Clinical use

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    Error in algorithm to assess risk (and inform prescription of statins)

Error in algorithm to assess risk (and inform prescription of statins)

Computer error may have led to incorrect prescribing of statins to thousands of patients

BMJ 2016;353:i2742

 
Thousands of patients in England may have been incorrectly prescribed or taken off statins because of a major IT glitch.

The Medicines and Healthcare Products Regulatory Agency (MHRA) has launched an investigation after a fault was discovered with the digital QRISK2 calculator in SystmOne, run by […]

Accelerating access to new drugs in Japan

Writing in Nature Reviews Drug Discovery, Yasuhiro Fujiwara outlines developments in Japan to reduce the time required for new therapeutic drugs to gain marketing authorisation.

Fujiwara notes that Japan historically has taken longer than the United States and the European Union to give marketing approval for therapeutic drugs. Over the course of the last 20 years approval times have been […]

$1 million for a drug used once

This is a story of precision medicines and their value.

The drug is alipogene tiparvovec (aka Glybera). Approved in 2012, it is “a medicine widely heralded as the “first gene therapy” in the Western world” – a treatment to correct DNA.
But when the Berlin physician Elisabeth Steinhagen-Thiessen wanted to give a patient Glybera last fall, it wasn’t so easy. She […]

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    IT interventions to improve antimicrobial prescribing – evidence of effectiveness?

IT interventions to improve antimicrobial prescribing – evidence of effectiveness?

Baysari, M. T., Lehnbom, E. C., Li, L., Hargreaves, A., Day, R. O. and Westbrook, J. I. The effectiveness of information technology to improve antimicrobial prescribing in hospitals: A systematic review and meta-analysis. International Journal of Medical Informatics. Available online 30 April 2016
In Press, Accepted Manuscript

 
IT interventions took four main forms: 1) stand-alone computerized decision support systems (CDSSs), 2) […]

EPS first 1 million prescriptions in a day

We have just heard the news: over the Easter period the Electronic Prescription Service processed one million prescriptions electronically in a day.

More EPS news and stats here.

April 26th, 2016|Clinical use|0 Comments|

Old drugs for new uses

Researchers at the University of Leeds are using: the anti-psychotic haloperidol; the anti-depressant fluoxetine and a local anaesthetic bupivacainein as anti-virals.

The drugs disrupt the regulation of potassium levels and this, in turn, blocks the ability of all of the group of bunyaviruses to infect cells. It’s not effective on all viruses, but is looking very promising research.

Full article here.

Telemedicine helping Refugees

Medical professionals working with Doctors Without Borders are increasingly using smartphones to help deliver more and better care in situations where resources are limited.

It is also, as the article suggests, increasingly useful for isolated and rural communities. Telemedicine (the use of communication technologies to aid medical care) has been around for 50 years or so, but the use of […]

11 biases, blinding statistics and leaps of imagination, or how does one ends up taking a medicine (or not)

Mrs B goes to the GP, having just visited the cardiology clinic. The discharge letter from the specialist registrar states: “Could you please start [Mrs B] on spironolactone 25mg daily and monitor her electrolytes in two weeks” …

Will Mrs B be prescribed spironolactone? No spoiler here!

Read this insightful delightful case study of how GPs make decisions about prescribing medicines. […]

Non-adherence to prescriptions is categorical construct. Non-persistence adds a time dimension to it

In a move to a more balanced doctor-patient relationship, and shared decision making, we have long moved from concepts of patient’s ‘compliance’ to ideas of ‘adherence’ and ‘concordance’ with/to prescription  (For definition of the three labels, and their implications, see for example the 2005 Report for the National Co-ordinatingCentre for NHS Service Delivery and Organisation R & D).

It is […]

September 14th, 2015|Clinical use, Medicines|0 Comments|

E-prescribing and ADE in primary care – data and evidence from meaningful use in the US

The benefits for patient safety and patient outcomes of moving from prescribing on paper to E-prescribing have been demonstrated mainly in acute settings.

As primary care is being computerised in the US, there are new opportunities to study the effects of e-Prescribing in this area.

A recent paper by Powers et al, published on JAMIA, notes how “after Meaningful Use (MU) […]

September 14th, 2015|Clinical use, Research|0 Comments|