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Displaying Results 1 - 25 of 140 on page 1 of 6
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‘Potentially inappropriate or specifically appropriate?’ Qualitative evaluation of general practitioners views on prescribing, polypharmacy and potentially inappropriate prescribing in older people.
(2016)
Clyne, Barbara; Cooper, Janine A; Hughes, Carmel M; Fahey, Tom; Smith, Susan M; OPTI-SC...
‘Potentially inappropriate or specifically appropriate?’ Qualitative evaluation of general practitioners views on prescribing, polypharmacy and potentially inappropriate prescribing in older people.
(2016)
Clyne, Barbara; Cooper, Janine A; Hughes, Carmel M; Fahey, Tom; Smith, Susan M; OPTI-SCRIPT Study Team
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p><strong>Background:</strong> Potentially inappropriate prescribing (PIP) is common in older people in primary care, as evidenced by a significant body of quantitative research. However, relatively few qualitative studies have investigated the phenomenon of PIP and its underlying processes from the perspective of general practitioners (GPs). The aim of this paper is to explore qualitatively, GP perspectives regarding prescribing and PIP in older primary care patients.</p> <p><strong>Method:</strong> Semi-structured qualitative interviews were conducted with GPs participating in a randomised controlled trial (RCT) of an intervention to decrease PIP in older patients (≥70 years) in Ireland. Interviews were conducted with GP participants (both intervention and control) from the OPTI-SCRIPT cluster RCT as part of the trial process evaluation between January and J...
https://epubs.rcsi.ie/gpart/97
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A Concept for a Long-term Scalable Primary Care Model
(2009)
Maad, Soha; Dimitrov, Borislav D; Fahey, Tom
A Concept for a Long-term Scalable Primary Care Model
(2009)
Maad, Soha; Dimitrov, Borislav D; Fahey, Tom
Abstract:
<p>See also European and Mediterranean Conference on Information Systems (EMCIS) website at http://www.emcis.org</p>
<p>This paper presents a concept for development of a unified bioengineering framework that consolidates efforts in extending the geographical boundaries and outreach of primary care in Ireland and ensure its long-term scalability. This framework encompasses infrastructures, devices, systems, techniques, materials, engineering practices and socio-technical set-ups for improved access, safety and quality of care at national and global levels. In particular, we address the development of special purpose solutions, technologies and devices for healthcare from a bioengineering perspective, within the wider biotechnology agenda in Ireland.</p>
https://epubs.rcsi.ie/gpproc/2
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A process evaluation of a cluster randomised trial to reduce potentially inappropriate prescribing in older people in primary care (OPTI-SCRIPT study).
(2016)
Clyne, Barbara; Cooper, Janine A; Hughes, Carmel M; Fahey, Tom; Smith, Susan M; OPTI-SC...
A process evaluation of a cluster randomised trial to reduce potentially inappropriate prescribing in older people in primary care (OPTI-SCRIPT study).
(2016)
Clyne, Barbara; Cooper, Janine A; Hughes, Carmel M; Fahey, Tom; Smith, Susan M; OPTI-SCRIPT study team
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p>BACKGROUND: The OPTI-SCRIPT cluster randomised controlled trial (RCT) found that a three-phase multifaceted intervention including academic detailing with a pharmacist, GP-led medicines reviews, supported by web-based pharmaceutical treatment algorithms, and tailored patient information leaflets, was effective in reducing potentially inappropriate prescribing (PIP) in Irish primary care. We report a process evaluation exploring the implementation of the intervention, the experiences of those participating in the study and lessons for future implementation.</p> <p>METHODS: The OPTI-SCRIPT trial included 21 GP practices and 196 patients. The process evaluation used mixed methods. Quantitative data were collected from all GP practices and semi-structured interviews were conducted with GPs from intervention and control groups, and a purposive sample of patients from the intervention gr...
https://epubs.rcsi.ie/gpart/98
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A retrospective cohort study of mode of delivery among public and private patients in an integrated maternity hospital setting.
(2013)
Murphy, Deirdre J; Fahey, Tom
A retrospective cohort study of mode of delivery among public and private patients in an integrated maternity hospital setting.
