for repeaters is relatively low. However, this risk will vary and individual patients must be assessed thoroughly and managed accordingly. PMID:9681311

Taylor, D M; Cameron, P A; Eddey, D

1998-01-01

375

Guide to drug porphyrogenicity prediction and drug prescription in the acute porphyrias  

PubMed Central

What is already known about this subject Many drug safety lists for acute porphyrias, largely based on anecdotal evidence, are put forward, but no methods or rationale for the risk estimates are given. Many unexplained discrepancies between the lists exist. What this study adds A standardized method for assessment of the risk that a certain drug may activate these diseases has been developed. It also allows risk assessments for drugs lacking porphyria related clinical experience. About one thousand therapeutic drugs have been classified with regard to porphyrogenicity by the proposed method, which is most valuable for the care of porphyria patients. Aims This paper addresses two common problems in the care of carriers of acute porphyria: the choice of safe drugs for pharmacotherapy and the strategy to apply when potentially unsafe drugs cannot be avoided. Methods and results A technique is presented for prediction of risk that a certain drug may activate the disease in a gene carrier for acute porphyria. It is based on a model explaining the clinical manifestations as a result of the acute overloading of a deficient enzyme within the hepatic heme biosynthetic chain. The capacity of the drug for induction of the rate-limiting enzyme in heme biosynthesis, e.g. housekeeping 5-aminolevulinate synthase (ALAS1), is assessed by critical appraisal of reports of the outcomes of clinical use of the drug, and by theoretical criteria. The assessment occurs within the frame of a flow-scheme employing variables of increasing specificity, i.e. endocrine properties of the drug, structure and metabolism pointing to affinity to cytochrome P450, hepatic load in therapeutic use, recognized affinity to major CYP species, capacity for CYP-induction or irreversible inhibition, and capacity to activate or modulate the transduction mechanisms of nuclear receptors affecting ALAS1-gene transcription. It is proposed that in the absence of a safer alternative, an urgently needed drug not should be withheld on the grounds of potential porphyrogenicity. After risk-benefit analysis it should be prescribed, but individualized preventive measures adapted to patient vulnerability may be needed. Conclusions About 1000 therapeutic drugs categorized with regard to porphyrogenicity by the technique proposed are presented on the internet (http://www.drugs-porphyria.org). PMID:17578481

Thunell, Stig; Pomp, Erik; Brun, Atle

2007-01-01

376

Frequency of Prescription Drugs on Durable Medical Equipment Files by Brand Drug Name  

Cancer.gov

If a patient receives an oral chemotherapeutic agent that is equivalent to a chemotherapy administered intravenously, this agent may be captured in the Durable Medical Equipment (DME) file. Under most circumstances, CMS requires providers to use 11-digit National Drugs Codes (NDCs) when submitting DME claims for oral anti-cancer drugs. For patients in clinical trials, DME claims will be billed using HCPCS codes instead of DME codes.

377

Hidden in plain sight marketing prescription drugs to consumers in the twentieth century.  

PubMed

Although the public health impact of direct-to-consumer (DTC) pharmaceutical advertising remains a subject of great controversy, such promotion is typically understood as a recent phenomenon permitted only by changes in federal regulation of print and broadcast advertising over the past two decades. But today's omnipresent ads are only the most recent chapter in a longer history of DTC pharmaceutical promotion (including the ghostwriting of popular articles, organization of public-relations events, and implicit advertising of products to consumers) stretching back over the twentieth century. We use trade literature and archival materials to examine the continuity of efforts to promote prescription drugs to consumers and to better grapple with the public health significance of contemporary pharmaceutical marketing practices. PMID:20299640

Greene, Jeremy A; Herzberg, David

2010-05-01

378

Trust in prescription drug brand websites: website trust cues, attitude toward the website, and behavioral intentions.  

PubMed

Direct-to-consumer (DTC) prescription drug brand websites, as a form of DTC advertising, are receiving increasing attention due to the growing number and importance as an ad and a consumer information source. This study examined consumer trust in a DTC website as an important factor influencing consumers' attitude toward the website and behavioral intention. Applying the conceptual framework of website trust, the particular focus of investigation was the effect of the website trust cue factor on consumers' perceived DTC website trust and subsequent attitudinal and behavioral responses. Results show a significant relation between the website trust cue factor and consumers' perceived DTC website trust. Perceived DTC website trust, in turn, was found to be significantly associated with consumers' attitude toward the DTC website and behavioral intention. PMID:24094133

Huh, Jisu; Shin, Wonsun

2014-01-01

379

HIDDEN in PLAIN SIGHT Marketing Prescription Drugs to Consumers in the Twentieth Century  

PubMed Central

Although the public health impact of direct-to-consumer (DTC) pharmaceutical advertising remains a subject of great controversy, such promotion is typically understood as a recent phenomenon permitted only by changes in federal regulation of print and broadcast advertising over the past two decades. But today's omnipresent ads are only the most recent chapter in a longer history of DTC pharmaceutical promotion (including the ghostwriting of popular articles, organization of public-relations events, and implicit advertising of products to consumers) stretching back over the twentieth century. We use trade literature and archival materials to examine the continuity of efforts to promote prescription drugs to consumers and to better grapple with the public health significance of contemporary pharmaceutical marketing practices. PMID:20299640

Herzberg, David

2010-01-01

380

Differences in prescription drug use in HMO and self-insured health plans.  

PubMed

Using pharmacy benefits manager claims data, this study analyzed how cost-management techniques including cost sharing affected enrollees in health maintenance organizations (HMOs) versus employer-sponsored fee-for-service plans. Because HMOs bear the risk of pharmaceutical costs and influence the prescribing practices of the physicians in their network, we expected different patterns of prescription use, such as proportionately more generic medications in HMOs. Also, because HMO physicians are likely to prescribe relatively more drugs for high-severity conditions, HMO enrollee demand should be less price sensitive. The impact of cost sharing was found to be significantly less for HMOs. A 5-dollar increase in copayments decreased expenditures by 16 percent in fee-for-service plans but only by 1 percent in HMOs. Furthermore, when cost sharing was set at zero, HMO plans were found to have significantly fewer and cheaper medications, resulting in lower per-enrollee medication expenditures. PMID:17213460

Wallack, Stanley S; Thomas, Cindy Parks; Martin, Timothy C; Ryan, Andrew

2007-02-01

381

The unlicensed lives of antidepressants in India: generic drugs, unqualified practitioners, and floating prescriptions.  

PubMed

Antidepressant uses have been rising rapidly over the past decades. Two main theories have been advanced to explain this. One claims that socio-economic change causes a global rise of depressive illness. The other holds that European and North American corporations are aggressively marketing antidepressants to expand their global reach. Both theories assume that multinational capitalism drives rising depression rates. Based on ethnographic data from India, this article shows that antidepressants are increasingly used in this country as well, but for reasons than have been little explored yet. Taking fluoxetine (Prozac) as the main example, it is argued that the spread of antidepressants in India is ;unlicensed' by Euro-American corporations in at least three ways: (i) drug marketing is driven by Indian generic producers; (ii) fluoxetine is given by practitioners who have no license to do so; and (iii) knowledge of fluoxetine is spread through unlicensed ;floating' prescriptions that patients take from one prescriber to another. PMID:19293281

Ecks, Stefan; Basu, Soumita

2009-03-01

382

The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.  

PubMed

The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability. PMID:25217142

Ung, Brian L; Mullins, C Daniel

2014-08-12

383

Creating Demand for Prescription Drugs: A Content Analysis of Television Direct-to-Consumer Advertising  

PubMed Central

PURPOSE American television viewers see as many as 16 hours of prescription drug advertisements (ads) each year, yet no research has examined how television ads attempt to influence consumers. This information is important, because ads may not meet their educational potential, possibly prompting consumers to request prescriptions that are clinically inappropriate or more expensive than equally effective alternatives. METHODS We coded ads shown during evening news and prime time hours for factual claims they make about the target condition, how they attempt to appeal to consumers, and how they portray the medication and lifestyle behaviors in the lives of ad characters. RESULTS Most ads (82%) made some factual claims and made rational arguments (86%) for product use, but few described condition causes (26%), risk factors (26%), or prevalence (25%). Emotional appeals were almost universal (95%). No ads mentioned lifestyle change as an alternative to products, though some (19%) portrayed it as an adjunct to medication. Some ads (18%) portrayed lifestyle changes as insufficient for controlling a condition. The ads often framed medication use in terms of losing (58%) and regaining control (85%) over some aspect of life and as engendering social approval (78%). Products were frequently (58%) portrayed as a medical breakthrough. CONCLUSIONS Despite claims that ads serve an educational purpose, they provide limited information about the causes of a disease or who may be at risk; they show characters that have lost control over their social, emotional, or physical lives without the medication; and they minimize the value of health promotion through lifestyle changes. The ads have limited educational value and may oversell the benefits of drugs in ways that might conflict with promoting population health. PMID:17261859

Frosch, Dominick L.; Krueger, Patrick M.; Hornik, Robert C.; Cronholm, Peter F.; Barg, Frances K.

2007-01-01

384

Exposure to Prescription Drugs Labeled for Risk of Adverse Effects of Suicidal Behavior or Ideation among 100 Air Force Personnel Who Died by Suicide, 2006-2009  

ERIC Educational Resources Information Center

Prescription drugs for many indications are labeled with warnings for potential risk of suicidal ideation or behavior. Exposures to prescription drugs labeled for adverse effects of suicidal behavior or ideation among 100 Air Force personnel who died by suicide between 2006 and 2009 are described. Air Force registry data were linked to…

Lavigne, Jill E.; McCarthy, Michael; Chapman, Richard; Petrilla, Allison; Knox, Kerry L.

