...0974-2441 Research Article EVALUATING THE EFFECT OF MEDICAL REPRESENTATIVE ON PHYSICIAN PRESCRIBING PATTERN IN IRAQ EHAB MUDHER MIKHAEL 1 University of Baghdad - College of pharmacy –Clinical pharmacy department. Email: ehab_pharma84@yahoo.com Received: 6 November 2013, Revised and Accepted: 5 December 2013 ABSTRACT Objective: Evaluation of the interaction between medical representatives (MRs) and physicians and the effect of such interaction on physician prescribing behavior, according to the site of view for Iraqi pharmacists. Methods: A survey for 36 pharmacists in their private pharmacies in different areas of Baghdad governorate was done through the use of a specific set of questions in a questionnaire format. Results: Most participated pharmacists agreed that physicians at most times change their prescribing pattern by attendance of the MRs, additionally there is a significant decline in the number of prescriptions for the promoted drug by the absence of medical representative for long period of time, furthermore participated pharmacists agreed that there is an irrational prescribing patterns by most physicians in Iraq. Conclusion: The interaction between MRs and physicians in Iraq, usually result in non rational prescribing patterns, which may in turn ne gatively affecting the health of the patients and on the other hand increases the cost of medications. Keywords: Promotion, medical representative, prescribing pattern. INTRODUCTION Drug promotion refers to all informational...
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...This paper aims to explore the role of the V100 nurse prescriber. The development of nurse prescribing will be outlined, followed by a reflective case study in which ethical and legal implications will be discussed and finally a reflective conclusion will be drawn. Where appropriate the paper will be written in the first person (Webb 1992). Nurse prescribing was first recommended, by the RCN, in 1980 and became part of the government’s policy agenda in 1986 with the Cumberlege Report (DH 1986). Further, the Crown Report (DH 1989) advocated prescribing by trained community nurses from a limited formulary. Legislation was introduced in 1992 -The Medicinal Products: Prescription By Nurses Act, 1992 followed by secondary legislation, Medicinal Prescriptions By Nurses etc which came into effect in 1994 - providing a legal basis to allow nurses to prescribe (Dimond 2002). Nurse prescribing using the Nurse Prescribers’ Formulary (NPF) was introduced nationally in 1998 following the success of eight demonstration sites set up four years earlier (Luker et al 1998). A second Crown Report (DH 1999) recommended the establishment of two groups of nurse prescribers: independent and supplementary. In 2000 the government announced proposals to extend nurse prescribing further to allow prescribing from an extended formulary following more intensive pharmacological training (DH 2000). In the case study the patient’s name, address, date of birth and gp’s details have been changed...
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...UNIVERSITY OF THE WEST OF SCOTLAND NURSE PRESCRIBING V150 CASE STUDY COURSE: NURS09125 BANNER NUMBER: B00113677 DATE OF SUBMISSION 13/12/10 COURSE LEADER FRANCES DOWNER WORD COUNT: 3745 CONTENTS PAGE 1. INTRODUCTION & GENERAL OVERVIEW, Pgs3-4. 2. ASSESSMENT PROCESS, Pgs 5-8 3. TREATMENT OPTIONS, Pgs 9-12. 4. EVALUATION, Pgs 13-16 5. CONCLUSION. Pg 17 6. COPY OF PRESCRIPTION, Pg 18 7. REFERENCE SECTION, Pgs 19-23 8. BIBLIOGRAPHY, Pg 24. INTRODUCTION In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of prescribing in the community setting. The author a (trainee nurse prescriber) will display the need for a robust assessment, exploring all areas of health and well-being in order to achieve a safe outcome. The author will further follow current guidelines and be mentored by a senior nurse prescriber throughout the process. The aim of the case study is to display the implications involved in issuing a nurse prescription if deemed appropriate. With regard to writing a prescription as a qualified practioner, the author will adhere to the guidance within the Nursing and Midwifery Council (NMC 2006a) standards for safe prescribing. To protect this patient’s identity and maintain confidentiality, she will be referred to as Mrs X throughout the...