(2013)
Murphy, Deirdre J; Fahey, Tom
Abstract:
<p>The original is available at <a href="https://bmjopen.bmj.com/content/3/11/e003865">bmjopen.bmj.com</a></p>
<p><strong>OBJECTIVE:</strong> To examine the associations between mode of delivery and public versus privately funded obstetric care within the same hospital setting.</p> <p><strong>DESIGN:</strong> Retrospective cohort study.</p> <p><strong>SETTING:</strong> Urban maternity hospital in Ireland.</p> <p><strong>POPULATION:</strong> A total of 30 053 women with singleton pregnancies who delivered between 2008 and 2011.</p> <p><strong>METHODS:</strong> The study population was divided into those who booked for obstetric care within the public (n=24 574) or private clinics (n=5479). Logistic regression analyses were performed to examine the associations between operative delivery and type of care, adjusting for potential confou...
https://epubs.rcsi.ie/gpart/135
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A simplified approach to the pooled analysis of calibration of clinical prediction rules for systematic reviews of validation studies.
(2015)
Dimitrov, Borislav D; Motterlini, Nicola; Fahey, Tom
A simplified approach to the pooled analysis of calibration of clinical prediction rules for systematic reviews of validation studies.
(2015)
Dimitrov, Borislav D; Motterlini, Nicola; Fahey, Tom
Abstract:
<p>The original article is available at <a href="http://www.dovepress.com">www.dovepress.com</a></p>
<p>OBJECTIVE: Estimating calibration performance of clinical prediction rules (CPRs) in systematic reviews of validation studies is not possible when predicted values are neither published nor accessible or sufficient or no individual participant or patient data are available. Our aims were to describe a simplified approach for outcomes prediction and calibration assessment and evaluate its functionality and validity.</p> <p>STUDY DESIGN AND METHODS: Methodological study of systematic reviews of validation studies of CPRs: a) ABCD(2) rule for prediction of 7 day stroke; and b) CRB-65 rule for prediction of 30 day mortality. Predicted outcomes in a sample validation study were computed by CPR distribution patterns ("derivation model"). As confirmation, a logistic regression model (with derivation study coefficients) was...
https://epubs.rcsi.ie/gpart/65
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Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study)
(2013)
Clyne, Barbara; Bradley, Marie C; Hughes, Carmel M; Clear, Daniel; McDonnell, Ronan; Wi...
Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study)
(2013)
Clyne, Barbara; Bradley, Marie C; Hughes, Carmel M; Clear, Daniel; McDonnell, Ronan; Williams, David; Fahey, Tom; Smith, Susan M; on behalf of the OPTI-SCRIPT study team
Abstract:
Abstract Background Potentially inappropriate prescribing (PIP) in older people is common in primary care and can result in increased morbidity, adverse drug events, hospitalizations and mortality. The prevalence of PIP in Ireland is estimated at 36% with an associated expenditure of over €45 million in 2007. The aim of this paper is to describe the application of the Medical Research Council (MRC) framework to the development of an intervention to decrease PIP in Irish primary care. Methods The MRC framework for the design and evaluation of complex interventions guided the development of the study intervention. In the development stage, literature was reviewed and combined with information obtained from experts in the field using a consensus based methodology and patient cases to define the main components of the intervention. In the pilot stage, five GPs tested the proposed intervention. Qualitative interviews were co...
http://dx.doi.org/10.1186/1472-6963-13-307
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Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study).
(2013)
Clyne, Barbara; Bradley, Marie C; Hughes, Carmel M; Clear, Daniel; McDonnell, Ronan; Wi...
Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study).
(2013)
Clyne, Barbara; Bradley, Marie C; Hughes, Carmel M; Clear, Daniel; McDonnell, Ronan; Williams, David; Fahey, Tom; Smith, Susan M; OPTI-SCRIPT study team
Abstract:
<p>The original article is available at <a href="http://www.biomedcentral.com">www.biomedcentral.com</a></p>
<p>BACKGROUND: Potentially inappropriate prescribing (PIP) in older people is common in primary care and can result in increased morbidity, adverse drug events, hospitalizations and mortality. The prevalence of PIP in Ireland is estimated at 36% with an associated expenditure of over €45 million in 2007. The aim of this paper is to describe the application of the Medical Research Council (MRC) framework to the development of an intervention to decrease PIP in Irish primary care.</p> <p>METHODS: The MRC framework for the design and evaluation of complex interventions guided the development of the study intervention. In the development stage, literature was reviewed and combined with information obtained from experts in the field using a consensus based methodology and patient cases to define the main components of the int...
https://epubs.rcsi.ie/gpart/39
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An evaluation of prescribing trends and patterns of claims within the Preferred Drugs Initiative in Ireland (2011-2016): an interrupted time-series study.
