Thesis (Ph. D.)--Duquesne University, 2004. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 138-143).

The objectives of this study were to investigate the hypotheses that: (1) Job satisfaction is related to medical specialty, the physician's nationality, and length of tenure. (2) The physician's attitude toward the Drug Utilization Review (DUR) program is related to medical specialty, the place of residency training, length of tenure, and job satisfaction. (3) The quality of drug prescribing is related to medical specialty, the place of residency training, length of tenure, job satisfaction, and the physician's attitude toward the DUR program. The results indicated a significant relationship between the physician's nationality and job satisfaction (P = 0.001), and between job satisfaction and the physician's attitude toward the DUR program (P 0.001). Medical specialty was a strong independent predictor of the quality of drug prescribing (P = 0.002). However, the other independent variables of the locale of residency training, length of tenure, job satisfaction, and the physician's attitude toward the DUR program were not related to drug prescribing.

Chong, Kam Lin. / Thesis submitted in: December 2002. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 165-174). / Abstracts in English and Chinese. / ABSTRACT --- p.ii / ACKNOWLEDGEMENTS --- p.vii / TABLE OF CONTENTS --- p.viii / LIST OF ABBREVIATIONS --- p.xi / Chapter / Chapter 1. --- Introduction --- p.1 / Chapter 2. --- Literature review --- p.10 / Chapter 2.1 --- Prescribing patterns of antibiotics in hospital --- p.12 / Chapter 2.2 --- Worldwide problem of misuse of antibiotics --- p.15 / Chapter 2.2.1 --- Misuse of antibiotics in developed countries --- p.15 / Chapter 2.2.1.1 --- The United States of America --- p.16 / Chapter 2.2.1.2 --- The United Kingdom --- p.19 / Chapter 2.2.1.3 --- Australia --- p.23 / Chapter 2.2.1.4 --- Canada --- p.25 / Chapter 2.2.2 --- Misuse of antibiotics in African countries --- p.27 / Chapter 2.2.3 --- Misuse of antibiotics in Asian countries --- p.30 / Chapter 3. --- Objectives --- p.37 / Chapter 4. --- Methods --- p.39 / Chapter 4.1 --- Subjects --- p.39 / Chapter 4.2 --- Data --- p.41 / Chapter 4.3 --- Definition of terms --- p.44 / Chapter 4.3.1 --- Name of antibiotic --- p.44 / Chapter 4.3.2 --- Antibiotic course and antibiotic therapy --- p.44 / Chapter 4.3.3 --- Indications and types of antibiotic therapy --- p.47 / Chapter 4.3.4 --- Switch therapy --- p.50 / Chapter 4.3.5 --- Types of change --- p.50 / Chapter 4.3.6 --- Causes of change --- p.51 / Chapter 4.3.7 --- Clinical outcome of treatment --- p.53 / Chapter 4.3.8 --- Length of stay --- p.54 / Chapter 4.4 --- Determination of pattern of use --- p.54 / Chapter 4.5 --- Assessment of antibiotic therapies --- p.55 / Chapter 4.5.1 --- Assessment of indication and choice of agent --- p.59 / Chapter 4.5.2 --- Assessment of dosage --- p.60 / Chapter 4.5.3 --- Assessment of route of administration --- p.62 / Chapter 4.5.4 --- Assessment of duration of therapy --- p.62 / Chapter 4.6 --- Features of the guideline developed for the present study --- p.63 / Chapter 4.6.1 --- Ceftriaxone and cefotaxime are appropriate for treating serious infections --- p.72 / Chapter 4.6.2 --- Cefuroxime is not a first line agent --- p.72 / Chapter 4.6.3 --- Regimen for Helicobacter pylori eradication --- p.73 / Chapter 4.7 --- Statistical analysis --- p.73 / Chapter 5. --- Results --- p.74 / Chapter 5.1 --- Antibiotic courses and patients --- p.74 / Chapter 5.1.1 --- Inclusion and exclusion of antibiotic courses --- p.74 / Chapter 5.1.2 --- Patient sex and age --- p.76 / Chapter 5.1.3 --- Chronic disease/past medical history --- p.76 / Chapter 5.1.4 --- Length of stay --- p.78 / Chapter 5.2 --- Pattern of use --- p.79 / Chapter 5.2.1 --- Indications and sites of infection --- p.79 / Chapter 5.2.2 --- Types of antibiotic therapy --- p.83 / Chapter 5.2.3 --- Antibiotics prescribed in initial therapy --- p.84 / Chapter 5.2.4 --- Number of antibiotics in initial therapy --- p.87 / Chapter 5.2.5 --- Prescribing pattern of antibiotics in initial therapy --- p.88 / Chapter 5.2.5.1 --- Prescribing pattern of antibiotics in empirical treatment of lower respiratory tract infections --- p.89 / Chapter 5.2.5.2 --- Prescribing pattern of antibiotics in empirical treatment of sepsis --- p.90 / Chapter 5.2.6 --- Types of change --- p.92 / Chapter 5.2.7 --- Causes of change --- p.92 / Chapter 5.2.8 --- The relationship between causes of change and types of change --- p.93 / Chapter 5.2.9 --- Antibiotics prescribed in switch therapy --- p.96 / Chapter 5.2.10 --- Number of antibiotics in switch therapy --- p.99 / Chapter 5.3 --- Appropriateness of antibiotic therapy --- p.100 / Chapter 5.3.1 --- Appropriateness of empirical therapies --- p.101 / Chapter 5.3.2 --- Appropriateness of directed therapies --- p.102 / Chapter 5.3.3 --- Appropriateness of prophylactic therapies --- p.103 / Chapter 5.3.4 --- Appropriateness of unclassified therapies --- p.104 / Chapter 5.4 --- Clinical outcomes of treatment --- p.105 / Chapter 6. --- Discussion --- p.106 / Chapter 6.1 --- Limitations --- p.106 / Chapter 6.2 --- Method --- p.110 / Chapter 6.2.1 --- Symptom improved and not responded --- p.110 / Chapter 6.2.2 --- Grand round --- p.111 / Chapter 6.2.3 --- Susceptibility test result --- p.111 / Chapter 6.3 --- Results --- p.112 / Chapter 6.3.1 --- Patients --- p.112 / Chapter 6.3.2 --- Pattern of use --- p.113 / Chapter 6.3.2.1 --- Types of therapy --- p.113 / Chapter 6.3.2.2 --- Site of infection --- p.113 / Chapter 6.3.2.3 --- Prescribing pattern of antibiotics in initial therapy --- p.114 / Chapter 6.3.2.4 --- Relationship between types and causes of change --- p.115 / Chapter 6.3.3 --- Appropriateness of antibiotic therapies --- p.117 / Chapter 6.3.3.1 --- Misuse of empirical therapy --- p.118 / INAPPROPRIATE USE OF ANTIBIOTICS IN LOWER RESPIRATORY TRACT INFECTION --- p.118 / INAPPROPRIATE USE OF ANTIBIOTICS IN SEPSIS --- p.120 / MISUSE OF CEFUROXIME --- p.122 / MISUSE OF THIRD GENERATION CEPHALOSPORIN --- p.127 / Chapter 6.3.3.2 --- Appropriate use of directed therapy --- p.129 / Chapter 6.3.3.3 --- Appropriate use of prophylactic therapy --- p.130 / Chapter 6.3.3.4 --- Excessive use of unclassified therapy --- p.131 / Chapter 6.3.4 --- Clinical outcome of treatment --- p.133 / Chapter 6.4 --- Conclusion --- p.134 / Chapter 7. --- Summary --- p.136 / Chapter 8. --- Recommendations --- p.140 / APPENDICES --- p.143 / Chapter 1. --- Usual adult daily dose range of antibiotics --- p.144 / Chapter 2. --- Assessment of indications and choices of agent of initial therapies in an audit of 324 antibiotic courses in a medical ward --- p.146 / Chapter 3. --- Culture test results in an audit of use of antibiotics in a medical ward --- p.160 / Chapter 4. --- Generic to trade name conversion of antibiotics --- p.163 / REFERENCES --- p.165

published_or_final_version / Medicine / Master / Master of Philosophy

No description available.

Thesis (Ph. D.)--University of Texas at Austin, 2004. / Supervisor: M. Lynn Crismon. Vita. Includes bibliographical references. Also available from UMI.

Thesis (Ph. D.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains xii, 263 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 233-242).

Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 1997. / Typescript. Bibliography: leaves 154-161.

