Pharmacoepidemiology and drug safety
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Pharmacoepidemiol Drug Saf · Dec 2014
ReviewMeasures to quantify the abuse of prescription opioids: a review of data sources and metrics.
The abuse and nonmedical use of prescription opioids and its subsequent consequences are an important public health concern. This phenomenon has paralleled the increase in the therapeutic use of opioids for pain management. There is thus a need to measure prescription opioid abuse to understand trends over time and to compare abuse of one product to another. The purpose of this review is to provide an overview of the strengths and weaknesses of frequently used numerators and denominators in "abuse ratios" (ARs). ⋯ Moving forward, it is important that there be a common understanding in the scientific community regarding how to select appropriate measures to serve as numerators and denominators in AR calculations, and how to interpret the resultant findings. There is no single best measure of abuse for use as a numerator in an AR, and each must be chosen and interpreted in the context of what it measures. For public health considerations, one must always look at both absolute numbers and adjusted numbers. When conducting multiple analyses using different measures of exposure as denominators, differences in ARs are not unexpected, but one should explore why there are differences and assess the appropriateness of each of the denominators.
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Pharmacoepidemiol Drug Saf · Nov 2014
ReviewMortality rate in so-called "metformin-associated lactic acidosis": a review of the data since the 1960s.
The aim of this study is to study the mortality rate in so-called "metformin-associated lactic acidosis" (MALA) from the 1960s to date and to establish whether the rate has changed over time. ⋯ The overall mortality rate for MALA was around 50% during the period 1960-2000 but has since fallen to around 25%.
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Pharmacoepidemiol Drug Saf · Sep 2014
ReviewMeasuring frailty using claims data for pharmacoepidemiologic studies of mortality in older adults: evidence and recommendations.
Geriatric frailty is a common syndrome of older adults that is characterized by increased vulnerability to adverse health outcomes and influences treatment choice. Pharmacoepidemiologic studies that rely on administrative claims data in older adults are limited by confounding due to unmeasured frailty. A claims-based frailty score may be useful to minimize confounding by frailty in such databases. We provide an overview of definitions and measurement of frailty, evaluated the claims-based models of frailty in literature, and recommend ways to improve frailty adjustment in claims analysis. ⋯ We found little research conducted on development and application of a claims-based frailty index for confounding adjustment in pharmacoepidemiologic studies in older adults. More research is needed to advance this innovative, potentially useful approach by incorporating the expertise from aging research.
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Pharmacoepidemiol Drug Saf · Aug 2012
ReviewTerms used in patient safety related to medication: a literature review.
There is a lack of homogeneity in the terminology used in the context of patient safety related to medication. The aim of this review was to identify the terms and definitions used in patient safety related to medication within the scientific literature. ⋯ A multitude of terms and definitions are used in patient safety related to medication. This heterogeneity makes it difficult to compare the results among studies and to appreciate the true magnitude of the problem. Classifying and unifying the terminology is necessary to advance in patient safety strategies.
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Pharmacoepidemiol Drug Saf · Apr 2012
ReviewCommunity pharmacists' adoption of medicines reclassified from prescription-only status: a systematic review of factors associated with decision making.
Subsequent to reclassification of legal status, more than 90 prescription-only medicines have become available in the UK alone without a prescription. Similar changes are taking place internationally. The aim was to systematically review studies reporting factors associated with community pharmacists' decision making around adoption of these reclassified medicines into practice. ⋯ Patient safety appears to be the key to pharmacists' decision making. However, the study quality limitations indicate the need for further robust research. The 28 factors identified in this systematic review from international literature can aid rigorous research instrument development for future evaluations.