scholarly journals The Adoption and Increased Use of Electronic Prescribing of Controlled Substances

2021 ◽  
Vol 107 (2) ◽  
pp. 8-16
Author(s):  
Suraj Achar ◽  
Nikhil Sinha ◽  
William Norcross
Keyword(s):  
Systematic Reviews ◽  
Secondary Data ◽  
The United States ◽  
Electronic Prescribing ◽  
Primary Study ◽  
Controlled Substances ◽  
Controlled Drugs ◽  
Published Evidence ◽  
Response Gradient

ABSTRACT The electronic prescribing of controlled substances (EPCS) is now becoming implemented in most health care practices and pharmacies in the United States. This review aims to detail the steps needed for EPCS adoption and synthesize the most current literature on the benefits and challenges associated with its adoption. Our systematic review of seven published studies from 1990 to 2020 notes the benefits of EPCS in the reduction of errors, fraud, overprescribing, cost and efficiency improvements. There is limited published evidence of challenges, such as the cost of implementation and prescriber burden. With EPCS becoming a nationwide process, further research needs to be conducted to maximize the effectiveness of EPCS and explore additional benefits and challenges. We used a modified version of the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) system for systematic reviews highlighted in the “Cochrane Handbook for Systematic Reviews of Interventions” to assess the quality of the primary studies reviewed.1 Each author was tasked with determining the quality of each primary study reviewed and assigning a quality score of either high, moderate or low quality. Evidence stemming from randomized controlled trials starts as high quality while evidence from observational studies starts as low quality. Quality can be lowered by five factors: risk of bias, imprecision, inconsistency, indirectness, and publication bias and can be raised by a large magnitude of effect and a clear dose-response gradient. We extracted data from the text, tables and graphs of the original publications. Appendix A illustrates the quality of the studies. Databases reviewed included PubMed, Google Scholar, Cochrane and SCOPUS. The search was started in 1990, with the first wave of the opioid epidemic and the first published studies of e-prescribing, and continued to the year of 2020. The key phrases “electronic prescribing of controlled substances,” “e-prescribing of controlled substances,” “fraudulent prescribing of controlled substances,” “EPCS with PDMP,” and “drug interactions with e-prescribing of controlled drugs” were used as an inclusion criterion to search online scholarly databases for articles. Only primary and secondary data from reports, reviews and research studies written in English were included. The Centers for Disease Control (CDC), National Institute on Drug Abuse (NIDA), Drug Enforcement Administration (DEA), Substance Abuse and Mental Health Services Administration (SAMHSA), American Academy of Family Medicine (AAFP), and nationally represented health information networks were used to obtain updated statistics regarding EPCS.

scholarly journals An Overview of Systematic Reviews: Complementary Therapies for Cancer Patients

2019 ◽  
Vol 18 ◽  
pp. 153473541989002 ◽  
Author(s):  
Seong Min Lee ◽  
Ho Cheol Choi ◽  
Min Kyung Hyun
Keyword(s):  
Side Effects ◽  
Cancer Patients ◽  
Systematic Reviews ◽  
Complementary Therapies ◽  
The United States ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Future Research ◽  
Cancer Type

Introduction: This article critically examines the systematic reviews (SR) and meta-analysis (MA) of complementary therapies for cancer patients to appraise the evidence level, and offers suggestions for future research and practice. Methods: The Cochrane Library and MEDLINE were searched from their inception to January 2018, to identify SR and MA of complementary therapies available for cancer patients. Final selected SR and MA were methodologically evaluated for their quality by applying the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR2) instrument. Data extraction and risk of quality assessments were performed by 2 independent reviewers. Results: A total of 104 studies were included in the analysis. The majority of the individual clinical trials included in the SR and MA were performed in China (48%) and the United States (26.9%). Breast cancer was the most studied cancer type (25%), and acupuncture was the most studied intervention (21%). Side effects of cancer such as pain, depression, and fatigue were effectively managed with complementary therapies. The methodologically problematic items included not listing the excluded studies and lack of protocol or protocol registration. Conclusions: With increasing interest in research, complementary therapies appear to be beneficial in reducing side effects and raising the quality of life of cancer patients. Complementary therapies have generally been studied for all cancers, with acupuncture being the most researched, regardless of the cancer type. Since AMSTAR2 is a stricter assessment tool than before, future studies need to consider the risk of methodological bias with caution and discuss appropriate overall quality assessment tools.

