Pharmacoepidemiology and drug safety
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Pharmacoepidemiol Drug Saf · Jul 2008
Reliability of the assessment of preventable adverse drug events in daily clinical practice.
To determine the reliability of the assessment of preventable adverse drug events (ADEs) in daily practice and to explore the impact of the assessors' professional background and the case characteristics on reliability. ⋯ Individual assessment of preventable ADEs in real patients is difficult, possibly because of the difficult assessment of contextual information. Best approach seems to be a consensus method including both pharmacists and physicians.
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The Infectious Diseases Society of America and US CDC recommend 60 days of ciprofloxacin, doxycycline, or amoxicillin for anthrax prophylaxis. It is not possible to determine severe adverse drug event (ADE) risks from the few people thus far exposed to anthrax prophylaxis. This study's objective was to estimate risks of severe ADEs associated with long-term ciprofloxacin, doxycycline, and amoxicillin exposure using three large databases: one electronic medical record (General Practice Research Database) and two claims databases (UnitedHealthcare, HMO Research Network). ⋯ Long-term amoxicillin, ciprofloxacin, and doxycycline appear safe, supporting use of these medications if needed for large-scale post-exposure anthrax prophylaxis.
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Pharmacoepidemiol Drug Saf · Apr 2008
Antibiotics in Dutch general practice: nationwide electronic GP database and national reimbursement rates.
In order to assess whether different databases generate information which can be reliable compared with each other, this study aimed to assess to which degree prescribing rates for systemic antibiotics from a nationwide electronic general practitioner (GP) database correspond with national reimbursement rates, and to investigate for which indications antibiotics are prescribed. ⋯ GPs voluntarily participating in a research network prescribe less antibiotics than Dutch GPs in general, and are cautious in prescribing newer and more broad-spectrum antibiotics. This point has to be taken into account when databases will be compared with each other.
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Pharmacoepidemiol Drug Saf · Mar 2008
Population-based study of the effectiveness of bone-specific drugs in reducing the risk of osteoporotic fracture.
Evidence supports bone-specific drugs (BSDs) efficacy in the fracture risk reduction. But treatment rates for osteoporosis among high-risk patients are far below the recommended guidelines. A major concern about BSDs is the lack of adherence with treatment. ⋯ The incidence of fractures decreased by 16% among women with OP when more than 80% of BSDs was used for at least 3 years. Among women with a prior fracture, fracture risk reduction was not significant. Exposure to BSDs among women with a prior fracture is troubling, given that only approximately 12% of these individuals were being treated, and only 2% was using BSDs for the long term.