A presente pesquisa, tipo descritivo, objetivou descrever o sistema de utilização de medicamentos em dois hospitais situados na cidade de Recife-PE. Com essa finalidade, buscou-se caracterizar a estrutura do sistema de medicação, descrever o processo de medicação e analisar os resultados sob a perspectiva do paciente e dos profissionais de enfermagem sobre o sistema. Para tanto, a população foi composta por 14 médicos, 14 enfermeiros, 22 farmacêuticos, 30 auxiliares de farmácia, 50 auxiliares de enfermagem, 63 pacientes e 372 folhas de prescrição de medicamentos e evolução de enfermagem. As técnicas utilizadas para coleta de dados foram a observação não participante e a entrevista, por meio de roteiros estruturados. Os resultados revelaram que, na estrutura, os ambientes do preparo de medicamentos se encontraram em discordância com a legislação vigente; os recursos materiais para o preparo e administração dos medicamentos precisam ser revisados e ajustados de modo a suprirem as necessidades do serviço e oferecerem mais segurança aos pacientes; os recursos humanos da farmácia e da enfermagem precisam ser dimensionados. Foi observado que os recursos humanos de nível médio não receberam treinamento e nem foram reciclados, nos últimos cinco anos, sobre o tema medicamentos. Na análise do processo foi observado o conteúdo das prescrições e constatou-se que nelas faltavam informações importantes sobre as especificações dos medicamentos. Quanto ao processo de preparo e administração dos medicamentos revelaram pontos críticos nos dois hospitais. Apesar do sistema ter apresentado esses aspectos que comprometem a qualidade da assistência, na opinião de 70% dos pacientes no Hospital 1 e 52,4% do Hospital 2, o sistema foi considerado bom e na opinião de 44% dos profissionais de enfermagem do Hospital 1 e 53,3% do Hospital 2 o consideraram regular. Diante dos resultados apresentados para se atingir a qualidade no sistema de medicação, mudanças são necessárias em termos da política dos recursos humanos e do incremento da educação continuada. / The present descriptive research had the goal of describing the medication –use utilization system in two teaching hospitals located in the city of Recife – State of Pernambuco. With this aim, it was sought to characterize the structure of the medication system, describe the medication process, and analyze the results under the perspective of both patient and nursing professionals about the system. In order to do this, the population was composed of 14 doctors, 14 nurses, 22 pharmacists, 30 pharmacy auxiliaries, 50 nursing auxiliaries, 63 patients, and 372 medication prescription and nursing evolution sheets. The techniques used for data collection were non-participating observation and interview by means of structured questionnaires. The results showed that, within the structure, the environments for medication preparation are in disagreement with current legislation; material resources for the preparation and administration of medication must be reviewed and adjusted in a way to meet the needs of this service and offer greater safety to patients; human resources of both pharmacy and nursing must be better dimensioned. It was observed that the medium level human resources did not receive training and have not been recycled in the last five years regarding the theme of medications. In the analysis of the medication process, in regards to the content of the prescription, it was observed that the prescriptions lacked important information about the specifications of the medications. In regards to the process of preparation and administration of medications, critical points were revealed in both hospitals. Among these, special attention is drawn to the deficiency in washing hands and infusion lines during the administration of more than one medication. Despite the system having presented such aspects that compromise the quality of assistance, in the opinion of 70% of patients in Hospital 1 and 52.4% of patients in Hospital 2 the system was considered to be good, and 44% of the nursing professions of Hospital 1 and 53.3% of Hospital 2 considered the system medium. In view of the presented results, in order to achieve the quality in the medication system, there is a need for changes in terms of policy of human resources, and an increase of continuing education

Introduction: Many medications have an unproven safety profile for use during pregnancy, leading to issues when chronic diseases, such as hypertension and depression, present during pregnancy. The focus of this research programme is to determine whether in utero exposure to antihypertensive and antidepressant medication is associated with increased risk of adverse events at birth, and up to 27 months of age in the child. Methods: Two systematic reviews were performed to identify current published literature and knowledge gaps. Following this, using Scottish healthcare data, a cohort of 268,711 children born 2010-2014 were identified. Following cleaning of the data, multiple imputation was used to account for missing values. Poisson, linear and multinomial regressions were performed to identify the relationship between in utero medication exposure and child outcomes. Results: In utero antihypertensive exposure was associated with preterm birth, low birth weight, small for gestational age, but not developmental issues. However, untreated hypertension was associated with low birth weight, preterm birth, and small for gestational age. In utero antidepressant exposure was associated with preterm birth, low birth weight, small for gestational age, preeclampsia, having a special needs indicator at 10 days and 6-8 weeks post-birth, developmental issues at 27 months Conclusions: This research programme identified several adverse outcomes following in utero exposure to antihypertensive and antidepressant medication.