Yoga for Heart Failure Patients: A Feasibility Pilot Study with a Multiethnic Population

2011 ◽  
Vol 21 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Ai Kubo ◽  
Yun-Yi Hung ◽  
Jeffrey Ritterman
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Intervention Program ◽  
Pilot Trial ◽  
The United States ◽  
Management Program ◽  
Primary Study ◽  
Long Term Effects ◽  
Breathing Exercises

Background: Congestive heart failure (CHF) is highly prevalent and the most costly cardiovascular illness in the United States. Yoga is known to be effective in lowering stress, lessening depression, and increasing physical fitness and may be used as an adjuvant management program for CHF patients. Primary Study Objective:To determine the feasibility of a yoga intervention program among a multiethnic CHF population living in underserved neighborhoods. Methods: Uncontrolled intervention trial. Setting: Kaiser Permanente Medical Centers,Richmond and Oakland, California. Participants: 14 CHF patients (7 female), mean age 64 (SD = 6.4) years, and 62% African-American. Intervention: Eight-week, 2x/week, 1-hr yoga classes that included meditation, breathing exercises, gentle yoga poses, and relaxation. Primary outcome measures: The intervention feasibility was measured by recruitment rates, participant retention and adherence. Body weight and self-reported depression and quality of life were measured before and after the intervention. Results: Among the 14 patients enrolled, 13 completed the intervention. Of those who completed the trial, 92% attended at least 50% of the classes. There was a significant reduction in weight (-3.5 lb, p = 0.01) and improvement in the severity of depression (p < 0.05), as well as a trend toward increased quality of life (p = 08). No adverse events were observed. Conclusions: This pilot trial demonstrates that it is feasible for patients with CHF to incorporate yoga into their lifestyle. Yoga may help with routine disease management, prevention of fluid retention, and improvement of depression and quality of life. A larger trial is needed to confirm efficacy and to determine the long-term effects on other important outcomes, such as hospital re-admission rates or prognostic biomarkers.

scholarly journals A Mapping Literature Review of Medical Cannabis Clinical Outcomes and Quality of Evidence in Approved Conditions in the United States, from 2016 to 2019

2021 ◽  
Author(s):  
Sebastian Jugl ◽  
Aimalohi Okpeku ◽  
Brianna Costales ◽  
Earl Morris ◽  
Golnoosh Alipour-Harris ◽  
...  
Keyword(s):  
United States ◽  
Chronic Pain ◽  
Systematic Reviews ◽  
The United States ◽  
Evidence Base ◽  
Medical Cannabis ◽  
High Quality ◽  
Quality Of Evidence ◽  
Study Setting

Background: Medical cannabis is available to patients by physician order in two-thirds of the United States (U.S.) as of 2020, but remains classified as an illicit substance by federal law. States that permit medical cannabis ordered by a physician typically require a diagnosed medical condition that is considered qualifying by respective state law. Objectives: To identify and map the most recently (2016-2019) published clinical and scientific literature across approved conditions for medical cannabis, and to evaluate the quality of identified recent systematic reviews. Methods: Literature search was conducted from five databases (PubMed, Embase, Web of Science, Cochrane, and ClinicalTrials.gov), with expansion and update from the National Academies of Sciences, Engineering, and Medicine’s (NASEM) comprehensive evidence review through 2016 of the health effects of cannabis on several conditions. Following consultation with experts and stakeholders, 11 conditions were identified for evidence evaluation: amyotrophic lateral sclerosis (ALS), autism, cancer, chronic pain, Crohn’s disease, epilepsy, glaucoma, HIV/AIDS, multiple sclerosis (MS), Parkinson’s disease, and posttraumatic stress disorder (PTSD). The following exclusion criteria were imposed: preclinical focus, non-English language, abstracts only, editorials/commentary, case studies/series, and non-U.S. study setting. Data extracted from studies included: study design type, outcome, intervention, sample size, study setting, and reported effect size. Studies classified as systematic reviews with or without meta-analysis were graded using the AMSTAR-2 tool by two raters to evaluate the quality of evidence, with additional raters to resolve cases of evidence grade disagreement. Results: A total of 438 studies were included after screening. Five completed randomized controlled trials (RCTs) were identified, and an additional 11 trials were ongoing, and 1 terminated. Cancer, chronic pain, and epilepsy were the most researched topic areas, representing more than two-thirds of all reviewed studies. The quality of evidence assessment for each condition suggests that few high-quality systematic reviews are available for most conditions, with the exceptions of MS, epilepsy, and chronic pain. In those areas, findings on chronic pain are mostly in alignment with the previous literature, suggesting that cannabis or cannabinoids are potentially beneficial in treating chronic neuropathic pain. In epilepsy, findings suggest that cannabidiol is potentially effective in reducing seizures in pediatric patients with drug-resistant Dravet and Lennox-Gastaut syndromes. In MS, recent high-quality systematic reviews did not include new RCTs, and are therefore not substantially expanding the evidence base. In sum, the most recent clinical evidence suggests that for most of the conditions assessed, we identified few studies of substantial rigor and quality to contribute to the evidence base. However, there are some conditions for which significant evidence suggests that select dosage forms and routes of administration likely have favorable risk-benefit ratios (i.e., epilepsy and chronic pain), with the higher quality of evidence for epilepsy driven by FDA-approved formulations for cannabis-based seizure treatments. Conclusion: The body of evidence for medical cannabis requires more rigorous evaluation before consideration as a treatment option for many conditions and evidence necessary to inform policy and treatment guidelines is currently insufficient for many conditions.