2012-01-01

385

Black Beauties, Gorilla Pills, Footballs, and Hillbilly Heroin: Some Reflections on Prescription Drug Abuse and Diversion Research over the past 40 Years  

Microsoft Academic Search

Although the problem of prescription drug abuse has endured for well over two centuries, research into the abuse and diversion of these drugs has been relatively recent. The first general population survey to document the abuse of prescription medications occurred in 1970, and subsequent studies demonstrated that the abuse and diversion of amphetamines, opioids, and sedatives has continued to be

James A. Inciardi; Theodore J. Cicero

2009-01-01

386

Development and Reliability of Items Measuring the Nonmedical Use of Prescription Drugs for the Youth Risk Behavior Survey: Results Froman Initial Pilot Test  

ERIC Educational Resources Information Center

Background: The purpose of this study was to develop and test the reliability of self-report survey items designed to monitor the nonmedical use of prescription drugs among adolescents. Methods: Eighteen nonmedical prescription drug items designed to be congruent with the substance abuse items in the US Centers for Disease Control and Prevention's…

Howard, Melissa M.; Weiler, Robert M.; Haddox, J. David

2009-01-01

387

The Ohio State University Office of Human Resources Page 1 of 1 Prescription Drug Benefit Summary Edited 02/06/14  

E-print Network

-Formulary Brand Name Drug 50% coinsurance, no maximum 50% coinsurance, no maximum Infertility Medication Plan5 sheets, visit hr.osu.edu/benefits/hb_prescription. 5 The infertility treatment medical benefit includes The Prescription Drug Program annual out-of-pocket maximum does not apply to infertility medications. 7 Infertility

388

Castor oil overdose  

MedlinePLUS

Castor oil is a yellowish liquid often used as a lubricant and in laxatives. This article discusses poisoning from swallowing a large amount (overdose) of castor oil. This is for information only and not for ...

389

Non-Medical Use of Prescription Drugs among Youth in an Appalachian Population: Prevalence, Predictors, and Implications for Prevention  

ERIC Educational Resources Information Center

This article examines prevalence of non-medical use of prescription drugs (NMUPD) in a sample of elementary and high school students in an Appalachian Tennessee county. We found that lifetime prevalence of NMUPD (35%) was higher than prevalence of cigarette use (28%) and marijuana use (17%), but lower than lifetime prevalence of alcohol use (46%).…

Collins, David; Abadi, Melissa Harris; Johnson, Knowlton; Shamblen, Steve; Thompson, Kirsten

2011-01-01

390

Design, Development, and Evaluation of Visual Aids for Communicating Prescription Drug Instructions to Nonliterate Patients in Rural Cameroon.  

ERIC Educational Resources Information Center

Culturally sensitive visual aids designed to help convey drug information to nonliterate female adults requiring antibiotics were developed. Researchers conceptualized the messages, and a local artist produced the visual aids. Comprehension and compliance with prescription instructions were evaluated (N=78). Results and practical implications are…

Ngoh, Lucy N.; Shepherd, Marvin D.

1997-01-01

391

Exploring the Use of Nonmedical Sources of Prescription Drugs among Immigrant Latinos in the Rural Southeastern USA  

ERIC Educational Resources Information Center

Background: Little is known about access to medicine among immigrant Latinos in the United States (US). This study explored access to, and use of, prescription drugs obtained from nonmedical sources among recently arrived, Spanish-speaking immigrant Latinos in rural North Carolina (NC). Methods: Our community-based participatory research…

Vissman, Aaron T.; Bloom, Fred R.; Leichliter, Jami S.; Bachmann, Laura H.; Montano, Jaime; Topmiller, Michael; Rhodes, Scott D.

2011-01-01

392

Health Disparities and Direct-to-Consumer Prescription Drug Advertising: A Content Analysis of Targeted Magazine Genres, 1992–2002  

Microsoft Academic Search

Health disparities exist in the United States based on race, gender, and socioeconomic status. One way to alleviate some of the disparities regarding certain diseases or conditions is to increase awareness among populations most affected. Physicians have suggested that direct-to-consumer advertising (DTCA) of prescription drugs could play a role in awareness. Social identity theory suggests that individuals are likely to

Teresa Mastin; Julie L. Andsager; Jounghwa Choi; Kyungjin Lee

2007-01-01

393

The Effects of North Carolina's Prescription Drug Monitoring Program on the Prescribing Behaviors of the State's Providers.  

PubMed

State-level prescription drug monitoring programs (PDMPs) show promise as a key strategy to respond to the epidemic of the misuse and abuse of controlled substances (CS), particularly opioid analgesics, in the United States. Undocumented concerns have been expressed that these PDMPs may have a "chilling effect" on providers' willingness to prescribe these substances to their patients. Using data from North Carolina's PDMP for the 3-year period from 2009 through 2011, we examined whether rapid increases in (1) the number of providers who queried the system, and (2) the number of days on which they queried it, would be related to their prescribing practices in regards to CS. We hypothesized that neither marker of PDMP utilization would be associated with a decrease in either patients receiving CS prescriptions or CS prescriptions filled. We found no association between either of these variables and the number of patients who filled prescriptions for CS or the number of prescriptions for CS filled. However, we did find a slight positive relationship between the growth in the utilization of the PDMP and the number of prescriptions filled for opioid analgesics. Concerns that PDMPs may constrain prescribing behavior with regards to CS are not supported. PMID:25466768

Ringwalt, Chris; Garrettson, Mariana; Alexandridis, Apostolos

2015-04-01

394

Unapproved prescription cough, cold, and allergy drug products: recent US Food and Drug Administration regulatory action on unapproved cough, cold, and allergy medications.  

PubMed

The US Food and Drug Administration (FDA) drug approval and over-the-counter drug monograph processes play an essential role in ensuring that all drugs are both safe and effective for their intended uses. Manufacturers of drugs that lack required approval have not provided the FDA with evidence demonstrating that their products are safe and effective. Some of these prescription drugs have been marketed for many years and have remained on the market despite changes to the Federal Food, Drug, and Cosmetic Act, which requires approval for safety and efficacy purposes. Many health-care providers may be unaware that unapproved drugs exist because the product labels of these drugs do not disclose that they lack FDA approval. The FDA recently took action against unapproved prescription oral cough, cold, and allergy drug products because of concerns about the potential risks of these products, particularly some extended-release formulations that have not been reviewed for quality. There is a potential for medication errors because product names and labeling have not been reviewed for potential confusion, with some products inappropriately labeled for use in children aged ? 2 years. FDA-approved prescription drugs or drugs appropriately marketed as over the counter remain available for treatment of cough, cold, and allergy symptoms. Such products are of known efficacy, safety, identity, quality, and purity. Removing unapproved drugs from the marketplace and encouraging manufacturers of unapproved products to seek FDA review and approval is a top priority for the FDA. Since the initiation of the Unapproved Drugs Initiative in 2006, the FDA has removed ~1,500 unapproved products from the market and has worked with firms to bring other unapproved drugs into the approval process. The FDA remains committed to its mission of ensuring that safe and effective drugs are available to American consumers. PMID:21813527

Ostroff, Craig; Lee, Charles E; McMeekin, Judith

2011-08-01

395

Prescription drug communication strategies: A comparative analysis of physician attitudes in Europe, the Middle East, and the Far East  

Microsoft Academic Search

Research into direct-to-consumer (DTC) advertising of prescription drugs is extensive in individualistic cultures. In contrast, using Hofstede's classification to select representative collectivist countries in high potential regions and conducting surveys of 308 physicians in Greece, the United Arab Emirates, and Taiwan, this research investigates physician attitudes towards the value of drug manufacturers' physician- and consumer-targeted communication strategies. The analysis reveals

Jon D. Reast; Adam Lindgreen; Dayananda Palihawadana; Graham Spickett-Jones; Bradley R. Barnes

2011-01-01

396

Tricyclic antidepressant overdose: an unusual method of administration  

PubMed Central

Drug poisoning as a result of tricyclic antidepressant overdose is frequently encountered in emergency departments and is a significant cause of mortality and morbidity. The usual route of administration is oral. Here we report the case of a 42-year-old man with a history of depression who had taken a large overdose of amitriptyline by the rectal route. This case highlights the management difficulties that arose as a result of rectal administration of the drug and possible ways in which treatment should differ from that of an oral overdose.

Barton, Marc; Harris, Dan

2010-01-01

397

Identification of potential drug-drug interactions between antiretroviral drugs from prescriptions in the private health-care sector in South Africa.  

