Abstract:
OBJECTIVE:To determine the overdose rate of drugs that require renal dose adjustment and factors related with overdose. SUBJECTS:Total of 23,635,210 records of prescriptions and laboratory data of inpatients at a tertiary teaching hospital for the period from January 2002 to December 2005. METHODS:A clinical data mart was constructed. A knowledge base containing dose adjusting information about 56 drugs was built. One day dose was compared to the reference dose adjusted to the patient's renal function. RESULTS:Considering the patient's renal function, 5.3% of drug doses were excessive. The overdose rate in the patients with moderate to severe renal insufficiency was 28.2%. Only 25% of physicians were responsible for 50.6% of the overdoses. Of 56 drugs studied, 10 drugs, including ranitidine, amoxicillin, and piperacillin/tazobactam, were involved in 85.4% of the overdoses. The physicians with high overdose rate had patients with more impaired renal function (correlation coefficient = 0.192, P < .001). There were negative correlation between clinical experiences of physician and overdose rate (correlation coefficient = -0.221, P < .001) and workload of prescription (correlation coefficient = -0.446, P < .001), when excluding interns from the analyses. There was positive correlation between workload of prescription and overdose rate (correlation coefficient = 0.361, P < .001). CONCLUSION:A clinical data mart was useful to analyze the vast amount of electronic hospital data. Drug overdose is quite common among inpatients with renal insufficiency. Only a few drugs are responsible for most of drug overdoses. The physicians' clinical experience, workload of prescriptions, and patients' renal function are correlated with drug overdose.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Sheen SS,Choi JE,Park RW,Kim EY,Lee YH,Kang UGdoi
10.1007/s11606-007-0336-8subject
Has Abstractpub_date
2008-04-01 00:00:00pages
423-8issue
4eissn
0884-8734issn
1525-1497journal_volume
23pub_type
杂志文章abstract:OBJECTIVE:To evaluate the effects of an intensive intervention to implement guidelines for cost-effective management of hypertension on medication use and cost, blood pressure control, and other resource use. DESIGN:Retrospective cohort trial based on the Cleveland Veterans' Affairs Medical Center Firm System. SETTIN...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600265
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abstract::Nicotine meets all critical criteria for an addictive drug. Furthermore, there is no evidence that there would be widespread compulsive use of tobacco without nicotine. These findings have led to consideration of the cigarette as a contaminated vehicle for an addictive drug (nicotine). Nevertheless, nicotine itself ma...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
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更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Multi-faceted depression care programs based within the healthcare system have been found to be effective, but may not fully address the needs of African American Intimate Partner Violence (IPV) survivors, many of whom are not seeking depression care in healthcare settings. OBJECTIVES:To develop and evaluat...
journal_title:Journal of general internal medicine
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abstract:BACKGROUND:Approximately 20% of patients with atherosclerotic cardiovascular disease (ASCVD) suffer from depression. OBJECTIVE:To compare healthcare expenditures and utilization, healthcare-related quality of life, and patient-centered outcomes among ASCVD patients, based on their risk for depression (among those with...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05325-8
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:There are no life-tables quantifying the average life-spans of post-hospitalized heart failure populations across various strata of risk. OBJECTIVE:To quantify the life-expectancies (i.e., average life-spans) of heart failure patients at the time of hospital discharge according to age, gender, predictive 30...
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pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND:Patients frequently experience suboptimal transitions from the hospital to the community, which can increase the likelihood of readmission. It is not known which care coordination services can lead to improvements in readmission rates. OBJECTIVE:To evaluate the effects of two care coordination interventions...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-017-4218-4
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Despite growing emphasis on public reporting of health care quality data, available data are often ignored. OBJECTIVE:To evaluate the usefulness of web-based physician-level data for patients choosing a new primary care physician (PCP). DESIGN:Patients seeking a new PCP (n = 2225) were invited to view web-...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0278-1
更新日期:2007-10-01 00:00:00
abstract::Academic departments of family medicine and divisions of general internal medicine and general pediatrics exist in the majority of medical schools in the United States and have important roles in generalist medical education. The major organizational issues facing these units concern institutional influence, faculty d...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02598123
更新日期:1994-04-01 00:00:00
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更新日期:2019-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-10-01 00:00:00
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更新日期:2021-01-19 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:1995-06-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
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更新日期:2006-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2003.20919.x
更新日期:2003-08-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05164-7
更新日期:2019-10-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2006.00611.x
更新日期:2006-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1525-1497.2000.07001.x
更新日期:2000-07-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2004-09-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2020-02-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:1992-07-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-018-4590-8
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Depression is common among older patients yet is often inadequately treated. Patient beliefs about antidepressants are known to affect treatment initiation and adherence, but are often not expressed in clinical settings. OBJECTIVE:To explore attitudes toward antidepressants in a sample of depressed, communi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.00296.x
更新日期:2006-02-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.40099.x
更新日期:2005-02-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between chronic illness with complexity (CIC) and optimal glycemic control. PARTICIPANTS:Cross-sectional and longitudinal analyses of Diabetes Epidemiologic Cohort database of Veterans Health Administration (VHA) users with diabetes, less than 75 years old, with HbA1c tests in fis...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:In response to the landmark report "Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering," the NIH Office of Research on Women's Health issued a request for applications that funded 14 R01 grants to investigate causal factors to career success for women in STEM. Fol...
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pub_type: 杂志文章,评审
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更新日期:2019-03-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2006.00411.x
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To examine the knowledge of, counseling about, and use of prior directives among patients with HIV-related disease. DESIGN:Cross-sectional survey with personal interviews that was part of the evaluation of a multi-site AIDS Health Services Program. SETTING:Outpatient clinics and AIDS community-based organiz...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:1990-11-01 00:00:00