Australian Medicines Handbook Research Articles

Prescribing Antipsychotics for Young People and Monitoring Physical Health and Adverse Effects

ABSTRACTBackgroundAntipsychotics are increasingly prescribed in young people for psychiatric and behavioural disorders.AimTo determine the appropriateness of antipsychotic prescribing in young people; to ascertain the usage of an antipsychotic monitoring program; and to determine congruence with the antipsychotic monitoring program.MethodA prospective 3‐month audit was conducted of patients aged < 18 years prescribed antipsychotics. Prescribing was deemed ‘appropriate’ if the diagnosis was listed as an indication for the antipsychotic in the Therapeutic Guidelines: Psychotropic and/or the Australian Medicines Handbook and within the recommended dose. For patients on an antipsychotic long term (>1 month), case notes were examined to determine if patients had a monitoring chart and if it was being used as recommended.ResultsMedical records of 60 young patients prescribed antipsychotics were reviewed. 41/70 (59%) antipsychotic prescriptions were congruent with Australian guidelines. Intellectual disability with comorbid psychiatric disorder/behavioural disturbance (20/70; 29%) was the most common indication followed by autism spectrum disorder with behavioural disturbance (13/70; 19%), and schizophrenia and related psychoses (10/70; 14%). Risperidone (36/70; 51%) was the most commonly prescribed antipsychotic. 54/60 patients were prescribed antipsychotics long term (>1 month) and it was deemed necessary they have a monitoring chart. Only 10/54 (19%) patients had an antipsychotic monitoring chart and only 4/54 (7.4%) patients were optimally monitored.ConclusionMost antipsychotics prescribed for the young people were congruent with Australian guidelines. In most instances of ‘inappropriate’ prescribing, there was evidence that ‘appropriate’ antipsychotics and doses were trialled and had been unsuccessful. Use of the antipsychotic monitoring program was low; strategies are needed to ensure monitoring occurs in this vulnerable population.

Medicine use and safety while breastfeeding: investigating the perspectives of community pharmacists in Australia

Consumers and health professionals rely on community pharmacists for accurate information about the safety of medicines. Many breastfeeding women require medications, yet we know little about the advice provided to them by pharmacists in Australia. The aim of this study therefore was to investigate the perspectives of community pharmacists in Australia on medication use and safety in breastfeeding using a postal survey of a national random sample of 1166 community pharmacies in 2011. One hundred and seventy-six pharmacists responded (51% female). Of the 52% of participants with children, many (70%) had a total breastfeeding duration (self or partner) of 27 weeks or more. The majority (92%) were confident about supplying or counselling on medication during breastfeeding. The most commonly used resources were drug company information, Australian Medicines Handbook and the Royal Women's Pregnancy and Breastfeeding Medicine Guide. Most (80%) believed the available information to be adequate and 86% thought it accessible. Over one-third were unaware that ibuprofen and metronidazole are compatible with breastfeeding. Most (80%) were able to name at least one medicine that may decrease milk supply. We found that community pharmacists discuss medicine use in lactation and are confident of their ability to do so; however, their knowledge may be variable.

Nurse practitioner prescribing practices: the most frequently prescribed medications

To explore which medications Australian nurse practitioners most frequently prescribe. Although nurse practitioners in Australia have prescriptive authority, little is known about which specific medications nurse practitioners are prescribing and how frequently they do so. Descriptive electronic survey. A total of 209 nurse practitioners reported current prescribing practices. Medications reported were categorised according to the Australian Medicines Handbook major drug classifications and frequencies presented. Seventy-eight per cent of respondents reported prescribing medications as part of their Nurse Practitioner practice. In total, participants reported prescribing 234 separate medications from most Australian Medicines Handbook major drug classifications. Medications from the classification anti-infective drugs were most frequently prescribed followed by medications from analgesic, psychotropic, cardiovascular, musculoskeletal, genitourinary and gastrointestinal classifications. The majority of nurse practitioners in Australia prescribe medications in their clinical practice, although the proportion of nurse practitioners prescribing has not changed significantly in the past four years. The medications prescribed are comparable with those most frequently prescribed by all prescribers in Australia and highlight the diversity in scope of practice among nurse practitioners. Findings highlight the importance of Nurse Practitioner's a capacity to prescribe wide variety of medications, especially in practice areas such acute, primary and emergency care. The unique role nurse practitioners in relation to management of patients with infective processes and patients requiring pain relief is highlighted. Insight into current Nurse Practitioner prescribing trends informs future Nurse Practitioner curricular and future continuing education programmes. Findings give unique insight for future service planning, especially service providers considering introducing nurse practitioners to their service. The finding that nurse practitioners prescribing patterns are similar to other non-nurse practitioner prescribers in Australia highlights the potential for service providers to introduce new models of care that are Nurse Practitioner lead.