PubMed

The aim of this study was to identify potential drug-drug interactions (DDIs) between antiretroviral drugs (ARVs) and to determine whether prescribed daily doses (PDDs) from prescriptions can be used in the evaluation of these interactions. A quantitative, retrospective drug utilization study was performed on 49,995 and 81,096 ARV prescriptions from a South African pharmacy benefit management company, which were prescribed to 7664 and 10,162 HIV patients for 2005 and 2006, respectively. Potential DDIs identified across different age groups were 778 for 2005 and 1155 for 2006; the majority occurred in patients aged 19 to ?45 years. The potential DDIs identified between ARVs were all interacting at clinical significance level 2 according to guidelines indicated by Tatro. These results demonstrate that potential DDIs were identified between ARVs mostly in three ARV combinations: Kaletra(®) (lopinavir/ritonavir) and efavirenz, lopinavir/ritonavir and nevirapine and combinations of indinavir and ritonavir. There is a need for more education on the prescribing protocols for ARVs in the treatment of HIV-infected patients in the private health-care sector in South Africa. PMID:22581868

Katende-Kyenda, N L; Lubbe, M S; Serfontein, J H P; Truter, I

2012-03-01

398

Predicting risk in patients with acetaminophen overdose  

PubMed Central

Acetaminophen (APAP) overdose is a very common cause of drug overdose and acute liver failure in the US and Europe. Mechanism-based biomarkers of APAP toxicity have the potential to improve the clinical management of patients with large dose ingestions of APAP. The current approach to the management of APAP toxicity is limited by imprecise and time-constrained risk assessments and late-stage markers of liver injury. A recent study of “low-risk” APAP overdose patients who all received treatment with N-acetylcysteine, found that cell-death biomarkers were more sensitive than alanine aminotransferase (ALT) and APAP concentrations in predicting the development of acute liver injury. The data suggest a potential role for new biomarkers to identify “low risk” patients following APAP overdose. However, a practical and ethical consideration that complicates predictive biomarker research in this area is the clinical need to deliver antidote treatment within 10 hours of APAP overdose. The treatment effect and time-dependent nature of N-acetylcysteine treatment must be considered in future “predictive” toxicology studies of APAP-induced liver injury. PMID:23984999

James, Laura P.; Gill, Prit; Simpson, Pippa

2014-01-01

399

Predicting risk in patients with acetaminophen overdose.  

PubMed

Acetaminophen (APAP) overdose is a very common cause of drug overdose and acute liver failure in the US and Europe. Mechanism-based biomarkers of APAP toxicity have the potential to improve the clinical management of patients with large-dose ingestions of APAP. The current approach to the management of APAP toxicity is limited by imprecise and time-constrained risk assessments and late-stage markers of liver injury. A recent study of 'low-risk' APAP overdose patients who all received treatment with N-acetylcysteine found that cell death biomarkers were more sensitive than alanine aminotransferase (ALT) and APAP concentrations in predicting the development of acute liver injury. The data suggest a potential role for new biomarkers to identify 'low-risk' patients following APAP overdose. However, a practical and ethical consideration that complicates predictive biomarker research in this area is the clinical need to deliver antidote treatment within 10 h of APAP overdose. The treatment effect and time-dependent nature of N-acetylcysteine treatment must be considered in future 'predictive' toxicology studies of APAP-induced liver injury. PMID:23984999

James, Laura P; Gill, Prit; Simpson, Pippa

2013-08-01

400

Prescription trends of immunosuppressive drugs in post-heart transplant recipients in Taiwan, 2000–2009  

PubMed Central

Purpose Significantly increasing heart transplantations have been performed in Taiwan in the past decades, but the trends of maintenance immunosuppression for heart transplant recipients have not been well known. In this study, we aimed to explore the trends of maintenance immunosuppressive therapy and common complications for heart transplant recipients. Methods We retrospectively analyzed ambulatory prescriptions in 488 heart transplant recipients for the period 2000–2009. Patient complications after heart transplantation were also identified. Results The annual number of new heart transplant recipients ranged from 18 to 68. The 5-year survival rate was 77.9%. The total number of regimens was 10 in 2000, and increased to 28 in 2009. Most prescriptions were immunosuppressive combinations (95.5%–89.5%). The majority of immunosuppressive regimens were a triple regimen: cyclosporine, mycophenolic acid and corticosteroid in 2009. Cyclosporine was a predominant calcineurin inhibitor with a decreasing trend from 73.9% to 59.1%, whereas the use of tacrolimus significantly increased from 11.9% to 38.4%. Mycophenolic acid was the most frequently used antimetabolite (60.1%–80.3%), while the use of azathioprine was reduced (21.6%–2.3%). From 2008, the launch of everolimus initiated a new era in the utilization of mammalian target of rapamycin inhibitors for maintenance immunosuppression. Conclusions Cyclosporine remained the most frequently used calcineurin inhibitors, and tacrolimus increased gradually. Mycophenolic acid was the most popular antimetabolite rather than azathioprine. The rapidly increased everolimus combined regimen may change the patterns of maintenance immunosuppression. The increasing number of combination therapies indicates an active role of everolimus and a tendency of complex tailored individual therapies. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. PMID:25335855

Chou, Chia-Lin; Chou, Chia-Yu; Huang, Ying-Yu; Wu, Min-Shan; Hsu, Chia-Chen; Chou, Yueh-Ching

2014-01-01

401

Study of prescription of injectable drugs and intravenous fluids to inpatients in a teaching hospital in Western Nepal  

PubMed Central

Unnecessary, excessive and poor injection practices in the South East Asia region (including Nepal) have been observed previously. The authors aim to study prescription of injectable drugs to inpatients in a teaching hospital in Western Nepal. Prescription of injectable drugs (IDs) and intravenous fluids (IVFs) to inpatients discharged from the wards of the Manipal Teaching Hospital during 1st January to 30th June 2006 was studied. The mean number of drugs, IDs and IVFs administered, median cost of drugs and of IDs/IVFs per prescription calculated. Comparison of ID/IVF use in the four major hospital departments (Medicine, Obstetrics and Gynecology, Pediatrics and Surgery) was done. The administration of IDs/IVFs and injectable antimicrobials were measured in Defined Daily Dose (DDD)/100 bed-days and of Intravenous fluid in Liters (L)/100 bed-days. Of the 1131 patients discharged, 938 (82.94%) patients received one or more IDs/IVFs. The mean number of drugs, IDs and IVFs prescribed were 8.75, 4.72 and 1.42. Median cost of drugs and IDs/IVFs per prescription were 8.26US$ and 5.12US$ respectively. IDs/IVFs accounted for 81.37% of total drug cost. The most commonly used ID, injectable antimicrobial and IVF were Diclofenac (19.3 DDD/100 bed-days), Metronidazole (7.68 DDD/100 bed-days) and Dextrose normal saline (8.56 L/100 bed-days), respectively. The total IVF consumption was 24.25 L/100 bed-days. Significant differences between departments were observed (p<0.05). In conclusion, the use of IDs/IVFs was higher compared to other studies. Interventions to improve IDs/IVFs prescribing practices may be required. PMID:19753281

Gyawali, Sudesh; Shankar, P Ravi; Saha, Archana; Mohan, Lalit

2009-01-01

402

Longitudinal Effects of Universal Preventive Intervention on Prescription Drug Misuse: Three Randomized Controlled Trials With Late Adolescents and Young Adults  

PubMed Central

Objectives. We examined long-term prescription drug misuse outcomes in 3 randomized controlled trials evaluating brief universal preventive interventions conducted during middle school. Methods. In 3 studies, we tested the Iowa Strengthening Families Program (ISFP); evaluated a revised ISFP, the Strengthening Families Program: For Parents and Youth 10–14 plus the school-based Life Skills Training (SFP 10–14 + LST); and examined the SFP 10–14 plus 1 of 3 school-based interventions. Self-reported outcomes were prescription opioid misuse (POM) and lifetime prescription drug misuse overall (PDMO). Results. In study 1, ISFP showed significant effects on POM and PDMO, relative reduction rates (RRRs; age 25 years) of 65%, and comparable benefits for higher- and lower-risk subgroups. In study 2, SFP 10–14 + LST showed significant or marginally significant effects on POM and PDMO across all ages (21, 22, and 25 years); higher-risk participants showed stronger effects (RRRs?=?32%–79%). In study 3, we found significant results for POM and PDMO (12th grade RRRs?=?20%–21%); higher-risk and lower-risk participants showed comparable outcomes. Conclusions. Brief universal interventions have potential for public health impact by reducing prescription drug misuse among adolescents and young adults. PMID:23409883

Trudeau, Linda; Shin, Chungyeol; Ralston, Ekaterina; Redmond, Cleve; Greenberg, Mark; Feinberg, Mark

2013-01-01

403

Prescription Drug Misuse and Sexual Risk Behaviors Among Adolescents and Emerging Adults  

PubMed Central

Objective: The purpose of this study was to evaluate associations between prescription drug misuse (PDM) and sexual risk behaviors (SRBs) among adolescents and emerging adults. Method: In a hospital emergency department, 2,127 sexually active 14- to 20-year-olds (61% female) reported on past-year alcohol use severity (using the Alcohol Use Disorders Identification Test–consumption [AUDIT-C]), cannabis use, PDM (n = 422), and SRBs (inconsistent condom use, multiple partners, intercourse following alcohol/other drug use). Results: Bivariately, AUDIT-C score, cannabis use, and PDM of stimulants, opioids, and sedatives were positively associated with each SRB. Because many participants reported PDM for multiple drug classes (i.e., sedatives, stimulants, opioids), participants were categorized as (a) no PDM (n = 1,705), (b) PDM of one class (n = 251), (c) PDM of two classes (n = 90), or (d) PDM of three classes (n = 81). Three hierarchical logistic regression models evaluated the associations of number of classes of PDM with SRBs separately, after accounting for demographics (age, gender, race), AUDIT-C score, and cannabis use. Adding PDM statistically improved each model beyond what was accounted for by demographics, alcohol, and cannabis use. For inconsistent condom use and substance use before sex, PDM of one, two, or three classes was significantly associated with increased odds of these SRBs. PDM of two or three classes was associated with increased odds of reporting multiple partners. Conclusions: Findings suggest that PDM, especially poly-PDM, may be a pertinent risk factor for SRBs among youth. Event-based research could further evaluate how PDM, as well as other substance use, is related to SRBs at the event level in order to inform interventions. PMID:24650820