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...Drugs and Medicines Policy Geneva WHO/EDM/PAR/2001.2 DISTRIBUTION: GENERAL ORIGINAL: ENGLISH Teacher’s Guide to Good Prescribing World Health Organization Department of Essential Drugs and Medicines Policy Geneva, Switzerland Authors Hans V. Hogerzeil1 (Editor) Karen I. Barnes2 Rob H. Henning3 Yunus E. Kocabasoglu3 Helene Möller4 Anthony J. Smith5 Rob S. Summers6 Theo P.G.M. de Vries7 with contributions from Hannelie Meyer, Sule Oktay, Budiono Santoso and Sri Suryawati 1 2 3 4 5 6 7 WHO Department of Essential Drugs and Medicines Policy, Geneva, Switzerland WHO Collaborating Centre for Drug Policy, Information and Safety Monitoring, Department of Clinical Pharmacology, Medical School, University of Cape Town, Cape Town, South Africa WHO Collaborating Centre for Pharmacotherapy Teaching and Training, Department of Pharmacology and Clinical Pharmacology, Medical Faculty, Groningen University, Groningen, The Netherlands WHO, South African Drug Action Programme, Pretoria, South Africa WHO Collaborating Centre for Pharmacotherapy Teaching and Training, Discipline of Clinical Pharmacology, Medical School, Newcastle, Australia WHO Collaborating Centre for Pharmacy Curriculum Development and Rational Use of Drugs, School of Pharmacy, Medical University of Southern Africa, Pretoria, South Africa Department of Pharmacology, Medical Faculty, University of Amsterdam, Amsterdam, The Netherlands Acknowledgements The support of the following persons in reviewing...
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...tragic. Today there are four times more deaths related to opioids such as, “oxycodone, hydrocodone, and methadone” (CDC). the most popular age for opioid users is between the ages of 18 and 25. Due to the convenience, price, and potency, nearly three out of four new heroin users began by using prescription opioids. Sadly, the CDC reports “heroin-related deaths more than tripled between 2010 and 2015”. Clearly, this indicates if officials can control the prescription opioid epidemic than heroin usages would decrease greatly. Thus, the focus should be on the medical industry because most enforcement officials are trying their hardest. But they can only do so much if the medical industry continues to leak them onto the streets. To prevent these deaths, the CDC states the prescribing of opioids needs improvement, expansion of addiction treatment and a reduction in access to illegal opioids. Thus indicating both the medical industry, enforcement and treatment centers need to all work...
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...E P I DE M IC: R E SP ON DI NG T O A M ER ICA’ S PR E S CR I P T ION DRUG A BUSE CR I SI S 2 011 Background Prescription drug abuse is the Nation’s fastest-growing drug problem. While there has been a marked decrease in the use of some illegal drugs like cocaine, data from the National Survey on Drug Use and Health (NSDUH) show that nearly one-third of people aged 12 and over who used drugs for the first time in 2009 began by using a prescription drug non-medically.1 The same survey found that over 70 percent of people who abused prescription pain relievers got them from friends or relatives, while approximately 5 percent got them from a drug dealer or from the Internet.2 Additionally, the latest Monitoring the Future study—the Nation’s largest survey of drug use among young people—showed that prescription drugs are the second most-abused category of drugs after marijuana.3 In our military, illicit drug use increased from 5 percent to 12 percent among active duty service members over a three-year period from 2005 to 2008, primarily attributed to prescription drug abuse.4 Although a number of classes of prescription drugs are currently being abused, this action plan primarily focuses on the growing and often deadly problem of prescription opioid abuse. The number of prescrip tions filled for opioid pain relievers—some of the most powerful medications available—has increased dramatically in recent years. From 1997 to 2007, the milligram per person use of prescription...
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...| The Addiction of America | The Abuse of Prescription Drugs in the United States | Sean Barnes | Western Governors University | 12/19/2014 | The abuse of prescription drugs in the United States has reached epidemic proportions and continues to get worse. Most people, however, do not realize how big the problem really is. It continues to get worse every year and it demands our attention. In 2011, just three short years ago, an estimated 52 million people in the United States over the age of 12 had used prescription drugs for a non-medical reason (National survey on drug use, 2011). The most commonly abused prescription drugs are pain relievers. Why are people abusing these drugs and where do they get them? This paper will attempt to answer those questions as well as pose a possible solution on how it can be corrected. Analyzing the Problem To begin, we must first take a look at why so many American citizens are abusing prescription drugs. Most will probably tell us that they became addicted to pain relievers after some sort of horrible accident or surgery. They were prescribed these medications by their Primary Care Provider and told to take them in the correct manner, which are usually one or two tablets/pills every four to six hours apart, as needed for pain. What they were probably not told by their Primary Care Provider is that they should not take them sooner than directed, nor should they take them whenever they are not experiencing pain. The directions on...