BICEPP: an example-based statistical text mining method for predicting the binary characteristics of drugs

BackgroundThe identification of drug characteristics is a clinically important task, but it requires much expert knowledge and consumes substantial resources. We have developed a statistical text-mining approach (BInary Characteristics Extractor and biomedical Properties Predictor: BICEPP) to help experts screen drugs that may have important clinical characteristics of interest.ResultsBICEPP first retrieves MEDLINE abstracts containing drug names, then selects tokens that best predict the list of drugs which represents the characteristic of interest. Machine learning is then used to classify drugs using a document frequency-based measure. Evaluation experiments were performed to validate BICEPP's performance on 484 characteristics of 857 drugs, identified from the Australian Medicines Handbook (AMH) and the PharmacoKinetic Interaction Screening (PKIS) database. Stratified cross-validations revealed that BICEPP was able to classify drugs into all 20 major therapeutic classes (100%) and 157 (of 197) minor drug classes (80%) with areas under the receiver operating characteristic curve (AUC) > 0.80. Similarly, AUC > 0.80 could be obtained in the classification of 173 (of 238) adverse events (73%), up to 12 (of 15) groups of clinically significant cytochrome P450 enzyme (CYP) inducers or inhibitors (80%), and up to 11 (of 14) groups of narrow therapeutic index drugs (79%). Interestingly, it was observed that the keywords used to describe a drug characteristic were not necessarily the most predictive ones for the classification task.ConclusionsBICEPP has sufficient classification power to automatically distinguish a wide range of clinical properties of drugs. This may be used in pharmacovigilance applications to assist with rapid screening of large drug databases to identify important characteristics for further evaluation.

Book Review: Australian Medicines Handbook Drug Choice Companion: Emergency and primary care

Book Review: Australian Medicines Handbook Drug Choice Companion: Emergency and primary care

Junior doctors, prescribing resources and the Australian Medicines Handbook

Junior doctors, prescribing resources and the Australian Medicines Handbook

Junior doctors, prescribing resources and the Australian Medicines Handbook

Junior doctors, prescribing resources and the Australian Medicines Handbook

Australian Medicines Handbook Drug Choice Companion: Emergency and Primary Care

The Australian Journal of Hospital PharmacyVolume 31, Issue 3 p. 237-237 Book ReviewFree Access Australian Medicines Handbook Drug Choice Companion: Emergency and Primary Care Fran Vaughan, Fran Vaughan Formerly, Pharmacy Department fran.vaughan@cadphc.org.au Alice Springs Hospital Alice Springs NT 0871Search for more papers by this author Fran Vaughan, Fran Vaughan Formerly, Pharmacy Department fran.vaughan@cadphc.org.au Alice Springs Hospital Alice Springs NT 0871Search for more papers by this author First published: 01 September 2001 https://doi.org/10.1002/jppr2001313237AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume31, Issue3September 2001Pages 237-237 RelatedInformation

Book Review: Australian Medicines Handbook Drug Choice Companion: Emergency and Primary Care

Book Review: Australian Medicines Handbook Drug Choice Companion: Emergency and Primary Care

Book Review: Australian medicines handbook. First edition.

Book Review: Australian medicines handbook. First edition.

Editorial: The Australian Medicines Handbook

What is the AMH? The Australian Medicines Handbook (AMH) is a project to develop a national formulary for Australia.1...