Bonar, Erin E; Cunningham, Rebecca M; Chermack, Stephen T; Blow, Frederic C; Barry, Kristen L; Booth, Brenda M; Walton, Maureen A

2014-01-01

404

Gender bias in clinical research, pharmaceutical marketing, and the prescription of drugs  

PubMed Central

This thesis is part of the studies of gender bias in health which together with the paradigm of evidence-based medicine shares the empirical assumption that there are inaccuracies in medical practice, in addition to a lack of rigour and transparency. It worked with the distinction between the concepts of sex and gender and between the concepts of sex-related differences and gender inequalities, in terms of applying a gender perspective in the study design and the subsequent analysis. This PhD review presents the research process conducted in Spain, which can provide an example for future research. Study I described a review of 58 clinical trials (CTs) of etoricoxib to assess its compliance with the Recommendations of Evaluation of Gender Differences in the Clinical Evaluation of Drugs. In Study II, key informants from professions related to different areas in drug development and pharmacovigilance held a working meeting to reach a consensus document on recommendations for the study and evaluation of gender differences in CTs in Spain. In Study III, the websites of the eight best-selling hormone replacement therapy drugs in Spain on Google first page of results were analysed. In Study IV, a logistic regression analysis was performed to compare analgesic prescription by sex in regions with a higher or lower Gender Development Index (GDI) than the Spanish average. Gender biases identified in this thesis limited the legitimacy of medicine, which is not based on the best possible evidence. The results also demonstrate the existence of inequalities between men and women that are not due merely to biological differences, but are gender inequalities stemming from the social differences that exist between both sexes. PMID:25498360

Chilet-Rosell, Elisa

2014-01-01

405

What Matters Most? Assessing the Influence of Demographic Characteristics, College-Specific Risk Factors, and Poly-Drug Use on Nonmedical Prescription Drug Use  

ERIC Educational Resources Information Center

Objective: Although prior recent research has revealed a significant relationship between the nonmedical use of prescription drugs, demographic characteristics, college-specific risk factors, and other substance use among college students, there remains a need to conduct a comparative analysis on the differential impact these factors may have on…

Lanier, Christina; Farley, Erin J.

2011-01-01

406

Pill-poppers and dopers: A comparison of non-medical prescription drug use and illicit\\/street drug use among college students  

Microsoft Academic Search

Data from the 2001 College Alcohol Study, a national sample of U.S. college students, were used to conduct multinomial logistic regression analysis examining correlates of substance use. Students were divided into three groups based on their lifetime substance use: non-users, non-medical prescription drug use only, and illicit\\/street drug use only. The purpose of this analytic strategy was to examine the

Jason A. Ford; Meagan C. Arrastia

2008-01-01

407

Who Enrolls in the Medicare Part D Prescription Drug Benefit Program? Medication Use Among Patients With Heart Failure  

PubMed Central

Background Dispensing data from Medicare Part D standalone prescription drug plans are now available, but characteristics of enrollees with heart failure have not been well described. Methods and Results We identified 81 874 patients with prevalent heart failure as of January 1, 2010, in a nationally representative 5% sample of Medicare beneficiaries. We classified patients according to enrollment in a Medicare Part D plan as of January 1, 2010. Demographic characteristics, comorbid conditions, and prescriptions were compared by enrollment status. A total of 49 252 (60.2%) were enrolled in a Medicare Part D plan as of January 1. Enrollees were more often women, black, and of lower socioeconomic status. Enrollees with heart failure more often filled prescriptions for loop diuretics than angiotensin?converting enzyme inhibitors or angiotensin receptor blockers, ??blockers, or aldosterone antagonists. During the first 4 months of 2010, 5444 (12.3%) reached the coverage gap, and 566 (1.3%) required catastrophic coverage beyond the gap. Conclusions Medicare beneficiaries with heart failure differ significantly according to enrollment in Part D prescription drug plans and represent a population underrepresented in clinical efficacy trials. Many face the coverage gap, and few select Medicare Part D plans that provide coverage during the gap. Linking Medicare Part D event data with clinical registries could help to determine whether eligible enrollees are undertreated for heart failure. PMID:24025363

Eapen, Zubin J.; Hammill, Bradley G.; Setoguchi, Soko; Schulman, Kevin A.; Peterson, Eric D.; Hernandez, Adrian F.; Curtis, Lesley H.

2013-01-01

408

Preventing death among the recently incarcerated: an argument for naloxone prescription before release.  

PubMed

Death from opiate overdose is a tremendous source of mortality, with a heightened risk in the weeks following incarceration. The goal of this study is to assess overdose experience and response among long-term opiate users involved in the criminal justice system. One hundred thirty-seven subjects from a project linking opiate-dependent individuals being released from prison with methadone maintenance programs were asked 73 questions regarding overdose. Most had experienced and witnessed multiple overdoses; 911 was often not called. The majority of personal overdoses occurred within 1 month of having been institutionalized. Nearly all participants expressed an interest in being trained in overdose prevention with Naloxone. The risk of death from overdose is greatly increased in the weeks following release from prison. A pre-release program of overdose prevention education, including Naloxone prescription, for inmates with a history of opiate addiction would likely prevent many overdose deaths. PMID:19340674

Wakeman, Sarah E; Bowman, Sarah E; McKenzie, Michelle; Jeronimo, Alexandra; Rich, Josiah D

2009-01-01

409

Digital social media, youth, and nonmedical use of prescription drugs: the need for reform.  

PubMed

The tragic death of 18-year-old Ryan Haight highlighted the ethical, public health, and youth patient safety concerns posed by illicit online nonmedical use of prescription drugs (NUPM) sourcing, leading to a federal law in an effort to address this concern. Yet despite the tragedy and resulting law, the NUPM epidemic in the United States has continued to escalate and represents a dangerous and growing trend among youth and adolescents. A critical point of access associated with youth NUPM is the Internet. Internet use among this vulnerable patient group is ubiquitous and includes new, emerging, and rapidly developing technologies-particularly social media networking (eg, Facebook and Twitter). These unregulated technologies may pose a potential risk for enabling youth NUPM behavior. In order to address limitations of current regulations and promote online safety, we advocate for legislative reform to specifically address NUPM promotion via social media and other new online platforms. Using more comprehensive and modernized federal legislation that anticipates future online developments is critical in substantively addressing youth NUPM behavior occurring through the Internet. PMID:23892156

Mackey, Tim K; Liang, Bryan A; Strathdee, Steffanie A

2013-01-01

410

Digital Social Media, Youth, and Nonmedical Use of Prescription Drugs: The Need for Reform  

PubMed Central

The tragic death of 18-year-old Ryan Haight highlighted the ethical, public health, and youth patient safety concerns posed by illicit online nonmedical use of prescription drugs (NUPM) sourcing, leading to a federal law in an effort to address this concern. Yet despite the tragedy and resulting law, the NUPM epidemic in the United States has continued to escalate and represents a dangerous and growing trend among youth and adolescents. A critical point of access associated with youth NUPM is the Internet. Internet use among this vulnerable patient group is ubiquitous and includes new, emerging, and rapidly developing technologies—particularly social media networking (eg, Facebook and Twitter). These unregulated technologies may pose a potential risk for enabling youth NUPM behavior. In order to address limitations of current regulations and promote online safety, we advocate for legislative reform to specifically address NUPM promotion via social media and other new online platforms. Using more comprehensive and modernized federal legislation that anticipates future online developments is critical in substantively addressing youth NUPM behavior occurring through the Internet. PMID:23892156

Liang, Bryan A; Strathdee, Steffanie A

2013-01-01

411

Predictors of $4 Generic Prescription Drug Discount Programs use in the Low-income Population  

PubMed Central

Background Generic drug discount programs (GDDPs) are an option to provide affordable prescription medication to low-income individuals. However, the factors that influence the use of GDDPs in low-income population are unknown. Objectives To evaluate factors associated with utilization of generic a drug discount program in a low-income population. Methods A survey was administered to adult participants at health centers and community based organizations in Houston, Texas, USA (n=525). Exploratory factor analysis was conducted to determine the construct validity of the survey instrument and to assess distinct factors associated with GDDP utilization. Descriptive statistics were used to summarize the distribution of patient socio-demographic characteristics and questionnaire responses. Multivariate logistic regression was used to compute adjusted odds ratios and to examine the strength of association with GDDP utilization after adjusting for participant socio-demographic features that were statistically significant at a priori level of p<0.05. Results In this study, 72% of respondents were aware of the GDDP, and 61% had utilized the GDDP. Participants were 4 times likely to use a GDDP when their physician (AOR: 4.0, 95% CI: 2.6 – 6.4, P < 0.001) or pharmacist (AOR: 4.0, 95% CI: 2.6 – 6.3, P < 0.001) talked to them about it. Participants indicated that the most important barriers to utilization of GDDPs were lack of awareness (44%), and lack of recommendation by a physician (19%). Conclusions Increased patient awareness and physician recommendation may increase the use of GDDPs, which may lead to improved compliance with medications, better health outcomes and reduced health care costs. PMID:23684716

Hernandez, Mike; Sansgiry, Sujit; Paxton, Raheem; Jones, Lovell

2013-01-01

412

Data for drugs available through low-cost prescription drug programs are available through pharmacy benefit manager and claims data  