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...Agency Overview HCA/210 Dianne Blount 08/31/2012 Joan Craine The purpose of the Board of Medical Examiners is to help licensed. Physicians in Georgia to consider and reevaluate their prescribing practice of controlled substances. Practicing physicians who become new Board members to help them to become more educated and teach them about the laws. Of Georgia and they or giving detail information on prescribing medication, in certain specific situations, the Medical Board, is the agency that licenses physicians. Physician assistants, respiratory care professionals, pre fusionists, acupuncturists, they even train professionals on how to treat people that have ear problems. The Medical Board even has to investigates, complaints and disciplines those who violate. The Medical Practice or other laws that’s governing the professional behavior of its licensees there mission. Is to protect the health of Georgians through the proper licensing, physicians and certain members of the healing arts, even though the. Georgia Medical Examiners have a lot of work to do they have to make sure that they train their residency’s the correct way. Because they do have the rights to take away any professional licenses away if they don’t follow the rules and the requirements and the enforcements of the Medical laws. The Service that the Medical Examiner’s Perform. The Medical Examiner’s office of Georgia they provide a complete forensic pathology services to 153 of Georgia’s...
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...Prescription Opioids Deanna Pannell Aurora University One of the growing problems in America is the abuse of prescription opioids. In the past 10 years, the misuse of prescribed opioids has gone out of control, making it a national issue that many people are attempting to attack. Prescription opioid use is increasing in public health, creating an epidemic that is growing rapidly. According to the National Institute on Drug Abuse: opiates, depressants, and stimulants are the three drug classifications most commonly abused by Americans. A multitude of research on the subject has concluded that there is more than a single solution to the problem, such as taking immediate action as well as creating prevention strategies. I decided to do additional research on this topic since it plays a huge part in my career as well as personal life. Being a substance abuse counselor in the criminal justice field, I experience first-hand the effects of prescription opioid abuse. A large number of client’s participating in the TASC (Treatment Alternatives for Safer Communities) are dealing with prescription opioid abuse due to an injury or surgical procedure. On April 25, 2015, my first cousin died from a heroin overdose at the age of 23. After a football injury, he was prescribed Hydrocodone and became addicted. Since the pills are too expensive, he began using heroin and his battle ended 5 years later. In 2009, 16 million Americans age 12 and older reported taking a prescription pain reliever...
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...States. It is also one of the most rapidly growing dilemmas in America influencing people of all ages. Prescription drug use in the past was limited to adults. Over the last decade, more and more children and adolescents are consumers of these drugs. Coping with children who behaved badly in the past has taken a new direction that includes prescribing medications. Medical professions now have the option to prescribe these medications as they see fit. Many physicians are more than willing to write a prescription based on the complaints of a patient rather than finding other treatment options or the root of the problem. Drugs manufactures have had to come up with new and innovative ways to market these drugs to healthcare providers and the public as well. As society changes so will the way drugs are marketed, prescribed and taken. Demand for prescription drugs will continue to increase as well as the overall cost. Consumers today demand more flexibility in acquiring prescription medications rather than using the traditional drug stores. Patients are swamped by pharmaceutical ads and physicians are repeatedly proliferated with drug prescribing information from pharmaceuticals representatives. Getzen and Allen (2007) states, “the average American fills 11 prescriptions per year. Pharmaceuticals were a $188.5 billion industry in 2004, for which government and private insurance paid two-thirds of the bill” (p. 263). This paper provides a snapshot of the issue of prescription drugs...
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...Assessment 6 Change Management Proposal Recent evidence and current trends show both nursing and medical professions have a lack of understanding in certain aspects of safe prescribing and safe administration of medicines. The concept of prescribing and the ability to calculate is the basic requirement of all qualified medical and nursing professions We are proposing over a three year period to run an inter professional collaborative working programme, whereby both student nurses and doctors will come together on a regular basis in a teaching environment to work alongside each other to gain the following skills: • Patient safety in relation to drug administration • Patient safety in relation to drug prescribing • A clearer understanding of each others role • Practical experience in drug administration and drug prescribing in a non –threatening environment • Insight into pharmacology and pharmokinetics and it’s importance in prescribing and administration of drugs. This three-year study we propose to write up and evaluate and hope to publish with the intention to produce learning materials and educational packs to be marketed at later date Rationale for Change Project Medications Errors within any health care setting can have severe consequences not only for the patient but financially for the organisation if litigation comes about. Medication errors can be defined as “any incorrect or wrongful administration of a medication...
