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[PMID]:29343479
[Au] Autor:Brat GA; Agniel D; Beam A; Yorkgitis B; Bicket M; Homer M; Fox KP; Knecht DB; McMahill-Walraven CN; Palmer N; Kohane I
[Ad] Endereço:Department of Biomedical Informatics, Harvard Medical School, Countway Library, Boston, MA 02215, USA gbrat@bidmc.harvard.edu.
[Ti] Título:Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study.
[So] Source:BMJ;360:j5790, 2018 01 17.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To quantify the effects of varying opioid prescribing patterns after surgery on dependence, overdose, or abuse in an opioid naive population. DESIGN: Retrospective cohort study. SETTING: Surgical claims from a linked medical and pharmacy administrative database of 37 651 619 commercially insured patients between 2008 and 2016. PARTICIPANTS: 1 015 116 opioid naive patients undergoing surgery. MAIN OUTCOME MEASURES: Use of oral opioids after discharge as defined by refills and total dosage and duration of use. The primary outcome was a composite of misuse identified by a diagnostic code for opioid dependence, abuse, or overdose. RESULTS: 568 612 (56.0%) patients received postoperative opioids, and a code for abuse was identified for 5906 patients (0.6%, 183 per 100 000 person years). Total duration of opioid use was the strongest predictor of misuse, with each refill and additional week of opioid use associated with an adjusted increase in the rate of misuse of 44.0% (95% confidence interval 40.8% to 47.2%, P<0.001), and 19.9% increase in hazard (18.5% to 21.4%, P<0.001), respectively. CONCLUSIONS: Each refill and week of opioid prescription is associated with a large increase in opioid misuse among opioid naive patients. The data from this study suggest that duration of the prescription rather than dosage is more strongly associated with ultimate misuse in the early postsurgical period. The analysis quantifies the association of prescribing choices on opioid misuse and identifies levers for possible impact.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Overdose de Drogas/epidemiologia
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Dor Pós-Operatória/tratamento farmacológico
Uso Excessivo de Medicamentos Prescritos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Bases de Dados Factuais
Esquema de Medicação
Feminino
Seres Humanos
Masculino
Meia-Idade
Padrões de Prática Médica/estatística & dados numéricos
Estudos Retrospectivos
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180119
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5790


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[PMID]:28760143
[Au] Autor:Gifford J; Vaeth E; Richards K; Siddiqui T; Gill C; Wilson L; DeLisle S
[Ad] Endereço:Veterans Affairs Maryland Health Care System, Baltimore, MD, USA.
[Ti] Título:Decision support during electronic prescription to stem antibiotic overuse for acute respiratory infections: a long-term, quasi-experimental study.
[So] Source:BMC Infect Dis;17(1):528, 2017 Jul 31.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Interventions to support decision-making can reduce inappropriate antibiotic use for acute respiratory infections (ARI), but they may not be sustainable. The objective of the study is to evaluate the long-term effectiveness of a clinical decision-support system (CDSS) interposed at the time of electronic (e-) prescriptions for selected antibiotics. METHODS: This is a retrospective, observational intervention study, conducted within a large, statewide Veterans Affairs health system. Participants are outpatients with an initial visit for ARI. A CDSS was deployed upon e-prescription of selected antibiotics during the study period. From 01/2004 to 05/2006 (pre-withdrawal period), the CDSS targeted azithromycin and the fluoroquinolone gatifloxacin. From 05/2006 to 12/2011 (post-withdrawal period), the CDSS was retained for azithromycin but withdrawn for the fluoroquinolone. A manual record review was conducted to determine concordance of antibiotic prescription with ARI treatment guidelines. RESULTS: Of 1131 included ARI visits, 380 (33.6%) were guideline-concordant. For azithromycin, concordance did not change between the pre- and post-withdrawal periods, and adjusted odds of concordance was 8.8 for the full study period, compared to unrestricted antibiotics. For fluoroquinolones, guideline concordance decreased from 88.6% (39 of 44 visits) to 51.3% (59 of 115 visits), pre- vs. post-withdrawal periods (p < 0.005). The adjusted odds of concordance compared to "All Other Antibiotics" visits decreased from 24.4 (95% CI 9.0-66.3) pre-withdrawal to 5.5 (95% CI 3.5-8.8) post-withdrawal (p = .008). Concordance did not change between those same time periods for antibiotics that were never subjected to the intervention ("All Other Antibiotics"). CONCLUSIONS: A CDSS interposed at the time of e-prescription of selected antibiotics can shift their use toward ARI treatment guidelines, and this effect can be maintained over the long term as long as the CDSS remains in place. Removal of the CDSS after 3.5 years of implementation resulted in a rise in guideline-discordant antibiotic use.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Sistemas de Apoio a Decisões Clínicas
Prescrição Eletrônica/estatística & dados numéricos
Uso Excessivo de Medicamentos Prescritos/prevenção & controle
Infecções Respiratórias/tratamento farmacológico
[Mh] Termos MeSH secundário: Azitromicina/uso terapêutico
Fluoroquinolonas/uso terapêutico
Seres Humanos
Maryland
Pacientes Ambulatoriais
Padrões de Prática Médica
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Fluoroquinolones); 83905-01-5 (Azithromycin); L4618BD7KJ (gatifloxacin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2602-7