PubMed Central

Background Observational data are increasingly being used for pharmacoepidemiological, health services and clinical effectiveness research. Since pharmacies first introduced low-cost prescription programs (LCPP), researchers have worried that data about the medications provided through these programs might not be available in observational data derived from administrative sources, such as payer claims or pharmacy benefit management (PBM) company transactions. Method We used data from the Indiana Network for Patient Care to estimate the proportion of patients with type 2 diabetes to whom an oral hypoglycemic agent was dispensed. Based on these estimates, we compared the proportions of patients who received medications from chains that do and do not offer an LCPP, the proportion trend over time based on claims data from a single payer, and to proportions estimated from the Medical Expenditure Panel Survey (MEPS). Results We found that the proportion of patients with type 2 diabetes who received oral hypoglycemic medications did not vary based on whether the chain that dispensed the drug offered an LCPP or over time. Additionally, the rates were comparable to those estimated from MEPS. Conclusion Researchers can be reassured that data for medications available through LCPPs continue to be available through administrative data sources. PMID:22726249

2012-01-01

413

Exploring the use of pharmaceutical patient assistance programs as an option to improve access to and affordability of prescription drugs  

Microsoft Academic Search

Background. Pharmaceutical-sponsored patient assistance programs (PAPs) are charity programs that provide free or reduced-priced medications to eligible patients. PAPs have the potential to improve prescription drug accessibility for patients but currently there is limited information about their use and effectiveness. ^ Objectives and methods. This dissertation described the use of PAPs in the U.S. through the conduct of two studies:

Tisha Moniek Felder

2010-01-01

414

PTSD, Depression, Prescription Drug Use, and Health Care Utilization of Chinese Workers Affected by the WTC Attacks  

Microsoft Academic Search

This study assessed the impact of the World Trade Center (WTC) attacks on emotional problems, prescription drug usage, and\\u000a utilization of medical and mental health services within the Chinese community in lower Manhattan. We administered a survey\\u000a to 148 randomly selected Chinese workers affected by the WTC attacks in March 2003. Although nearly half of the respondents\\u000a had elevated PTSD

Heike Thiel de Bocanegra; Sophia Moskalenko; Elizabeth J. Kramer

2006-01-01

415

Successful treatment of massive carbamazepine overdose.  

PubMed

Overdose of carbamazepine (CBZ) can be fatal. We report the case of a patient with near-lethal toxicity due to delayed absorption of drug. A 36-year-old woman was admitted with coma, hypotension, and unusual movements. Carbamazepine (CBZ) level several hours later was 36 mg/L. Gastric lavage revealed no pill fragments, and activated charcoal was administered. CBZ level initially fell, reaching 28 mg/L 36 h after admission. Blood level then rose sharply, reaching 54 mg/L 64 h after admission. The pattern of rise suggested renewed absorption of drug. Vigorous cathartics were given, and further doses of charcoal were administered. Three hours after onset of diarrhea, roving eye movements occurred. Two hours later she grimaced to pain. Eight hours after the onset of diarrhea, she was awake. In CBZ overdose, activated charcoal therapy coupled with aggressive intestinal purging helps prevent continued absorption of drug, late exacerbation of symptoms, and potentially fatal outcome. PMID:2912721

Sethna, M; Solomon, G; Cedarbaum, J; Kutt, H

1989-01-01

416

Butyrfentanyl overdose resulting in diffuse alveolar hemorrhage.  

PubMed

Butyrfentanyl is a potent short-acting opioid and a fentanyl analog with uncertain clinical effects. A review of the literature reveals no human case reports of butyrfentanyl overdose. As the use of analog and synthetic drugs continues to increase, clinicians are often faced with tremendous uncertainty when they encounter patients exposed to these synthetic drugs. We describe, to our knowledge, the first case of a butyrfentanyl overdose that resulted in clinically significant hemoptysis, acute lung injury, hypoxic respiratory failure, and diffuse alveolar hemorrhage. Complicating this case was a false-positive urine drug screen for fentanyl. Clinicians who encounter fentanyl exposures should be aware they may in fact be dealing with butyrfentanyl. As little is known of butyrfentanyl and our patient suffered a significant pulmonary hemorrhage, those who encounter butyrfentanyl exposures should monitor for hemorrhagic complications. PMID:25713275

Cole, Jon B; Dunbar, John F; McIntire, Sarah A; Regelmann, Warren E; Slusher, Tina M

2015-03-01

417

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2012 CFR

...101 Amphetamine and methamphetamine inhalers regarded as prescription...reports of abuse and misuse of methamphetamine (also known as desoxyephedrine...potentiality for harmful effect and that they should...are being removed and the methamphetamine they contain is...

2012-04-01

418

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2010 CFR

...101 Amphetamine and methamphetamine inhalers regarded as prescription...reports of abuse and misuse of methamphetamine (also known as desoxyephedrine...potentiality for harmful effect and that they should...are being removed and the methamphetamine they contain is...

2010-04-01

419

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2014 CFR

...101 Amphetamine and methamphetamine inhalers regarded as prescription...reports of abuse and misuse of methamphetamine (also known as desoxyephedrine...potentiality for harmful effect and that they should...are being removed and the methamphetamine they contain is...

2014-04-01

420

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2011 CFR

...101 Amphetamine and methamphetamine inhalers regarded as prescription...reports of abuse and misuse of methamphetamine (also known as desoxyephedrine...potentiality for harmful effect and that they should...are being removed and the methamphetamine they contain is...

2011-04-01

421

Getting Medical Care and Prescription Drugs in a Disaster or Emergency Area  

MedlinePLUS

... an out-of-network pharmacy. Using in-network pharmacies • You’ll be able to move most prescriptions ... 1-877-486-2048. Using out-of-network pharmacies • Contact your plan for information about their out- ...

422

Costs and Benefits of Elderly Prescription Drug Coverage: Evidence from Veterans’ Health Care  

Microsoft Academic Search

This study tests the impact of a public prescription benefit on Medicare-eligible veterans, utilizing a mid-1990s benefit change in the VA health care system. Using data from the Medicare Current Beneficiary Survey, I compare prescription spending and utilization, as well as use of other health services and health outcomes for veterans and non-veterans before and after the VA insurance change.

Melissa Boyle

2008-01-01

423

The instrumental role of product information: a study of warning labels for non-prescription drugs.  

PubMed

The study extends work in informative labeling, fear appeals, and negative information effects. Respondents were given two labels from two packages, one of which contained the experimental treatment. Warning strength was manipulated at three levels: weak, medium, and strong. The data show that, unlike labels on prescription medications, non-prescription warning labels tend to discourage use of the product. Results have implications for information theorists, marketers, and public policy makers. PMID:10124787

Discenza, R; Ferguson, J M

1992-01-01

424

Characteristics of inmates witnessing overdose events in prison: implications for prevention in the correctional setting  

PubMed Central

Background Although prevention of opiate overdose has been gaining attention as a harm reduction measure with community drug users, there is scarce information about drug overdose in prison. In correctional institutions without a drug free environment, awareness of overdose events is an important public health concern. This study explores the frequency with which inmates in a state penitentiary system report having witnessed drug overdose events in prison. It also explores whether participants who have witnessed an overdose in prison and know someone who died from an overdose in prison significantly differ from those that do not in selected sociodemographic variables and drug use history to identify a target population for prevention interventions. Methods Data comes from a cross-sectional survey of sentenced inmates in the state prisons of Puerto Rico. A complex probabilistic, multistage sampling design was used. A total of 1,179 individuals participated for an 89% response rate. Results Factors associated with witnessing an overdose event in prison include: male sex, age 25 or older, drug use during current incarceration, and drug injection in prison. Factors associated with knowing someone who died from an overdose in prison include: male sex, age between 25–35, previous incarcerations, and drug use during current incarceration. Conclusion Witnessing a drug overdose is a frequent occurrence within the prison system. The likelihood of witnessing an overdose is greater with being male, polydrug use and drug injection in prison. Findings signal an urgent public health challenge that requires prompt interventions to reduce this drug related harm within the correctional system, including adequate access to medication with opiate agonists. PMID:19589157

Albizu-García, Carmen E; Hernández-Viver, Adriana; Feal, Jacqueline; Rodríguez-Orengo, José F

2009-01-01

425

Seniors' perceptions of prescription drug advertisements: A pilot study of the potential impact on informed decision making  

PubMed Central

Objective To conduct a pilot study exploring seniors' perceptions of direct-to-consumer advertising (DTCA) of prescription drugs and how the advertisements might prepare them for making informed decisions with their physicians. Methods We interviewed 15 seniors (ages 63-82) individually after they each watched nine prescription drug advertisements recorded from broadcast television. Grounded Theory methods were used to identify core themes related to the research questions. Results Four themes emerged from the interviews about DTCA: (1) awareness of medications was increased, (2) information was missing or misleading and drugs were often perceived as more effective than clinical evidence would suggest, (3) most seniors were more strongly influenced by personal or vicarious experience with a drug – and by their physician – than by DTCA, and (4) most seniors were circumspect about the information in commercial DTCA. Conclusions DTCA may have some limited benefit for informed decision making by seniors, but the advertisements do not provide enough detailed information and some information is misinterpreted. Practical Implications Physicians should be aware that many patients may misunderstand DTCA, and that a certain amount of time may be required during consultations to correct these misconceptions until better advertising methods are employed by the pharmaceutical industry. PMID:21044826

Grenard, Jerry L.; Uy, Vsith; Pagán, José A.; Frosch, Dominick L.