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...Introduction The saying health is wealth has different meanings. It could mean that healthy people have less medical expenses or that people treasure good health more than money. The goal of a healthy lifestyle is to have a long life and remain disease or cancer free. The United States of America is known as a developed nation and people would assume that it provides its citizens with equal and an adequate medical care. According to the World Health Organization (WHO), “America spent more on health care per capita ($8,608) and more on health care as a percentage of its GDP (17.2%), than any other nation in 2011.” This means that the US puts a lot of emphasis on their healthcare compared to any other country in the world. But the reality is the Commonwealth Fund, a private American foundation, ranked the United States of America last in the quality of healthcare compared to the world in 2014. Also, America is ranked as one of the most expensive healthcare providers in the world. The US was compared to countries like Australia, Canada, United Kingdom, France, Germany, Netherlands, New Zealand, Sweden and Switzerland. The rankings prove that the American healthcare system is indeed facing many issues. Some of the major issues are accessibility of healthcare to all, lack of consolidation within the industry, deficiency in technology, lack of data availability and lastly, over dependence on medications by healthcare professionals such as doctors. The issue highlighted in this...
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...Clinical Audit An audit of subcutaneous syringe drivers in a non-specialist hospital K Dunne, K Sullivan, A Garvey, G Kernohan, A Diamond, C Duffy, J Hutchinson drug administration can facilitate the management of pain, control of nausea and vomiting, restlessness, confusion and drying secretions in the throat. Abstract T he use of syringe drivers as a method of drug delivery to control symptoms in palliative care is a common and accepted practice, but one which has evolved rather than been subject to close multiprofessional scrutiny and guideline formation. There is evidence that adverse incidents may arise as a result of syringe driver use (Medical Devices Agency (MDA), 1998), for example, errors in drug calculations, drug stability, equipment failure (including disconnection) and the wrong rate of infusion. Inadequate user training, poor servicing of equipment and inadequate documentation and record keeping are all thought to be contributing factors (MDA, 1998). In the hospital where this audit was carried out, syringe drivers are used to administer drugs to patients with cancer during the palliative phase of illness. The purpose of this clinical audit was to establish the standard of current practice in wards where syringe drivers were being used. A retrospective study of 13 cases of syringe driver use is presented. The results highlight many areas of unregulated practice with regard to setting up, monitoring and maintenance of syringe drivers. The choice of...
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...study seeking out barriers to the implementation of non pharmacological interventions for patients with dementia by nursing home staff. To better recognize and understand these barriers and to in hopes of providing a stronger evidence base for cultural change, researchers elicited nursing staff, recreational therapists, activity personnel and medical directors in a study titled “Its About Time: Use of Nonpharmacological Interventions in the Nursing Home.” Problem Statement Dementia is one of the most common diagnoses on the rise amongst the geriatric population. Alzheimer’s The most common form of dementia is Alzheimers, affecting well over 5 million people nationally. Institutionalization is common amongst this population as the disease begins to progress, typically bringing on behavioral and psychological symptoms of dementia (BPSD) including agitation, aggression and depression. This population is recognized as vulnerable and fragile, both mentally and physically. Many frequently have physical comorbidities along with dementia. This issue of suffering from comorbidities brings on the prescribing of multiple medications, which over time interact and accelerate their functional decline (Kolanowski, Fick, Frazer, Penrod, 2009). Due to the lack of beneficial effects when weighted against both short and long term adverse effects of various medications used to treat BPSD, majority of practice guidelines advocate for non-pharmacological approaches to be used as the first line...
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...Patient Group Directions December 2009 A practical guide and framework of competencies for all professionals using patient group directions National Prescribing Centre Patient Group Directions 2009 Acknowledgements Editors John Wright Business Manager - Non-Medical Prescribing Department of Health Gillian Arr-Jones National Pharmacy Advisor Care Quality Commission Angela Bussey PGD Website Pharmacist Editor London and South East Medicines Information Service, Guy’s and St Thomas’ NHS Foundation Trust Mary Golding Associate Director Community Health Services East & South East England Specialist Pharmacy Services Sandra Wolper Associate Director Community Health Services East & South East England Specialist Pharmacy Services Liz Mellor Clinical Governance Lead Pharmacist Leeds Teaching Hospitals NHS Trust Anne Fittock Non-Medical Prescribing National Advisor National Prescribing Centre Production Colin Bowers Web and Publications Officer (Corporate) Merissa Bellew Web and Publications Manager Published by: National Prescribing Centre Ground Floor, Building 2000 Vortex Court Enterprise Way Wavertree Technology Park Liverpool L13 1FB Tel No: (0151) 295 8671 Fax No. (0151) 220 4334 Websites: www.npc.co.uk www.npci.org.uk Contributors © National Prescribing Centre National Prescribing Centre Patient Group Directions 2009 Contents 1 Introduction 1.1 Purpose of this document 1.2 Audience for the document 02 03 03 03 06 06 07 07 08 11 11 11 12 12 13 14 15 15 16...
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