Racial and Socioeconomic Disparities in Risk and Reason for Revision Total Shoulder Arthroplasty.

Background: With the rise of total shoulder arthroplasty (TSA), revision TSA is also becoming more prominent. However, there is a paucity of literature on potential racial, ethnic and socioeconomic disparities regarding revision TSA. The purpose of this study is to determine the risk and reason for revision TSA between racial, ethnic and socioeconomic groups.

Racial and ethnic disparities in short-stay primary total shoulder arthroplasty.

Background: There is a paucity of literature evaluating the utilization of short-stay total shoulder arthroplasty (TSA) in different racial groups. The purpose of this study is to compare short-stay TSA utilization and postoperative outcomes across racial groups.

Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried from 2010 to 2018 to identify patients who underwent primary short-stay TSA, defined as a length of stay of less than 2 midnights.

Anatomic total shoulder arthroplasty revised to reverse total shoulder arthroplasty: clinical and radiographic outcomes compared to primary reverse total shoulder arthroplasty.

Background: Reverse total shoulder arthroplasty (rTSA) has become the procedure of choice for a failed anatomic total shoulder arthroplasty (aTSA). Little data exist regarding outcomes; the few studies published to date have small numbers, short follow-up, and most do not have a control group or use first-generation implants. The purpose of this study is to compare the clinical and radiographic outcomes of failed aTSA revised to rTSA to primary rTSA.

Multiple drug intolerance syndrome: a large-scale retrospective study.

Background: The term multiple drug intolerance syndrome (MDIS) has been used to describe patients who express adverse drug reactions to three or more drugs without a known immunological mechanism.

Objective: To identify patient factors that could increase the risk of MDIS.

Method: Inpatient records over a 5-year period were captured from an electronic prescribing system to identify patients with at least one documented drug allergy.

Temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system.

Background: A computerized physician order entry (CPOE) system with embedded clinical decision support can reduce medication errors in hospitals, but might increase the time taken to generate orders.

Aims: We aimed to quantify the effects of temporal (month, day of week, hour of shift) and other factors (grade of doctor, prior experience with the system, alert characteristics, and shift type) on the time taken to generate a prescription order.

Setting: A large university teaching hospital using a locally developed CPOE system with an extensive audit database.

Second-generation antipsychotic drug use in hospital inpatients with dementia: the impact of a safety warning on rates of prescribing.

Background: Behavioural and psychological symptoms of dementia are distressing for patients and are frequently treated with second-generation antipsychotics. Concerns about the drugs' safety resulted in a Medicines and Healthcare Products Regulatory Agency (MHRA) warning against their use in March 2009.

Methods: Second-generation antipsychotic drug use was determined amongst patients with dementia admitted to the University Hospitals Birmingham National Health Service Foundation Trust, between July 2005 and December 2011.

The impact of direct healthcare professional communication on prescribing practice in the UK hospital setting: an interrupted time series analysis.

Background: Direct Healthcare Professional Communications (DHPCs) aim to quickly disseminate information to key healthcare professionals to inform practice and minimize patient harm. The Medicines and Healthcare products Regulatory Agency (MHRA) issues warnings and alerts to communicate safety information effectively in the UK.

Objective: To investigate the impact of MHRA DHPCs on prescribing practice in the secondary-care setting, looking specifically at a drug-drug interaction-the concomitant use of clopidogrel and proton pump inhibitors (PPIs) [as omeprazole]-and a drug-disease contraindication-the use of conventional (typical) antipsychotics in dementia.

Variation in cost of newly qualified doctors' prescriptions: a review of data from a hospital electronic prescribing system.

Purpose Of The Study: To investigate the variation in the net ingredient cost (NIC) of the medications most commonly prescribed by Foundation Year 1 (F1) doctors in a teaching hospital and to compare the effects of working in different specialties and rotations on this cost.

Design Of The Study: Retrospective review of prescription data from 5 August 2010 to 3 August 2011 extracted from an electronic prescribing system.

Results: The F1 doctors generated 81 316 prescriptions with an estimated total cost of £579 398.

A practical guide to monitoring for adverse drug reactions during antihypertensive drug therapy.

Monitoring of patients taking antihypertensive treatment can identify potential adverse drug reactions (ADRs). However, published guidelines give divergent or incomplete recommendations on monitoring for ADRs. Using a predetermined strategy, we undertook a systematic review to identify hypertension guidelines published from January 2001 to October 2011 with recommendations for monitoring for ADRs.

Developing consensus on hospital prescribing indicators of potential harms amenable to decision support.

Aims: To develop a list of prescribing indicators specific for the hospital setting that would facilitate the prospective collection of high-severity and/or high-frequency prescribing errors, which are also amenable to electronic clinical decision support.

Methods: A two-stage consensus technique (electronic Delphi) was carried out with 20 experts across England. Participants were asked to score prescribing errors using a five-point Likert scale for their likelihood of occurrence and the severity of the most likely outcome.