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[PMID]:28617907
[Au] Autor:Gurwitz JH; Bonner A; Berwick DM
[Ad] Endereço:Meyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Fallon Health, and Reliant Medical Group, Worcester2Division of Geriatric Medicine, University of Massachusetts Medical School, Worcester.
[Ti] Título:Reducing Excessive Use of Antipsychotic Agents in Nursing Homes.
[So] Source:JAMA;318(2):118-119, 2017 07 11.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Antipsicóticos/uso terapêutico
Demência/tratamento farmacológico
Casas de Saúde/organização & administração
Uso Excessivo de Medicamentos Prescritos/tendências
[Mh] Termos MeSH secundário: Antipsicóticos/história
Centers for Medicare and Medicaid Services (U.S.)
Demência/terapia
Regulamentação Governamental/história
História do Século XX
História do Século XXI
Seres Humanos
Legislação de Medicamentos/história
Casas de Saúde/história
Casas de Saúde/legislação & jurisprudência
Uso Excessivo de Medicamentos Prescritos/legislação & jurisprudência
Uso Excessivo de Medicamentos Prescritos/prevenção & controle
Estados Unidos
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Antipsychotic Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171115
[Lr] Data última revisão:
171115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.7032


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[PMID]:28541978
[Au] Autor:Stockwell S
[Ad] Endereço:Serena Stockwell.
[Ti] Título:New Warnings About Protecting Children from Dangerous Substances.
[So] Source:Am J Nurs;117(6):16, 2017 Jun.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nurses can lead the way with education and advocacy.
[Mh] Termos MeSH primário: Substâncias Perigosas/toxicidade
Envenenamento/prevenção & controle
Uso Excessivo de Medicamentos Prescritos/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Seres Humanos
Defesa do Paciente
Pediatras
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hazardous Substances)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000520242.14396.a4