2014-01-01

426

76 FR 1182 - Determination of System Attributes for the Tracking and Tracing of Prescription Drugs; Public...  

Federal Register 2010, 2011, 2012, 2013, 2014

...products in the supply chain plays a significant...accountability in the drug supply chain. On September 27, 2007, the Food and Drug Administration...505D of the Federal Food, Drug, and Cosmetic...securing the drug supply chain against...

2011-01-07

427

AnIndependentMemberoftheBlueShieldAssociation Note: This plan's prescription drug coverage is on average equivalent to or better than the standard benefit set by the federal government for Medicare Part D (also called  

E-print Network

Shield of California Highlight: $0 Calendar-Year Brand-Name Drug Deductible $10 Formulary Generic/$30 Formulary Brand Name/$30 Non-Formulary Brand Name Drug - Retail Pharmacy $20 Formulary Generic/$60 Formulary supply) Formulary generic drugs $10 per prescription $10 per prescription Formulary brand name drugs $30

Ford, James

428

Trust in online prescription drug information among internet users: the impact on information search behavior after exposure to direct-to-consumer advertising.  

PubMed

The proliferation of both manufacturer-controlled and independent medication-related websites has aroused concern among consumers and policy-makers concerning the trustworthiness of Web-based drug information. The authors examine consumers' trust in on-line prescription drug information and its influence on information search behavior. The study design involves a retrospective analysis of data from a 1998 national survey. The findings reveal that trust in drug information from traditional media sources such as television and newspapers transfers to the domain of the Internet. Furthermore, a greater trust in on-line prescription drug information stimulates utilization of the Internet for information search after exposure to prescription drug advertising. PMID:12749596

Menon, Ajit M; Deshpande, Aparna D; Perri, Matthew; Zinkhan, George M

2002-01-01

429

Can gender difference in prescription drug use be explained by gender-related morbidity?: a study on a Swedish population during 2006  

PubMed Central

Background It has been reported that there is a difference in drug prescription between males and females. Even after adjustment for multi-morbidity, females tend to use more prescription drugs compared to males. In this study, we wanted to analyse whether the gender difference in drug treatment could be explained by gender-related morbidity. Methods Data was collected on all individuals 20 years and older in the county of Östergötland in Sweden. The Johns Hopkins ACG Case-Mix System was used to calculate individual level of multi-morbidity. A report from the Swedish National Institute of Public Health using the WHO term DALY was the basis for gender-related morbidity. Prescription drugs used to treat diseases that mainly affect females were excluded from the analyses. Results The odds of having prescription drugs for males, compared to females, increased from 0.45 (95% confidence interval (CI) 0.44-0.46) to 0.82 (95% CI 0.81-0.83) after exclusion of prescription drugs that are used to treat diseases that mainly affect females. Conclusion Gender-related morbidity and the use of anti-conception drugs may explain a large part of the difference in prescription drug use between males and females but still there remains a difference between the genders at 18%. This implicates that it is of importance to take the gender-related morbidity into consideration, and to exclude anti-conception drugs, when performing studies regarding difference in drug use between the genders. PMID:24713023

2014-01-01

430

Timely antemortem and postmortem concentrations in a fatal carbamazepine overdose.  

PubMed

There are no published reports that include both timely antemortem and postmortem carbamazepine concentrations after massive overdose. We report a fatal overdose of carbamazepine with both timely antemortem and postmortem carbamazepine concentrations. Carbamazepine concentrations were 47.7 mcg/mL 2 h antemortem and 53 mcg/mL at 9 h postmortem. The slight rise in drug concentration may reflect continued absorption of the drug in the last 2 h before death. Postmortem carbamazepine concentrations drawn from a peripheral vessel in this patient appeared to reflect drug concentrations at the time of death. PMID:11714170

Spiller, H A; Carlisle, R D

2001-11-01

431

Medicare Part D and Changes in Prescription Drug Use and Cost Burden: National Estimates for the Medicare Population, 2000–2007  

PubMed Central

Context The full effect of Medicare Part D, after the initial policy transition period and across the U.S. Medicare population, remains unclear. Objective To estimate nationally-representative changes in prescription drug use and out-of-pocket drug costs two years after implementation of Part D. Design, Setting, and Participants We examined study outcomes over 8 years (2000–2008) and estimated changes after Part D, accounting for prior trends. Our analyses used the community-dwelling sample of the Medicare Current Beneficiary Survey (unweighted unique n=38,798). Actual post-Part D outcomes were compared to projected values using 2000–2005 data. Subgroup analyses and standardization weights were used to address population-level shifts over time in health status and demographic characteristics. Main Outcome Measures Annual prescription drug fills and out-of-pocket drug costs. Results We observed significant average per person increases of 1.8 prescription fills (95% confidence interval [CI]: 1.1, 2.5) in 2006 and 3.4 prescription fills (95% CI: 2.7, 4.1) in 2007 above pre-Part D increases of 0.9 prescription fills per year. Average out-of-pocket drug costs decreased significantly by $143 (95% CI:?182.5,?103.1) in 2006 and $148 (95% CI: ?181.2, ?114.1) in 2007 above average pre-Part D increases of $12 per year. Prescription fills did not change for beneficiaries with fair to poor health until 2007 when large increases occurred (increases of 3.7 to 11.0 fills above pre-Part D trends). Poor beneficiaries without Medicaid had no reductions in out-of-pocket drug costs in 2006 or 2007. Conclusion After the transition year of 2006, the impact of Part D appeared larger and more consistent across the Medicare population. Of note, sick and poor beneficiaries experienced significant improvements in prescription drug use in 2007. PMID:21544002

Briesacher, Becky A.; Zhao, Yanfang; Madden, Jeanne M.; Zhang, Fang; Adams, Alyce S.; Tjia, Jennifer; Ross-Degnan, Dennis; Gurwitz, Jerry H.; Soumerai, Stephen B.

2011-01-01

432

Poor Prescription: The Costs of Imprisoning Drug Offenders in the United States. Policy Report.  

ERIC Educational Resources Information Center

Using data from the National Corrections Reporting Program, this study examined trends in imprisoning drug offenders in the United States, focusing on the numbers of incarcerated drug offenders and the relationship between incarceration for drug use and rates of drug use. Overall, the increase in drug admissions to prison from 1986 to 1996 is…

Schiraldi, Vincent; Holman, Barry; Beatty, Phillip

433

Reducing risk for illicit drug use and prescription drug misuse: High school gay-straight alliances and lesbian, gay, bisexual, and transgender youth.  

PubMed

Previous research suggests that lesbian, gay, bisexual, and transgender (LGBT) youth are at elevated risk for using illicit drugs and misusing prescription drugs relative to heterosexual youth. Previous research also indicates that LGBT youth who attend high schools with a gay-straight alliance (GSA) report having fewer alcohol problems and lower levels of cigarette smoking. The present study investigates whether the absence of a GSA is associated with risk for illicit drug use and prescription drug misuse in a sample of 475 LGBT high school students (M age=16.79) who completed an online survey. After controlling for demographic variables and risk factors associated with illicit drug use, the results of 12 logistic regression analyses revealed that LGBT youth attending a high school without a GSA evidenced increased risk for using cocaine (adjusted odds ratio [adjOR]=3.11; 95% confidence interval [95% CI]=1.23-7.86), hallucinogens (adjOR=2.59; 95% CI=1.18-5.70), and marijuana (adjOR=2.22; 95% CI=1.37-3.59) relative to peers attending a high school with a GSA. Youth without a GSA also evidenced increased risk for the misuse of ADHD medication (adjOR=2.00; 95% CI=1.02-3.92) and prescription pain medication (adjOR=2.00; 95% CI=1.10-3.65). These findings extend the research base related to GSAs and further demonstrate the importance of providing LGBT youth with opportunities for socialization and support within the school setting. Important limitations of the present study are reviewed. PMID:24531638

Heck, Nicholas C; Livingston, Nicholas A; Flentje, Annesa; Oost, Kathryn; Stewart, Brandon T; Cochran, Bryan N

2014-04-01

434

Reducing Risk for Illicit Drug Use and Prescription Drug Misuse: High School Gay-Straight Alliances and Lesbian, Gay, Bisexual, and Transgender Youth  

PubMed Central

Previous research suggests that lesbian, gay, bisexual, and transgender youth are at elevated risk for using illicit drugs and misusing prescription drugs relative to heterosexual youth. Previous research also indicates that LGBT youth who attend high schools with GSAs report having fewer alcohol problems and lower levels of cigarette smoking. The present study investigates whether the absence of a GSAs is associated with risk for illicit drug use and prescription drug misuse in a sample of 475 LGBT high school students (M age = 16.79) who completed an online survey. After controlling for demographic variables and risk factors associated with illicit drug use, the results of 12 logistic regression analyses revealed that LGBT youth attending a high school without a GSA evidenced increased risk for using cocaine (adjusted odds ratio [adjOR] = 3.11; 95% confidence interval [95% CI] = 1.23–7.86), hallucinogens (adjOR = 2.59; 95% CI = 1.18–5.70), and marijuana (adjOR = 2.22; 95% CI = 1.37–3.59) relative to peers attending a high school with a GSA. Youth without a GSA also evidenced increased risk for the misuse of ADHD medication (adjOR = 2.00; 95% CI = 1.02–3.92), and prescription pain medication (adjOR = 2.00; 95% CI = 1.10–3.65). These findings extend the research base related to GSAs and further demonstrate the importance of providing LGBT youth with opportunities for socialization and support within the school setting. Important limitations of the present study are reviewed. PMID:24531638

Heck, Nicholas C.; Livingston, Nicholas A.; Flentje, Annesa; Oost, Kathryn; Stewart, Brandon T.; Cochran, Bryan N.