(2018)
McDowell, Ronald; Bennett, Kathleen; Moriarty, Frank; Clarke, Sarah; Barry, Michael; Fa...
An evaluation of prescribing trends and patterns of claims within the Preferred Drugs Initiative in Ireland (2011-2016): an interrupted time-series study.
(2018)
McDowell, Ronald; Bennett, Kathleen; Moriarty, Frank; Clarke, Sarah; Barry, Michael; Fahey, Tom
Abstract:
To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at enhancing evidence-based cost-effective prescribing, on prescribing trends and the cost of prescription medicines across seven medication classe
To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at enhancing evidence-based cost-effective prescribing, on prescribing trends and the cost of prescription medicines across seven medication classes.
Retrospective repeated cross-sectional study spanning the years 2011-2016.
Health Service Executive Primary Care Reimbursement Service pharmacy claims data for General Medical Services (GMS) patients, approximately 40% of the Irish population.
Adults aged ≥18 years between 2011 and 2016 are eligible for the GMS scheme.
The percentage of PDI medications within each drug class per calendar quarter. Linear regression was used to model prescribing of the preferred drug within each medication gr...
http://hdl.handle.net/10147/622978
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An evaluation of prescribing trends and patterns of claims within the Preferred Drugs Initiative in Ireland (2011-2016): an interrupted time-series study.
(2018)
McDowell, Ronald; Bennett, Kathleen; Moriarty, Frank; Clarke, Sarah; Barry, Michael; Fa...
An evaluation of prescribing trends and patterns of claims within the Preferred Drugs Initiative in Ireland (2011-2016): an interrupted time-series study.
(2018)
McDowell, Ronald; Bennett, Kathleen; Moriarty, Frank; Clarke, Sarah; Barry, Michael; Fahey, Tom
Abstract:
<p>The original article is available at <a href="https://bmjopen.bmj.com/content/8/4/e019315.long">bmjopen.bmj.com</a></p>
<p><strong>OBJECTIVE:</strong> To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at enhancing evidence-based cost-effective prescribing, on prescribing trends and the cost of prescription medicines across seven medication classes.</p> <p><strong>DESIGN:</strong> Retrospective repeated cross-sectional study spanning the years 2011</p> <p><strong>SETTING:</strong> Health Service Executive Primary Care Reimbursement Service pharmacy claims data for General Medical Services (GMS) patients, approximately 40% of the Irish population.</p> <p><strong>PARTICIPANTS:</strong> Adults aged ≥18 years between 2011 and 2016 are eligible for the GMS scheme.</p> <p><strong>PRIMARY AND SECONDARY ...
https://epubs.rcsi.ie/gpart/136
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An ontological treatment of clinical prediction rules implementing the Alvarado score.
(2013)
Corrigan, Derek; Taweel, Adel; Fahey, Tom; Arvanitis, Theodoras; Delaney, Brendan
An ontological treatment of clinical prediction rules implementing the Alvarado score.
(2013)
Corrigan, Derek; Taweel, Adel; Fahey, Tom; Arvanitis, Theodoras; Delaney, Brendan
Abstract:
<p>This article is available with permission from IOS Press at <a href="http://ebooks.iospress.nl/volumearticle/32772">http://ebooks.iospress.nl/volumearticle/32772</a> and <a href="http://www.iospress.nl/">www.iospress.nl</a></p>
<p>A lack of acceptance has hindered the widespread adoption and implementation of clinical prediction rules (CPRs). The use of clinical decision support systems (CDSSs) has been advocated as one way of facilitating a broader dissemination and validation of CPRs. This requires computable models of clinical evidence based on open standards rather than closed proprietary content. The on-going TRANSFoRm project has developed ontological models of CPRs suitable for providing CPR based decision support. This paper presents a description of the design and implementation of the ontology model for CPRs that has been proposed. The conceptual validity of the ontology is discussed using the example of ...
https://epubs.rcsi.ie/gpart/43
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Antibiotics for acute bronchitis.
