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Physicians should look for misuse patterns that lead to overdose before prescribing opioids

...erns include overlapping prescriptions, use of more than one prescriber or pharmacy, and use of out-of-state prescribers or pharmacies. The authors of this study aimed to assess the relationship between ranges of patterns of potential opioid misuse behaviours relate to adverse outcomes during subsequent years. Misuse patterns were associated with higher risk of opioid overdose and death. This study had several limitations. Of note, the study was c...

High prevalence of pediatric dosing errors suggests unit standardization

...s 27.6%, P = 0.02) errors. Changes in units between physician ordering and pharmacy delivery occurred in 36.7% of prescriptions. Deviation errors from the prescribed dose were magnified in Spanish-speaking and low health literacy families. More from this author: Sexting linked to sexual activity in middle school students, Possible benefit in omega-3 supplementation for extremely preterm infants, PTSD symptoms in Boston-area youth after marathon bo...

Pharmacist-led educational intervention decreases inappropriate medications for older adults

...patients over-the-counter, so they may have not been captured through the pharmacy’s database, limiting the true usage of these medications among the study’s cohort. Additionally, patients were followed for 6 months after randomization and longer term follow-up will be necessary to determine whether some patients discontinue medications later or restart medications. Click to read the study, published today in JAMA Relevant Reading: Reduction of I...

Aspirin alone likely safest antithrombotic therapy after bioprosthetic aortic valve replacement

...tudy involving almost exclusively male patients, aspirin plus warfarin was linked with higher rates of bleeding events at 90 days however no less thromboembolism or all-cause mortality when compared with aspirin alone after bAVR. Dual antiplatelet therapy showed a similar pattern however the increased rate of bleeding did not reach statistical significance. The large sample size supports this study’s findings, however the almost entirely male popu...

2 Minute Medicine Rewind May 28, 2018

...e dispensing pharmacies, any out-of-state prescriber, and any out-of-state pharmacy. Adverse opioid-related outcomes were defined as any occurrence of opioid overdose. Results showed that the prevalence of possible misuse indicators ranged from 0.6% to 8.5% of patients per half year. Patients obtaining opioids from 5 or more pharmacies had the highest adjusted absolute risk (aAR) for subsequent overdose (aAR 12.9, 95% CI 11.3 to 14.5). All misuse...

MRI screening for fungal infection from methylprednisone injections

...injection of methylprednisolone acetate solution from a single compounding pharmacy Dr. Anurag M. Malani speaks to 2MinuteMedicine: “Providers must continue to be vigilant when following patients who have received spinal or paraspinal injections of contaminated methylprednisolone. Clinical symptoms of localized spinal or paraspinal infection can be subtle and difficult for patients to distinguish from underlying chronic pain.” In-Depth [prospectiv...

Social networks play key roles in parental vaccination decisions

...d non-conformers indicated that health care providers were among the top 5 network members in their “people networks.” However, nonconformers had a significantly greater percentage of network members recommending non-conformity (72% vs. 13%, p < .001). Nonconformers were more likely to have unfavorable perceptions of vaccination, more likely to have a graduate degree, had significantly more “people network” members in general (mean of 6.7 vs. 4.8,...

Validated index scores severity of postsurgical morbidity

...prehensive mortality endpoint for both research and quality literature. An online CCI calculator can be found at assessurgery.com. To create this index, authors surveyed a large population of preoperative patients, surgeons and physicians involved in postoperative care. Additionally, CCI was put through a rigorous validation process. For this score to be widely adopted, populations in other countries must be surveyed for their grading of each comp...

Rustbelt states may have greatest racial disparities between black and white men for firearm...

...[surveillance study]: Researchers used data from the WONDER (Wide-ranging Online Data for Epidemiologic Research) database of the Centers for Disease Control and Prevention to obtain data for homicide and suicide. Age-adjusted data between 2008 and 2016 was collected for all states and the District of Columbia for non-Hispanic black and white men. Data for firearm ownership was collected from 2004 data from the National Behavioral Risk Factor Sur...

2 Minute Medicine Rewind October 21, 2019

...very following complete stabilization of the infant. The introduction of a networked model of neonatal care in England has allowed for increased early postnatal transfer of these infants to tertiary care settings, which may, in fact, be associated with adverse outcomes. This retrospective cohort study aimed to examine how early postnatal transfer compares to ongoing non-tertiary neonatal care with respect to mortality and severe brain injury as ou...

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