Medical prescription

About: Medical prescription is a research topic. Over the lifetime, 24003 publications have been published within this topic receiving 476355 citations. The topic is also known as: prescription & ℞.

ACSM's guidelines for exercise testing and prescription

Abstract: SECTION I: HEALTH APPRAISAL AND RISK ASSESSMENT 1 Benefits and Risks Associated with Physical Activity 2 Preparticipation Health Screening SECTION II: EXERCISE TESTING 3 Preexercise Evaluation 4 Health-Related Physical Fitness Testing and Interpretation 5 Clinical Exercise Testing 6 Interpretation of Clinical Exercise Test Results SECTION III: EXERCISE PRESCRIPTION 7 General Principles of Exercise Prescription 8 Exercise Prescription for Healthy Populations With Special Considerations and Environmental Considerations 9 Exercise Prescription For Patients With Cardiovascular and Cerebrovascular Disease 10 Exercise Prescription for Populations With Other Chronic Diseases and Health Conditions 11 Behavioral Theories and Strategies for Promoting Exercise SECTION IV: APPENDICES Appendix A Common Medications Appendix B Medical Emergency Management Appendix C Electrocardiogram Interpretation Appendix D American College of Sports Medicine Certifications Appendix E Contributing Authors to the Previous Two Editions

Chronic disease management: what will it take to improve care for chronic illness?

Abstract: M eeting the complex needs of patients with chronic illness or impairment is the single greatest challenge facing organized medical practice. Usual care is not doing the job; dozens of surveys and audits have revealed that sizable proportions of chronically ill patients are not receiving effective therapy, have poor disease con- trol, and are unhappy with their care (1). Results of randomized trials also show that effective disease management programs can achieve substantially better outcomes than usual care, the control intervention. These trials, along with the ideas and efforts for improvement discussed in this issue, show that we can improve care and outcomes. As the articles suggest, these improvements will not come easily. If we are to improve care for most patients with chronic illness, the evidence strongly suggests that we reshape our ambulatory care systems for this purpose. Pri- mary care practice was largely designed to provide ready access and care to patients with acute, varied problems, with an emphasis on triage and patient flow; short appointments; diagnosis and treatment of symptoms and signs; reliance on laborato- ry investigations and prescriptions; brief, didactic patient education; and patient- initiated follow-up. Patients and families struggling with chronic illness have differ- ent needs, and these needs are unlikely to be met by an acute care organization and culture. They require planned, regular interactions with their caregivers, with a focus on function and prevention of exacerbations and complications. This interac- tion includes systematic assessments, attention to treatment guidelines, and behav- iorally sophisticated support for the patient's role as self-manager. These interactions must be linked through time by clinically relevant information systems and continu- ing follow-up initiated by the medical practice. Comprehensive System Change

Recent Patterns of Medication Use in the Ambulatory Adult Population of the United States: The Slone Survey

Abstract: ContextData on the range of prescription and over-the-counter drug use in the United States are not available.ObjectiveTo provide recent population-based information on use of all medications, including prescription and over-the-counter drugs, vitamins and minerals, and herbal preparations/natural supplements in the United States.Design, Setting, and ParticipantsOngoing telephone survey of a random sample of the noninstitutionalized US population in the 48 continental states and the District of Columbia; data analyzed here were collected from February 1998 through December 1999.Main Outcome MeasureUse of medications, by type, during the preceding week, compared by demographic characteristics.ResultsAmong 2590 participants aged at least 18 years, 81% used at least 1 medication in the preceding week; 50% took at least 1 prescription drug; and 7% took 5 or more. The highest overall prevalence of medication use was among women aged at least 65 years, of whom 12% took at least 10 medications and 23% took at least 5 prescription drugs. Herbals/supplements were taken by 14% of the population. Among prescription drug users, 16% also took an herbal/supplement; the rate of concurrent use was highest for fluoxetine users, at 22%. Reasons for drug use varied widely, with hypertension and headache mentioned most often (9% for each). Vitamins/minerals were frequently used for nonspecific reasons such as "health" (35%); herbals/supplements were also most commonly used for "health" (16%).ConclusionsIn any given week, most US adults take at least 1 medication, and many take multiple agents. The substantial overlap between use of prescription medications and herbals/supplements raises concern about unintended interactions. Documentation of usage patterns can provide a basis for improving the safety of medication use.

The Danish National Prescription Registry

Abstract: Introduction: Individual-level data on all prescription drugs sold in Danish community pharmacies has since 1994 been recorded in the Register of Medicinal Products Statistics of the Danish Medicines Agency. Content: The register subset, termed the Danish National Prescription Registry (DNPR), contains information on dispensed prescriptions, including variables at the level of the drug user, the prescriber, and the pharmacy. Validity and coverage: Reimbursement-driven record keeping, with automated bar-code-based data entry provides data of high quality, including detailed information on the dispensed drug. Conclusion: The possibility of linkage with many other nationwide individual-level data sources renders the DNPR a very powerful pharmacoepidemiological tool.

Impact of medication adherence on hospitalization risk and healthcare cost.

Abstract: Objective: The objective of this study was to evaluate the impact of medication adherence on healthcare utilization and cost for 4 chronic conditions that are major drivers of drug spending: diabetes, hypertension, hypercholesterolemia, and congestive heart failure. Research Design: The authors conducted a retrospective cohort observation of patients who were continuously enrolled in medical and prescription benefit plans from June 1997 through May 1999. Patients were identified for disease-specific analysis based on claims for outpatient, emergency room, or inpatient services during the first 12 months of the study. Using an integrated analysis of administrative claims data, medical and drug utilization were measured during the 12-month period after patient identification. Medication adherence was defined by days’ supply of maintenance medications for each condition. Patients: The study consisted of a population-based sample of 137,277 patients under age 65. Measures: Disease-related and all-cause medical costs, drug costs, and hospitalization risk were measured. Using regression analysis, these measures were modeled at varying levels of medication adherence. Results: For diabetes and hypercholesterolemia, a high level of medication adherence was associated with lower disease-related medical costs. For these conditions, higher medication costs were more than offset by medical cost reductions, producing a net reduction in overall healthcare costs. For diabetes, hypercholesterolemia, and hypertension, cost offsets were observed for all-cause medical costs at high levels of medication adherence. For all 4 conditions, hospitalization rates were significantly lower for patients with high medication adherence. Conclusions: For some chronic conditions, increased drug utilization can provide a net economic return when it is driven by improved adherence with guidelines-based therapy.