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Php31 Computerized Interventions to Obtain Indication Information for Inpatient Prescriptions: a Pilot Study in Drugs Frequently Used Off-label
| Content Provider | Semantic Scholar |
|---|---|
| Author | Walton, Surrey M. Galanter, William L. Tiryaki, Funda Stafford, Randall Scott |
| Copyright Year | 2010 |
| Abstract | s A87 PHP30 A DESCRIPTIVE EXAMINATION OF MARIJUANA AND COCAINE USE AMONG EMPLOYED PERSONS AND ITS ASSOCIATION WITH WORK DAYS SKIPPED AND HEALTH STATUS Padwal TB, Patel AS, Banahan BF The University of Mississippi, Oxford, MS, USA OBJECTIVES: To examine levels of cocaine and marijuana use among employed individuals and the relationship between illicit drug use and work days skipped and health status within different occupational types. METHODS: Self reported interview data from the 2008 National Survey on Drug Use and Health (n = 55,739) was analyzed. Employed individuals (n = 22,757) were categorized into three occupational types: “skilled labor” (n = 6,706), “retail industry” (n = 5,021) and “professionals” (n = 11,030). Comparative analysis were conducted for level of drug use, health status and days of work skipped within the three occupational types. RESULTS: Among marijuana users (4.7%), 3.2% were recreational users (<7 days marijuana used per month) and 1.5% were heavy users (>7days per month). “Professionals” had the lowest rate of heavy marijuana users (1.0%) compared to “retail industry” (1.9%) and “skilled labor” (2.1%) (χ2 = 62.7, p < 0.001). More heavy marijuana users (1.2%) had skipped > 7 work days per month than recreation users (0.3%) and non-users (0.4%) (χ2 = 120.5, p < 0.001). Irrespective of occupational type, more heavy marijuana users (10.4%) reported fair/poor health than recreational (6.9%) and non-users (7.1%) (χ2 = 93.1, p < 0.001). “Professionals” had the lowest rate of cocaine use (0.6%), compared to “retail industry” (0.9%) and “skilled labor” (0.9%). Among cocaine users, “skilled labor” and “retail industry” employees skipped more work days compared to non-cocaine users (χ2 = 8.3, p = 0.016). Irrespective of occupational type, a greater percentage (11.8%) of cocaine users reported fair/poor health than non-cocaine users (7.6%) (χ2 = 32.9, p < 0.001). CONCLUSIONS: A distinct relationship exists between levels of illicit drug use, work days skipped, health status and occupational type. “Professionals” use less illicit drugs and may have lower levels of loss in productivity and better health status compared to individuals in “skilled labor” and “retail industry”. Several interesting conclusions can be derived from these findings that can be used to implement and control for illicit drug use across industries. PHP31 COMPUTERIZED INTERVENTIONS TO OBTAIN INDICATION INFORMATION FOR INPATIENT PRESCRIPTIONS: A PILOT STUDY IN DRUGS FREQUENTLY USED OFF-LABEL Walton S, Galanter W, Tiryaki F, Stafford RS University of Illinois at Chicago, Chicago, IL, USA, The University of Illinois at Chicago, Chicago, IL, USA, Stanford University, Palo Alto, CA, USA OBJECTIVES: Linking indication and prescribed medicine is central to comparative effectiveness research and evidence based medicine. Little research exists regarding mechanisms for acquiring indications for inpatient medication use. The main objective of this pilot study was to assess an intervention during computerized physician order entry (CPOE) for gathering indications for inpatient medication use. METHODS: Three medications were selected based on clinical interest and likelihood of off-label use: the proton pump inhibitor (PPI), lansoprazole, the intravenous immune globulin (IVIG), Flebogamma®, and recombinant Factor VIIa (rFVIIa). Alerts were triggered at the time of CPOE for each medication. To minimize physician burden, alerts were not triggered when appropriate indications/diagnoses were already listed in the electronic problem list. The alerts requested clinicians to enter either a labeled or off-label indication for the medication order. The lansoprazole, IVIG, and rFVIIa interventions ran for 60, 175, and 93 days, while 873, 56, 25 alerts were displayed to clinicians, respectively. A random sample of 100 alerts was chosen for the lansoprazole analysis. Expert chart review was used as the actual indication gold-standard. RESULTS: For lansoprazole, 81 % of the medication orders were off-label and 71% were off-label if all indications of the PPI drug class were considered. For Flebogamma®, 100% of the orders were off-label and 86% were off-label when considering all indications of the IVIG class. All orders for rFVIIa were off-label. The match between indications entered through the alert system and chart review was 61% for lansoprazole, 46% for IVIG, and 40% for rFVIIa. CONCLUSIONS: This pilot of indication based prescribing during CPOE illustrates many challenges: number of indications, coding (ICD9 codes are limited), and the tradeoff of information versus nuisance. The indication data generated was not highly accurate. The high rate of off-label use noted suggests the value of efficiently defining prescribing indications. HEALTH CARE USE & POLICY STUDIES – Equity and Access PHP32 ASSOCIATION OF PAYER STATUS WITH LENGTH OF STAY IN PATIENTS HOSPITALIZED FOR INJURY IN 2006 NHAMCS-ED DATA Liu J, Shi L Tulane University SPHTM, New Orleans, LA, USA, Tulane University, New Orleans, LA, |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/S1098-3015(10)72412-8 |
| Volume Number | 13 |
| Alternate Webpage(s) | https://core.ac.uk/download/pdf/82008696.pdf |
| Alternate Webpage(s) | https://doi.org/10.1016/S1098-3015%2810%2972412-8 |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