2014-01-01

435

76 FR 21431 - Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit...  

Federal Register 2010, 2011, 2012, 2013, 2014

...industry can transition to include generic drugs in the 7-day-or-less requirement...states, often excludes lower cost generic drugs, is frequently limited to a subset...identification of brand name versus generic drugs. A commenter questioned...

2011-04-15

436

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2013 CFR

...are not applicable drugs (as defined in...A) Equal to the generic gap coinsurance...that are applicable drugs under the Medicare...d). (iii) Generic gap coinsurance percentage...2006, $2 for a generic drug or preferred...

2013-10-01

437

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2011 CFR

...are not applicable drugs (as defined in...A) Equal to the generic gap coinsurance...that are applicable drugs under the Medicare...d). (iii) Generic gap coinsurance percentage...2006, $2 for a generic drug or preferred...

2011-10-01

438

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2014 CFR

...are not applicable drugs (as defined in...A) Equal to the generic gap coinsurance...that are applicable drugs under the Medicare...d). (iii) Generic gap coinsurance percentage...2006, $2 for a generic drug or preferred...

2014-10-01

439

76 FR 2691 - Prescription Drug Products Containing Acetaminophen; Actions To Reduce Liver Injury From...  

Federal Register 2010, 2011, 2012, 2013, 2014

...INFORMATION: I. Acetaminophen Drug Products and Liver Injury Acetaminophen is the generic name of a drug used in many over-the...requested that makers of generic propoxyphene-acetaminophen...propoxyphene-containing drug products can be...

2011-01-14

440

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2012 CFR

...are not applicable drugs (as defined in...A) Equal to the generic gap coinsurance...that are applicable drugs under the Medicare...d). (iii) Generic gap coinsurance percentage...2006, $2 for a generic drug or preferred...

2012-10-01

441

78 FR 78367 - Draft Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment  

Federal Register 2010, 2011, 2012, 2013, 2014

...applications, biologics license applications, and new drug applications under the PDUFA program as well as abbreviated new drug applications under the Generic Drug User Fee Act program and describes new...

2013-12-26

442

Licit prescription drug use in a Swedish population according to age, gender and socioeconomic status after adjusting for level of multi-morbidity  

PubMed Central

Background There is a great variability in licit prescription drug use in the population and among patients. Factors other than purely medical ones have proven to be of importance for the prescribing of licit drugs. For example, individuals with a high age, female gender and low socioeconomic status are more likely to use licit prescription drugs. However, these results have not been adjusted for multi-morbidity level. In this study we investigate the odds of using licit prescription drugs among individuals in the population and the rate of licit prescription drug use among patients depending on gender, age and socioeconomic status after adjustment for multi-morbidity level. Methods The study was carried out on the total population aged 20?years or older in Östergötland county with about 400 000 inhabitants in year 2006. The Johns Hopkins ACG Case-mix was used as a proxy for the individual level of multi-morbidity in the population to which we have related the odds ratio for individuals and incidence rate ratio (IRR) for patients of using licit prescription drugs, defined daily doses (DDDs) and total costs of licit prescription drugs after adjusting for age, gender and socioeconomic factors (educational and income level). Results After adjustment for multi-morbidity level male individuals had less than half the odds of using licit prescription drugs (OR 0.41 (95% CI 0.40-0.42)) compared to female individuals. Among the patients, males had higher total costs (IRR 1.14 (95% CI 1.13-1.15)). Individuals above 80?years had nine times the odds of using licit prescription drugs (OR 9.09 (95% CI 8.33-10.00)) despite adjustment for multi-morbidity. Patients in the highest education and income level had the lowest DDDs (IRR 0.78 (95% CI 0.76-0.80), IRR 0.73 (95% CI 0.71-0.74)) after adjustment for multi-morbidity level. Conclusions This paper shows that there is a great variability in licit prescription drug use associated with gender, age and socioeconomic status, which is not dependent on level of multi-morbidity. PMID:22846625

2012-01-01

443

Fair Balance? An Analysis of the Functional Equivalence of Risk and Benefit Information in Prescription Drug Direct-to-Consumer Television Advertising  

ERIC Educational Resources Information Center

Prescription drug direct-to-consumer advertising (DTCA) has been a subject of controversy in recent years. Though government regulations require equivalent prominence of risks and benefits, there is concern about the ability of consumers with limited health literacy to fully comprehend the risks and benefits associated with drug use. Evaluating…

Baird-Harris, Kay

2009-01-01

444

77 FR 22071 - Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit...  

Federal Register 2010, 2011, 2012, 2013, 2014

...coverage in the coverage gap for both generic drugs (beginning in 2011) and brand...for all covered brand-name and generic drugs and biological products after...Other Part D drugs, such as generic drugs (as defined in Sec....

2012-04-12

445

76 FR 63017 - Medicare Program; Proposed Changes to the Medicare Advantage and the Medicare Prescription Drug...  

Federal Register 2010, 2011, 2012, 2013, 2014

...coverage in the coverage gap for both generic drugs (beginning in 2011) and brand...for all covered brand-name and generic drugs and biological products will equal...Other Part D drugs, such as generic drugs (as defined in Sec....

2011-10-11

446

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...for actual costs for covered Part D drugs covered under the Part D plan above...Coinsurance for costs for covered Part D drugs above the initial coverage limit...Copayments. (1 ) In 2006, $2 for a generic drug or preferred drug that is a...

2010-10-01

447

AnIndependentMemberoftheBlueShieldAssociation Note: This plan's prescription drug coverage is on average equivalent to or better than the standard benefit set by the federal government for Medicare Part D (also called  

E-print Network

Highlight: $0 Calendar-Year Brand-Name Drug Deductible $10 Formulary Generic/$20 Formulary Brand Name/$20 Non-Formulary Brand Name Drug - Retail Pharmacy $20 Formulary Generic/$40 Formulary Brand Name/$40 Non a copayment of: Retail prescriptions (For up to a 30-day supply) Formulary generic drugs $10 per prescription

Ford, James

448

Valproate overdose: a comparative cohort study of self poisonings  

PubMed Central

Aims Based on individual case reports of massive overdoses, valproate is often regarded as having significant toxicity. This study aimed to describe the epidemiology of valproate poisoning and the spectrum of its clinical effects. Methods Consecutive valproate poisonings were identified and compared with other anticonvulsant overdoses and all other poisonings, from a prospective database of poisoning admissions presenting to a regional toxicology service. National prescription data for the same period were obtained. Results There were 79 patients with valproate poisoning from January 1991 to November 2001, 15 cases with valproate alone. Of the 15 cases, drowsiness occurred in two patients (both taking>200 mg kg?1), vomiting occurred in four and tachycardia in five. In patients co-ingesting other medications, moderate to severe effects were consistent with the co-ingestants. There was one death not directly related to valproate. One patient had metabolic acidosis and thrombocytopaenia consistent with severe valproate toxicity. Comparison of valproate, carbamazepine, phenytoin and control groups showed that length of stay for both phenytoin and carbamazepine was significantly longer than for valproate (P < 0.0001), and there was a significantly increased risk of intensive care unit admission for carbamazepine vs valproate (OR 2.73; 95% CI 1.22, 6.28; P = 0.015). Although valproate prescriptions increased over the 10 years, there was relatively greater increase in the incidence of valproate poisoning. The odds of a valproate overdose in 1992 compared with carbamazepine were 0.29 (95% CI 0.07, 1.28; P = 0.141), but in 2001 were 2.73 (95% CI 1.38, 5.39; P = 0.004). Conclusions Valproate causes mild toxicity in the majority of cases. Massive overdoses of greater than 400 mg kg?1 can cause severe toxicity, but these are uncommon. The older anticonvulsants phenytoin and carbamazepine remain a greater problem than valproate in overdose. PMID:12680889

Isbister, Geoffrey K; Balit, Corrine R; Whyte, Ian M; Dawson, Andrew

2003-01-01

449

The Effects of Direct-to-Consumer Advertising in the Prescription Drug Market  

Microsoft Academic Search

The year of 1997 witnessed an important regulatory change in direct-to-consumer (DTC) advertising of ethical drugs. For the first time, the Food and Drug Administration (FDA) permitted brand-specific DTC ads on TV without a \\

Toshiaki Iizuka; Ginger Z. Jin

450

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2010 CFR

...and Drug Administration's policy in administering the...Food and Drugs based on his evaluation of the appropriate National Academy of Sciences-National Research Council...Administration, based on evaluation of the NAS-NRC...

2010-04-01

451

3 CFR 13588 - Executive Order 13588 of October 31, 2011. Reducing Prescription Drug Shortages  

Code of Federal Regulations, 2012 CFR

...The affected medicines include cancer treatments, anesthesia drugs, and other drugs that are critical to the treatment and prevention of serious diseases...the use of sterile injectable cancer treatments has increased by...

2012-01-01

452

75 FR 71189 - Medicare Program; Proposed Changes to the Medicare Advantage and the Medicare Prescription Drug...  

Federal Register 2010, 2011, 2012, 2013, 2014

...postpone applying the requirement to generic drugs until a later date which we will...industry can transition to include generic drugs in the 7-day-or-less requirement...states, often excludes lower cost generic drugs, and is frequently limited...