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[PMID]:28531306
[Au] Autor:Hoffman EM; Watson JC; St Sauver J; Staff NP; Klein CJ
[Ad] Endereço:Department of Neurology, Mayo Clinic, Rochester, Minnesota.
[Ti] Título:Association of Long-term Opioid Therapy With Functional Status, Adverse Outcomes, and Mortality Among Patients With Polyneuropathy.
[So] Source:JAMA Neurol;74(7):773-779, 2017 Jul 01.
[Is] ISSN:2168-6157
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Polyneuropathy is one of the most common painful conditions managed within general and specialty clinics. Neuropathic pain frequently leads to decisions about using long-term opioid therapy. Understanding the association of long-term opioid use with functional status, adverse outcomes, and mortality among patients with polyneuropathy could influence disease-specific decisions about opioid treatment. Objectives: To quantify the prevalence of long-term opioid use among patients with polyneuropathy and to assess the association of long-term opioid use with functional status, adverse outcomes, and mortality. Design, Setting, and Participants: A retrospective population-based cohort study was conducted of prescriptions given to patients with polyneuropathy and to controls in ambulatory practice between January 1, 2006, and December 31, 2010, to determine exposure to long-term opioid use as well as other outcomes. The latest follow-up was conducted through November 25, 2016. Exposures: Long-term opioid therapy, defined by 1 or multiple consecutive opioid prescriptions resulting in 90 continuous days or more of opioid use. Main Outcomes and Measures: Prevalence of long-term opioid therapy among patients with polyneuropathy and controls. Patient-reported functional status, documented adverse outcomes, and mortality were compared between patients with polyneuropathy receiving long-term opioid therapy (≥90 days) and patients with polyneuropathy receiving shorter durations of opioid therapy. Results: Among the 2892 patients with polyneuropathy (1364 women and 1528 men; mean [SD] age, 67.5 [16.6] years) and the 14 435 controls (6827 women and 7608 men; mean [SD] age, 67.5 [16.5] years), patients with polyneuropathy received long-term opioids more often than did controls (545 [18.8%] vs 780 [5.4%]). Patients with polyneuropathy who were receiving long-term opioids had multiple functional status markers that were modestly poorer even after adjusting for medical comorbidity, including increased reliance on gait aids (adjusted odds ratio, 1.9; 95% CI, 1.4-2.6); no functional status markers were improved by long-term use of opioids. Adverse outcomes were more common among patients with polyneuropathy receiving long-term opioids, including depression (adjusted hazard ratio, 1.53; 95% CI, 1.29-1.82), opioid dependence (adjusted hazard ratio, 2.85; 95% CI, 1.54-5.47), and opioid overdose (adjusted hazard ratio, 5.12; 95% CI, 1.63-19.62). Conclusions and Relevance: Polyneuropathy increased the likelihood of long-term opioid therapy. Chronic pain itself cannot be ruled out as a source of worsened functional status among patients receiving long-term opioid therapy. However, long-term opioid therapy did not improve functional status but rather was associated with a higher risk of subsequent opioid dependency and overdose.
[Mh] Termos MeSH primário: Analgésicos Opioides/efeitos adversos
Depressão/epidemiologia
Prescrições de Medicamentos/estatística & dados numéricos
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Polineuropatias/tratamento farmacológico
Polineuropatias/epidemiologia
Uso Excessivo de Medicamentos Prescritos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Comorbidade
Feminino
Seres Humanos
Masculino
Meia-Idade
Minnesota/epidemiologia
Transtornos Relacionados ao Uso de Opioides/etiologia
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170523
[St] Status:MEDLINE
[do] DOI:10.1001/jamaneurol.2017.0486


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[PMID]:28408320
[Au] Autor:Keystone JS; Connor BA
[Ad] Endereço:Tropical Disease Unit, Toronto General Hospital, University of Toronto, Canada. Electronic address: jay.keystone@utoronto.ca.
[Ti] Título:Antibiotic self-treatment of travelers' diarrhea: It only gets worse!
[So] Source:Travel Med Infect Dis;16:1-2, 2017 Mar - Apr.
[Is] ISSN:1873-0442
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Antibacterianos
Diarreia/tratamento farmacológico
Farmacorresistência Bacteriana
Uso Excessivo de Medicamentos Prescritos
Viagem
[Mh] Termos MeSH secundário: Antibacterianos/administração & dosagem
Antibacterianos/farmacologia
Antibacterianos/uso terapêutico
Enterobacteriaceae/efeitos dos fármacos
Infecções por Enterobacteriaceae/tratamento farmacológico
Infecções por Enterobacteriaceae/microbiologia
Seres Humanos
Saúde Pública
Autocuidado
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE


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[PMID]:28399441
[Au] Autor:Manconi M; Ferri R; Miano S; Maestri M; Bottasini V; Zucconi M; Ferini-Strambi L
[Ad] Endereço:Sleep and Epilepsy Center, Neurocenter of the Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland. Electronic address: mauro.manconi@eoc.ch.
[Ti] Título:Sleep architecture in insomniacs with severe benzodiazepine abuse.
[So] Source:Clin Neurophysiol;128(6):875-881, 2017 Jun.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Benzodiazepines (BZDs) are the most commonly prescribed compounds in insomnia. A long-term of BZDs use may cause dependence and abuse. The aim of this study was to evaluate sleep architecture and microstructure (in terms of cyclic alternating pattern - CAP - analysis and of sleep EEG power spectral analysis) in a group of long-term users of high doses of BZDs for their primary chronic insomnia. METHODS: Twenty patients consecutively admitted at the Sleep Centre for drug discontinuation and 13 matched healthy controls underwent a full nocturnal video-polysomnographic recording, after one adaptation night. RESULTS: Significant differences were found in time in bed, REM sleep latency and sleep stage 1% which were increased in patients compared to controls, while CAP rate was dramatically decreased. During NREM sleep, patients showed a clear decrease in the relative power of delta band. CONCLUSIONS: Our data demonstrate that in adults with chronic insomnia, long-term use of high doses of BZDs induces a severe disruption of sleep microstructure, while sleep architecture seems to be much less affected. SIGNIFICANCE: The long term use of high doses of BZDs for chronic insomnia induces a marked depression of slow wave activity and of its physiological instability.
[Mh] Termos MeSH primário: Benzodiazepinas/efeitos adversos
Ondas Encefálicas
Uso Excessivo de Medicamentos Prescritos/efeitos adversos
Distúrbios do Início e da Manutenção do Sono/fisiopatologia
Sono REM
[Mh] Termos MeSH secundário: Adulto
Benzodiazepinas/administração & dosagem
Benzodiazepinas/uso terapêutico
Estudos de Casos e Controles
Feminino
Seres Humanos
Masculino
Meia-Idade
Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
12794-10-4 (Benzodiazepines)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170804
[Lr] Data última revisão:
170804
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170412
[St] Status:MEDLINE


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[PMID]:28323765
[Au] Autor:Gangavalli A; Malige A; Terres G; Rehman S; Nwachuku C
[Ad] Endereço:*Department of Orthopaedic Surgery, St. Luke's University Health Network, Bethlehem, PA; †Temple-St. Luke's University School of Medicine, Bethlehem, PA; ‡Temple University School of Medicine, Philadelphia, PA; and §Department of Orthopaedic Surgery, Temple University Hospital, Philadelphia, PA.
[Ti] Título:Misuse of Opioids in Orthopaedic Postoperative Patients.
[So] Source:J Orthop Trauma;31(4):e103-e109, 2017 Apr.
[Is] ISSN:1531-2291
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In light of the recent uptrend in the prescription of opioids, this study seeks to identify patterns of opioid misuse among orthopaedic postoperative patients and principal external sources in obtaining these medications. DESIGN: Ten-month survey-based study. SETTING: Two Level I trauma centers (urban and suburban). PATIENTS/PARTICIPANTS: Two hundred seven patients between the ages of 18 and 89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist. MAIN OUTCOME MEASUREMENTS: Patients who believed they were undermedicated, used prescribed opioids at higher than recommended doses, and took extra opioids in addition to their prescribed analgesics were analyzed by age, employment, income, education, controlled substance use, pain interference with activities of daily living, and anatomic surgical site. RESULTS: One hundred eighty-two patients completed the survey; 19.2% of patients (n = 35) felt undermedicated [unemployed (P < 0.05), low income (P < 0.05), and self-reported controlled substance users (P < 0.05)]; 12.6% of patients (n = 23) admitted to using pain medications at a higher dose than prescribed [unemployed (P < 0.05), lower income (P < 0.05), nonhigh school graduates (P < 0.05), and previous controlled substance users (P < 0.05)]; 9.3% (n = 17) admitted to using external opioids [unemployed patients (P < 0.05) and self-reported controlled substance users (P < 0.05)]. Major sources of extraneous opioids include family/friends (n = 5) and other doctors (n = 4). CONCLUSION: Unemployed and lower-income patients were significantly more likely to believe that their surgeon was not prescribing them enough pain medications as well as use their prescribed opioid medications at a higher than recommended dose compared with their employed counterparts with higher incomes. Unemployed patients were also significantly more likely to use additional opioid analgesics in addition to those prescribed to them by their primary surgeon. Surgeon awareness of a patient's socioeconomic background and associated risk of opioid misuse is crucial to prescribe the safest most effective pain regimen. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Dor Pós-Operatória/epidemiologia
Dor Pós-Operatória/prevenção & controle
Uso Excessivo de Medicamentos Prescritos/estatística & dados numéricos
Automedicação/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Dor Crônica
Escolaridade
Emprego/estatística & dados numéricos
Feminino
Seres Humanos
Renda/estatística & dados numéricos
Masculino
Meia-Idade
Transtornos Relacionados ao Uso de Opioides/diagnóstico
Medição da Dor/efeitos dos fármacos
Medição da Dor/estatística & dados numéricos
Dor Pós-Operatória/diagnóstico
Pennsylvania/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE
[do] DOI:10.1097/BOT.0000000000000741