scholarly journals Buteyko method for people with asthma: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049213
Author(s):  
Karla Morganna Pereira Pinto de Mendonça ◽  
Sean Collins ◽  
Tácito ZM Santos ◽  
Gabriela Chaves ◽  
Sarah Leite ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Secondary Data ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Plain Language ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionButeyko method is recommended as a non-pharmacological treatment for people with asthma. Although the worldwide interest in the Buteyko method, there is a paucity of studies gathering evidence to support its use. Therefore, we aim to conduct a systematic review and meta-analysis to assess the effects of the Buteyko method in children and adults with asthma.Methods and analysisWe will search on Cochrane Central Register of Controlled Trials, MEDLINE, Embase, US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for studies focusing on the Buteyko method for children and adults with asthma. The searches will be carried out in September 2021 from database’s inception to the present. We will include randomised controlled trials comparing Buteyko method alone with asthma education or inactive control intervention. There will be no restriction on language. Primary outcomes include quality of life, asthma symptoms and adverse events/side effects. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the ‘Risk of Bias’ tool. The certainty of the evidence will be assessed using the GRADE approach. Data synthesis will be conducted using Review Manager software. Reporting of the review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and the Cochrane Handbook for Systematic Reviews of Interventions.Ethics and disseminationThis study will assess and provide evidence for the use of the Buteyko method in people with asthma. We will analyse secondary data and this does not require ethics approval. The findings will be published in peer-reviewed journals, at relevant conferences and will be shared in plain language in social media. Moreover, the findings of this review could guide the direction of healthcare practice and research.PROSPERO registration numberCRD42020193132.

An affordable, sustainable tourist QoL model: the case study of Appalachian mountain towns

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
John M. McGrath
Keyword(s):  
Secondary Data ◽  
The United States ◽  
Content Type ◽  
Appalachian Mountain ◽  
The Us ◽  
Research Gap ◽  
Index Value ◽  
First Time

PurposeThis article proposes a model for benchmarking tourism quality of life (QoL) that is practical and affordable to implement by communities of all sizes. The model is tested on a group of 30 mountain towns in the Appalachian region of the United States.Design/methodology/approachAn existing model measuring resident QoL from Roanoke, Virginia, is discussed and a new model for tourist QoL is proposed. Both models employ secondary data from free sources to calculate a practical, affordable and quantifiable QoL index.FindingsAnalysis of the data indicates the Appalachian mountain town with the highest tourist QoL score is Lynchburg, Virginia, with a composite QoL index value of 128, followed closely by Charlottesville, Virginia, with an index of 126 (where an index of 100 = the US national average).Practical implicationsA tourist QoL model has practical value because it can be used by local policymakers to benchmark their region's QoL, make comparisons with other destinations, and ultimately, as a tool to help market their community – all using free and readily available data.Originality/valueThis case study adds value to the hospitality and tourism literature by sharing the Roanoke QoL model for the first time with the academic and practitioner community and extends its methods to propose how a tourist QoL model would work. It also addresses the research gap noted by Uysal et al. (2016) who observed a dearth of tourism research studies that utilize objective measures.

HIV Prevention Research on Men Who Have Sex With Men: A Scoping Review of Systematic Reviews, 1988–2017

2020 ◽  
Vol 32 (1) ◽  
pp. 1-S7 ◽  
Author(s):  
Darrel H. Higa ◽  
Nicole Crepaz ◽  
Christina M. McDonald ◽  
Adebukola Adegbite-Johnson ◽  
Julia B. DeLuca ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Systematic Reviews ◽  
Scoping Review ◽  
The United States ◽  
Primary Study ◽  
Treatment As Prevention ◽  
Prevention Research ◽  
Study Quality ◽  
Research Gaps ◽  
Sex With Men

In the United States, men who have sex with men (MSM) are disproportionately affected by HIV. To identify research gaps and inform HIV prevention for MSM, we conducted a scoping review of systematic reviews using CDC's Prevention Research Synthesis database. Eligibility criteria comprised English-language systematic reviews focused on HIV prevention for MSM, published during 1988–2017, and included at least one U.S. primary study. We coded data type, subpopulations, topics, and key findings. To assess study quality, we used the Assessment of Multiple Systematic Reviews (AMSTAR). Among 129 relevant systematic reviews, study quality was high or moderate for 63%. Most common topics were sexual behavior and disease vulnerability. The most frequently mentioned MSM subgroups were HIV-positive, Black or African American, and young. Research gaps include Hispanic/Latino MSM, pre-exposure prophylaxis (PrEP), treatment as prevention, social determinants of health, health disparities, syndemics, and protective factors for sexual health.