2010-11-22

453

Physicians' Persistence and Its Implications for Their Response to Promotion of Prescription Drugs  

Microsoft Academic Search

Motivated by the medical literature findings that physicians are inertial, we seek to understand (1) whether physicians exhibit structural persistence in drug choice (structural persistence occurs when the drug chosen for a patient depends structurally on the drug previously prescribed by the physician to other patients) and (2) whether persistence, if present, is a physician-specific characteristic or a physician state

Ramkumar Janakiraman; Shantanu Dutta; Catarina Sismeiro; Philip Stern

2008-01-01

454

The Burden of Nephrotoxic Drug Prescriptions in Patients with Chronic Kidney Disease: A Retrospective Population-Based Study in Southern Italy  

PubMed Central

Background The use of nephrotoxic drugs can further worsening renal function in chronic kidney disease (CKD) patients. It is therefore imperative to explore prescribing practices that can negatively affect CKD patients. Aim To analyze the use of nephrotoxic drugs in CKD patients in a general population of Southern Italy during the years 2006–2011. Methods The general practice “Arianna” database contains data from 158,510 persons, registered with 123 general practitioners (GPs) of Caserta. CKD patients were identified searching: CKD-related ICD-9 CM codes among causes of hospitalization; CKD-relevant procedures undergone in hospital (e.g. dialysis); drug prescriptions issued for a CKD-related indication. A list of nephrotoxic drugs was compiled and validated by pharmacologists and nephrologists. The summary of product characteristics was used to classify drugs as ‘contraindicated’ or ‘to be used with caution’ in renal diseases. Frequency of nephrotoxic drug use, overall, by drug class and single compounds, by GPs within one year prior or after first CKD diagnosis and within one year after dialysis entry was calculated. Results Overall, 1,989 CKD patients and 112 dialysed patients were identified. Among CKD patients, 49.8% and 45.2% received at least one prescription for a contraindicated nephrotoxic drug within one year prior or after first CKD diagnosis, respectively. In detail, 1,119 CKD patients (56.3%) had at least one nonsteroidal anti-inflammatory drugs (NSAIDs) prescription between CKD diagnosis and end of follow-up. A large proportion of CKD patients (35.6%) were treated with NSAIDs for periods exceeding 90 days. Contraindicated nephrotoxic drugs were used commonly in CKD, with nimesulide (16.6%) and diclofenac (11.0%) being most frequently used. Conclusions Contraindicated nephrotoxic drugs were highly prescribed in CKD patients from a general population of Southern Italy. CKD diagnosis did not seem to reduce significantly the prescription of nephrotoxic drugs, which may increase the risk of preventable renal function deterioration. PMID:24558471

Ingrasciotta, Ylenia; Sultana, Janet; Giorgianni, Francesco; Caputi, Achille Patrizio; Arcoraci, Vincenzo; Tari, Daniele Ugo; Linguiti, Claudio; Perrotta, Margherita; Nucita, Andrea; Pellegrini, Fabio; Fontana, Andrea; Cavagna, Lorenzo; Santoro, Domenico; Trifirò, Gianluca

2014-01-01

455

Detoxication treatment for carbamazepine and lithium overdose.  

PubMed

This article reports detoxication treatments of a case of combined overdose of carbamazepine and lithium in a 38-year-old female with bipolar disorder. She was brought to the emergency unit after the family found her unresponsive and lying near empty packages for carbamazepine (corresponded to 7.7 g) and lithium carbonate (corresponded to 6.6 g) tablets. On admission, her blood pressure, heart rate and respiratory rate were 80/55 mmHg, 90 per minute and 13 per minute, respectively. Her GCS was 3 (E1, M1, V1). She received gastric lavage after intratracheal intubation, followed by administration of activated charcoal via gastric tube, and a large volume (800 ml/h) of lactate Ringer's solution by intravenous infusion. The serum levels of carbamazepine and lithium approximately 5 h after ingestion were 56.0 mug/ml and 3.56 mEq/l, respectively. The carbamazepine overdose was mainly treated by a 3 h charcoal hemoperfusion (CHP). The CHP treatment decreased serum carbamazepine levels by approximately 30-40% as compared with the levels simulated by Bayesian analysis using 1-point or 2-points serum level(s) (without detoxication treatment). For lithium overdose continuous infusion of Ringer's solution was effective, which increased serum sodium gradually and facilitated the elimination of lithium. In conclusion, the treatments with CHP and continuous infusion of Ringer's solution were considered to be effective for detoxification of carbamazepine and lithium overdose, respectively, when compared with those drug levels without detoxication treatment that simulated by Bayesian analysis method. PMID:18176069

Unei, Hiroko; Ikeda, Hiroaki; Murakami, Teruo; Tanigawa, Koichi; Kihira, Kenji

2008-01-01

456

Co-proxamol overdose is associated with a 10-fold excess mortality compared with other paracetamol combination analgesics  

PubMed Central

Aims To assess the relative toxicity of co-proxamol in overdose in comparison to the 2 other paracetamol-opioid combination products, co-codamol and co-dydramol. Methods Data collected over a 2-year period (July 2000–June 2002) was used to estimate the frequency of overdose and death for the three most popular paracetamol-opioid compound analgesics. Prescription data for Scotland and Edinburgh, the number of overdoses (derived from overdose admissions in Edinburgh) or Poisons Information Service contacts in Scotland, and national death records were used to calculate a series of indicators relating morbidity (admissions), surrogates of morbidity (poisons enquiries by telephone or internet) and mortality to prescriptions. Results When related to prescription volume overdoses involving co-proxamol in Scotland were 10 times more likely to be fatal (24.6 (19.7, 30.4)) when compared with co-codamol (2.0 (0.88, 4.0)) or co-dydramol (2.4 (0.5, 7.2)). In contrast there was no difference in the presentation rate or enquiry rates for these analgesics when corrected for prescriptions. Conclusions The excess hazard from co-proxamol is due to inherent toxicity rather than increased use in overdose. We estimate from this study that withdrawal of co-proxamol would prevent 39 excess deaths per annum in Scotland alone. PMID:16187978

Afshari, R; Good, AM; Maxwell, SRJ; Bateman, DN

2005-01-01

457

Health disparities and direct-to-consumer prescription drug advertising: a content analysis of targeted magazine genres, 1992-2002.  

PubMed

Health disparities exist in the United States based on race, gender, and socioeconomic status. One way to alleviate some of the disparities regarding certain diseases or conditions is to increase awareness among populations most affected. Physicians have suggested that direct-to-consumer advertising (DTCA) of prescription drugs could play a role in awareness. Social identity theory suggests that individuals are likely to attend messages if they can identify, often based on race or gender, with people portrayed in the messages. This study analyzed DTCA in 11 years of Black, women's, news, and entertainment magazines to determine whether models in the ads targeted specific populations. Black magazines were more likely to contain ads featuring Black models only than were other genres, which had more DTCA picturing White models only. Health conditions the drugs were intended for varied by genre and over time, with STD drugs appearing primarily in Black magazines, and DTCA for heart disease not published in Black magazines, despite cardiovascular diseases being the No. 1 cause of death for Blacks (and Whites). Women's magazines featured DTCA for a wide variety of drugs, reinforcing their roles as caretakers, with proportionally few ads for women's health. Implications for targeted use of magazine genres as a means of providing health information to specific populations are discussed. PMID:17617013

Mastin, Teresa; Andsager, Julie L; Choi, Jounghwa; Lee, Kyungjin

2007-01-01

458

Enough to Make You Sick: Prescription Drug Prices for the Elderly  

NSDL National Science Digital Library

Released on June 12, 2001 by Families USA, a national, nonprofit organization that advocates high-quality, affordable health and long term care for all Americans, this study finds that "last year and during the past 5 years, the prices of the 50 drugs most commonly used by older Americans have increased considerably faster than inflation." The report also demonstrates that the most expensive drugs are among the most commonly prescribed and that generic drugs are generally rising in price at much slower rates than brand-name drugs. Users may read the full text of the report in .pdf format at the FamiliesUSA site.

2001-01-01

459

Competition in prescription drug markets: the roles of trademarks, advertising, and generic names.  

PubMed

We take on two subjects of controversy among economists-advertising and trademarks-in the context of the market for generic drugs. We outline a model in which trademarks for drug names reduce search costs but increase product differentiation. In this particular framework, trademarks may not benefit consumers. In contrast, the generic names of drugs or "International Nonproprietary Names" (INN) have unquestionable benefits in both economic theory and empirical studies. We offer a second model where advertising of a brand-name drug creates recognition for the generic name. The monopoly patent-holder advertises less than in the absence of a competitive spillover. PMID:22815099

Feldman, Roger; Lobo, Félix

2013-08-01

460

Communication Strategies in Direct-to-Consumer Prescription Drug Advertising (DTCA): Application of the Six Segment Message Strategy Wheel.  

PubMed

This study addresses a void in the literature on direct-to-consumer prescription drug advertising (DTCA) with a theory-based content analysis. The findings indicate that Taylor's communication strategy wheel provides insight into what and how pharmaceutical marketers communicate with consumers by means of DTCA. Major findings are summarized as follows: (a) In most DTC ads, informational and transformational message themes and creative approaches were simultaneously used, indicating a combination strategy; (b) DTCA message themes were associated with creative strategies in alignment with Taylor's framework; and (c) message themes and creative strategies varied across therapeutic categories and DTCA categories with different levels of ad spending. Theoretical and practical implications of the findings are discussed. PMID:25794304

Ju, Ilwoo; Park, Jin Seong

2015-05-01