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Baseline And Follow-Up Laboratory Monitoring Of Cardiovascular Medications, Jennifer Tjia, Shira Fischer, Marsha Raebel, Daniel Peterson, Yanfang Zhao, Shawn Gagne, Jerry Gurwitz, Terry Field
Baseline And Follow-Up Laboratory Monitoring Of Cardiovascular Medications, Jennifer Tjia, Shira Fischer, Marsha Raebel, Daniel Peterson, Yanfang Zhao, Shawn Gagne, Jerry Gurwitz, Terry Field
Jennifer Tjia
BACKGROUND: Laboratory monitoring of medications is typically used to establish safety prior to drug initiation and to detect drug-related injury following initiation. It is unclear whether black box warnings (BBWs) as well as evidence- and consensus-based clinical guidelines increase the likelihood of appropriate monitoring. OBJECTIVE: To determine the proportion of patients newly initiated on selected cardiovascular medications with baseline assessment and follow-up laboratory monitoring and compare the prevalence of laboratory testing for drugs with and without BBWs and guidelines. METHODS: This cross-sectional study included patients aged 18 years or older from a large multispecialty group practice who were prescribed a …
Diagnostic E-Codes For Commonly Used, Narrow Therapeutic Index Medications Poorly Predict Adverse Drug Events, Charles Leonard, Kevin Haynes, A. Localio, Sean Hennessy, Jennifer Tjia, Abigail Cohen, Stephen Kimmel, Harold Feldman, Joshua Metlay
Diagnostic E-Codes For Commonly Used, Narrow Therapeutic Index Medications Poorly Predict Adverse Drug Events, Charles Leonard, Kevin Haynes, A. Localio, Sean Hennessy, Jennifer Tjia, Abigail Cohen, Stephen Kimmel, Harold Feldman, Joshua Metlay
Jennifer Tjia
OBJECTIVE: We sought to examine the validity of specific hospital discharge codes in identifying drug toxicity precipitating hospitalization, among elderly users of high-risk medications. STUDY DESIGN AND SETTING: We conducted a cross-sectional evaluation assessing the diagnostic test characteristics of International Classification of Diseases-9 External-Cause-of-Injury codes (E-codes) compared with a reference standard of medical record review. This study was nested within a prospective cohort of elders using warfarin, digoxin, or phenytoin as identified in the Pharmaceutical Assistance Contract for the Elderly benefit program. RESULTS: We identified 4,803 subjects contributing 11,409 person-years of exposure to at least one of three drug groups. …
Quality Measurement Of Medication Monitoring In The "Meaningful Use" Era, Jennifer Tjia, Terry Field, Shira Fischer, Shawn Gagne, Daniel Peterson, Lawrence Garber, Jerry Gurwitz
Quality Measurement Of Medication Monitoring In The "Meaningful Use" Era, Jennifer Tjia, Terry Field, Shira Fischer, Shawn Gagne, Daniel Peterson, Lawrence Garber, Jerry Gurwitz
Jennifer Tjia
Objectives: While the 2011 implementation of "meaningful use" legislation for certified electronic health records (EHRs) promises to change quality reporting by overcoming data capture issues affecting quality measurement, the magnitude of this effect is unclear. We compared the measured quality of laboratory monitoring of Healthcare Effectiveness Data and Information Set (HEDIS) medications based on specifications that (1) include and exclude patients hospitalized in the measurement year and (2) use physician test orders and patient test completion. Study Design: Cross-sectional study. Methods: Among patients 18 years and older in a large multispecialty group practice utilizing a fully implemented EHR between January …
Development And Pilot Testing Of Guidelines To Monitor High-Risk Medications In The Ambulatory Setting, Jennifer Tjia, Terry Field, Lawrence Garber, Jennifer Donovan, Abir Kanaan, Marsha Raebel, Yanfang Zhao, Jackie Fuller, Shawn Gagne, Shira Fischer, Jerry Gurwitz
Development And Pilot Testing Of Guidelines To Monitor High-Risk Medications In The Ambulatory Setting, Jennifer Tjia, Terry Field, Lawrence Garber, Jennifer Donovan, Abir Kanaan, Marsha Raebel, Yanfang Zhao, Jackie Fuller, Shawn Gagne, Shira Fischer, Jerry Gurwitz
Jennifer Tjia
OBJECTIVES: To develop guidelines to monitor high-risk medications and to assess the prevalence of laboratory testing for these medications among a multispecialty group practice. STUDY DESIGN: Safety intervention trial. METHODS: We developed guidelines for the laboratory monitoring of high-risk medications as part of a patient safety intervention trial. An advisory committee of national experts and local leaders used a 2-round Internet-based Delphi process to select guideline medications based on the importance of monitoring for efficacy, safety, and drug-drug interactions. Test frequency recommendations were developed by academic pharmacists based on a literature review and local interdisciplinary consensus. To estimate the potential …