Loss or Theft of Controlled Substances Declared to Health Canada From 2014 to 2018: A Retrospective Study

2021 ◽  
pp. 002204262110178
Author(s):  
Pierre-André Dubé ◽  
Tyler Morissette ◽  
Mélanie Tessier ◽  
Marc Parent ◽  
Pierre-Yves Tremblay
Keyword(s):  
Prescription Drugs ◽  
Health Care Professionals ◽  
Oral Morphine ◽  
Community Pharmacies ◽  
Controlled Substances ◽  
Drug Identification ◽  
Controlled Drugs ◽  
Location Type ◽  
Health Canada

Theft of prescription drugs is nothing new for Canadian pharmacists. Recently, an increasing body of literature has covered the diversion of controlled substances from Canadian hospitals. However, little has been published in the scientific literature concerning the data collected by Health Canada’s Loss or Theft Report Program regulated under the Controlled Drugs and Substances Act. Data from January 1, 2014, to December 31, 2018, were obtained from Health Canada’s Office of Controlled Substances (OCS). Reports to the OCS are mostly provided by pharmacies and hospitals, by veterinarian, dental, and physician clinics, pharmaceutical distributors and producers, and federal establishments and organizations. Entries include information related to the date, province, and location type; type of loss or theft; and generic name of the product, its strength, dosage form, quantity, and drug identification number. During the studied period, 45,379 submissions to the OCS provided information to create 213,895 entries to the database. After exclusions, 212,317 reports were retained for analysis. Opioids count for 45% of reports, benzodiazepines for 29%, and psychostimulants for 21%. Approximately, 29 million individual doses were lost or stolen of which 7.7 million were opioids (26%), totalizing approximately 178 million oral morphine milligram equivalents with 95% having been lost or stolen in community pharmacies. Moreover, approximately four out of 10 individual doses lost in community pharmacies are unexplained losses, which represent about 4.6 million individual doses. Reporting lost or stolen controlled substances and precursors is essential to tracking the diversion of Canada’s prescription drugs. Pharmacists therefore have an important role to play when it comes to minimizing their potential diversion. A better understanding of the situation across Canada may help to increase health care professionals’ awareness, improve practices, enhance the quality of collected data, and prevent further losses and thefts.

Subjective Quality of Life of Polish, Polish-Immigrant, and Polish-American Elderly

2000 ◽  
Vol 50 (4) ◽  
pp. 385-397 ◽  
Author(s):  
Celia Berdes ◽  
Adam A. Zych
Keyword(s):  
Quality Of Life ◽  
Secondary Data ◽  
The United States ◽  
Subjective Quality ◽  
Subjective Quality Of Life ◽  
Elderly Immigrants ◽  
Health Initiative ◽  
Cultural Construct ◽  
Self Assessments

This study compared the subjective quality of life of elderly Poles living in Poland, and Polish immigrants and Polish-American ethnics living in Chicago. The article is a secondary data analysis of a study that replicated an earlier study conducted in Poland. The study uses three measures of quality of life used in the earlier study—self assessments of health, initiative, and fulfillment of plans and wishes—and develops a composite measure. The results showed that Polish-American ethnic elderly had significantly better subjective quality of life than Polish-immigrant elderly, and Polish-immigrant elderly had significantly better subjective quality of life than elderly Poles in Poland. These conclusions lend support to the idea the U.S.-born elderly people and elderly immigrants to the United States have access to an American cultural construct of “vital aging.” However, immigration is also a risk factor worthy of being added to the traditional “triple jeopardy.”

Characteristics of the Frequency-Following Response to Speech in Neonates and Potential Applicability in Clinical Practice: A Systematic Review

2020 ◽  
Vol 63 (5) ◽  
pp. 1618-1635
Author(s):  
Céline Richard ◽  
Mary Lauren Neel ◽  
Arnaud Jeanvoine ◽  
Sharon Mc Connell ◽  
Alison Gehred ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cochrane Library ◽  
Neurodevelopmental Outcomes ◽  
Frequency Following Response ◽  
Ovid Medline ◽  
Published Evidence ◽  
Mesh Terms ◽  
Potential Applicability ◽  
Clinical Potential

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.

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