Browsing by Subject "prescription"
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Item Differences in Risk of Injury Between Stimulant-Treated and Untreated ADHD Patients(2006-08-01) Segars, Larry W.; Raghbir Sandhu; Krisine LykensSegars, Larry W., Differences in Risk of Injury between Stimulant-Treated and Untreated ADHD Patients. Doctor of Public Health (Epidemiology), August 2006, 63 pp, 7 tables, 0 illustrations, references, 78 titles. ADHD is a common psychiatric disorder of childhood and adolescence that also occurs in adults and spans the life of the patient. ADHD is characterized by lack of focus, distractibility, and poor concentration. Limited data have been generated focusing on ADHD patients and the association with an increased risk of injury. Unfortunately, no study has been published evaluating the effect of stimulant treatment for ADHD on the risk of injury requiring ambulatory medical care. This research utilized four concatenated years, specifically 1998-2001, of the National Ambulatory Medical Care Survey (NAMCS). This dissertation is comprised of five chapters beginning with a description of ADHD, its characteristics, diagnosis, and treatment. This overview chapter is followed by a complete review of the literature describing the publication’s which assessed the association between ADHD and the risk of injury. The next chapter is a thorough review of the NAMCS and its methodology. The concatenated dataset captured 889 office visits associated with a diagnosis of ADHD, 666 of which were also related to the prescription of a stimulant for the management of ADHD. Using NAMCS’s weight variable these values produced a national estimate of 21,223,391 office visits associated with the ADHD diagnosis and 15,604,329 office visits associated with the prescription of a stimulant for ADHD. This research determined that there was a borderline statistically significant increased association with the prescription of a stimulant for the treatment of ADHD and the risk of injury requiring treatment in an ambulatory medical care setting. Interestingly, compared to patient’s who recorded their race as Caucasian, patients who recorded their race as “Other”; representing the races of Asian, Native Hawaiian/Other Pacific Islander, or American Indian/Alaska Native, and individuals indicating more than one race, had a statistically significant increased risk of injury necessitating treatment in an ambulatory medical care setting. Potential theories for this unique finding, along with the limitations of this research, are provided in the final discussion chapter.Item DO PRESCRIPTION PICTOGRAMS IMPROVE UNDERSTANDING OF MEDICATION DIRECTIONS FOR SPANISH SPEAKING PATIENTS?(2013-04-12) Scifres, TimothyPurpose: Language barriers exist in the US between Spanish-speaking patients and English- speaking healthcare providers, especially in terms of explaining and understanding proper medication use. This study aimed to measure the understanding of prescription instructions within the Spanish speaking population by using pictograms. The study also aimed to determine if medication instruction comprehension was increased with prescription instructions in Spanish compared to English instructions customarily included. Methods: The investigators constructed a survey to measure the participants' prescription instruction comprehension and utilized a cross-sectional study design to conduct study analyses. The survey included participant demographics, Prescription Instruction Comprehension (PIC) scores, and participant reflections. The survey was conducted throughout the Dallas/Fort Worth Metroplex from June 2012 to August 2012. Participants were recruited from the Bob Mann Medical Clinic in Arlington, TX as well as other locations in the Dallas/Fort Worth Metroplex area. A paired sample T-test was performed to compare the means of participants' Prescription Instruction Comprehension (PIC) scores with the pictogram versus without pictograms as well using prescription instructions written in Spanish versus English. Results: A total of 128 surveys were conducted for this study. There was statistically significant difference between mean PIC score with pictograms (M = 89.76, SD = 16.17), and mean PIC score without pictograms (M = 82.94, SD 20.48), t (114) = 7.56, p < .0005 (2-tailed). A statistically significant difference was found between PIC scores of Spanish instructions (M = 89.76, SD = 16.17) and PIC scores of English instructions (M = 77.97, SD = 22.24), t (114) = 7.98, p < .0005. When participants were asked if pictograms increased their confidence in understanding prescriptions, 84.8% responded "yes." More than half of participants (64.8%) responded "yes" to "would like pictograms included with all of your prescriptions", and 27.2% of the participants responded "yes but with better pictures." Conclusions: Adding pictograms to prescription instructions improved overall understanding for Spanish-speaking participants. This study also found that including prescription instructions in Spanish, the participants' native language, increased correct interpretation of how to take prescription medications. Pictograms also increased participants' confidence for understanding their medication directions.Item The Effectiveness of Outpatient Antiemetic for Patients on Platinum, Camptosar, and Anthracycline-Based Chemotherapy(2002-07-25) Wiggins, Jenny Marie; Victoria Rudick; Julie PrejeanAbstract. Chemotherapy-induced nausea and vomiting (CINV) is a serious problem affecting at least 50% of patients. Some nausea and vomit pathways involve serotonin and serotonin type-3 (5-HT3) receptors for propagation of the reflex. 5-HT3 antagonists were developed to block the 5-HT3 receptors and inhibit emesis. Anzemet, Kytril, and Zofran are 5-HT3 antagonists used as antiemetics in patients receiving emetogenic chemotherapy. This study was designed to determine if current antiemetic therapy involving these 5-HT3 antagonists is effective for patents on platinum, camptosar, and anthracycline-based chemotherapy. The data from this study could be used to assert or adjust antiemetic therapy in patients on these chemotherapy regimens, thus providing better quality of life for patients as they undergo chemotherapy. Patients on platinum, camptosar, or anthracycline-based chemotherapies from three Fort Worth area clinics of Texas Cancer Care were chosen to gauge the effectiveness of their antiemetic regimen based on chemotherapy regimen, patient compliance, and specific 5-HT3 antagonist. Data was gathered based on questionnaires filled out by the patient for seven days and their chemotherapy nurse on the day of their treatment. It was found that Zofran was the 5-HT3 antagonist most often prescribed by the nurses. Patient compliance was not a factor in patient perception of CINV, because of the high levels of patient cooperation. Each of the chemotherapy regimens differed by day in overall average level of CINV. Patients on Kytril were found to experience more “severe” CINV than those taking Anzemet or those not taking a 5-HT3 antagonist as an outpatient. A recommendation from this study would be a larger sample size and a larger span of time. Each of the study sites should also be compared for nurse prescribing habits and patient compliance, as well as a higher level of decadron usage for patients experiencing moderate and severe CINV.