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[PMID]:28260403
[Au] Autor:Adeboyeje G; Agiro A; Malin J; Fisch MJ; DeVries A
[Ad] Endereço:HealthCore, Wilmington, DE; Anthem, Woodland Hills, CA; and AIM Specialty Health, Deerfield, IL.
[Ti] Título:Reducing Overuse of Colony-Stimulating Factors in Patients With Lung Cancer Receiving Chemotherapy: Evidence From a Decision Support-Enabled Program.
[So] Source:J Oncol Pract;13(4):e337-e345, 2017 Apr.
[Is] ISSN:1935-469X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Colony-stimulating factors (CSFs) are frequently overused for the primary prevention of febrile neutropenia (FN) in patients receiving chemotherapy. METHODS: A retrospective cohort study design was used to analyze commercial claims data in adults with lung cancer initiated on chemotherapy from April 1, 2013, to March 30, 2015. The tool was implemented at oncology practices in phases across 14 US states. Patients were assigned to intervention and nonintervention states according to whether they resided in service areas where the tool had been implemented. Patients were followed up to 6 months after initiating chemotherapy. Difference in pre- and postimplementation CSF use and FN incidence rates were compared with the use of difference-in-differences (DID) models that were adjusted for baseline FN risk factors. RESULTS: The study population of 3,467 patients (intervention states: pre, 707; post, 1,150; nonintervention states: pre, 636; post, 974) showed no significant differences in FN risk factors at baseline. In adjusted results before and after implementation, CSF use decreased from 48.4% to 35.6% in the intervention states versus 43.2% to 44.4% in the nonintervention states (DID, -8.7%; 95% CI, -14.65% to -2.67%; P ≤ .001). The rates of FN were consistent for both groups in both periods, with no statistical difference in trend for the intervention (2.8% to 4.3%) versus the nonintervention (3.1% to 5.1%) states (DID, -0.13; 95% CI, -0.35 to 0.10; P = .927). CONCLUSION: These findings demonstrate that a decision support-enabled utilization management tool can improve risk-appropriate, guideline-adherent CSF use in patients with lung cancer.
[Mh] Termos MeSH primário: Fatores Estimuladores de Colônias/uso terapêutico
Neoplasias Pulmonares/tratamento farmacológico
Neoplasias Pulmonares/epidemiologia
Uso Excessivo de Medicamentos Prescritos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Algoritmos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Fatores Estimuladores de Colônias/administração & dosagem
Sistemas de Apoio a Decisões Clínicas
Gerenciamento Clínico
Neutropenia Febril/epidemiologia
Neutropenia Febril/etiologia
Neutropenia Febril/prevenção & controle
Feminino
Hospitalização
Seres Humanos
Neoplasias Pulmonares/complicações
Neoplasias Pulmonares/diagnóstico
Masculino
Meia-Idade
Vigilância em Saúde Pública
Estudos Retrospectivos
Fatores de Risco
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Colony-Stimulating Factors)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170307
[St] Status:MEDLINE
[do] DOI:10.1200/JOP.2017.020867


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Fotocópia
[PMID]:28222452
[Au] Autor:Fields SA; Johnson WM; Hassig MB
[Ad] Endereço:West Virginia University School of Medicine-Charleston Division, USA. Email: sfields@hsc.wvu.edu.
[Ti] Título:Adult ADHD: Addressing a unique set of challenges.
[So] Source:J Fam Pract;66(2):68-74, 2017 Feb.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:ADHD diagnostic criteria are different for adults than they are for children. Plus, prescribing psychostimulants for adults raises the risk of misuse and diversion.
[Mh] Termos MeSH primário: Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico
Estimulantes do Sistema Nervoso Central/efeitos adversos
Estimulantes do Sistema Nervoso Central/uso terapêutico
Guias de Prática Clínica como Assunto
Uso Excessivo de Medicamentos Prescritos/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Central Nervous System Stimulants)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170619
[Lr] Data última revisão:
170619
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE



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