(2014)
Smith, Susan M; Fahey, Tom; Smucny, John; Becker, Lorne A
Antibiotics for acute bronchitis.
(2014)
Smith, Susan M; Fahey, Tom; Smucny, John; Becker, Lorne A
Abstract:
<p>This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2014, Issue 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.</p> <p>The review is also available at <a href="http://dx.doi.org/10.1002/14651858.CD000245.pub3" target="_blank">http://dx.doi.org/10.1002/14651858.CD000245.pub3</a></p>
<p>BACKGROUND: The benefits and risks of antibiotics for acute bronchitis remain unclear despite it being one of the most common illnesses seen in primary care.</p> <p>OBJECTIVES: To assess the effects of antibiotics in improving outcomes and assess adverse effects of antibiotic therapy for patients with a clinical diagnosis of acute bronchitis.</p> <p>SEARCH METHODS: We searched CENTRAL 2013, Issue 12, ...
https://epubs.rcsi.ie/gpart/55
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Antidepressant prescribing in Irish children: secular trends and international comparison in the context of a safety warning.
(2015)
O'Sullivan, Katriona; Boland, Fiona; Reulbach, Udo; Motterlini, Nicola; Kelly, Der...
Antidepressant prescribing in Irish children: secular trends and international comparison in the context of a safety warning.
(2015)
O'Sullivan, Katriona; Boland, Fiona; Reulbach, Udo; Motterlini, Nicola; Kelly, Dervla; Bennett, Kathleen; Fahey, Tom
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p>BACKGROUND: In 2003, the Irish Medicines Board (IMB) warned against the treatment of childhood depression with selective serotonin reuptake inhibitors (SSRIs) due to increased risk of suicide. This study examined the effect of this warning on the prevalence of anti-depressants in Irish children and compared age and gender trends and international comparisons of prescription rates.</p> <p>METHODS: A retrospective cohort study of the Irish Health Service Executive (HSE) pharmacy claims database for the General Medical Services (GMS) scheme for dispensed medication. Data were obtained for 2002-2011 for those aged ≤15 years. Prevalence of anti-depressants per 1000 eligible population, along with 95 % confidence intervals, were calculated. A negative binomial regression analysis was used to investigate trends and compare rates across years, sex and age groups (0-4, 5-11, 12-15 years). I...
https://epubs.rcsi.ie/gpart/87
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Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes - a prospective cohort study.
(2013)
Murphy, Deirdre J; Mullally, Aoife; Cleary, Brian J; Fahey, Tom; Barry, Joe
Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes - a prospective cohort study.
(2013)
Murphy, Deirdre J; Mullally, Aoife; Cleary, Brian J; Fahey, Tom; Barry, Joe
Abstract:
<p>This article is also available from <a href="http://www.biomedcentral.com">www.biomedcentral.com</a></p>
<p>BACKGROUND: There has been limited research addressing whether behavioural change in relation to alcohol exposure in pregnancy results in better perinatal outcomes. METHODS: A cohort study of 6725 women who booked for antenatal care and delivered in a large urban teaching hospital in 2010--2011. A detailed history of alcohol consumption pre-pregnancy and during early pregnancy was recorded at the first antenatal visit with follow-up of the mother and infant until discharge following birth. Adverse perinatal outcomes were compared for 'non-drinkers', 'ex-drinkers' and 'current drinkers'. RESULTS: Of the 6017 (90%) women who reported alcohol consumption prior to pregnancy 3325 (55%) engaged in binge drinking and 266 (4.4%) consumed more than 14 units on average per week. At the time of booking 5649 (94%...
https://epubs.rcsi.ie/gpart/33
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Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland.
(2015)
O'Sullivan, Katriona; Reulbach, Udo; Boland, Fiona; Motterlini, Nicola; Kelly, Der...
Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland.
(2015)
O'Sullivan, Katriona; Reulbach, Udo; Boland, Fiona; Motterlini, Nicola; Kelly, Dervla; Bennett, Kathleen; Fahey, Tom
Abstract:
<p>The original article is available at <a href="https://bmjopen.bmj.com/content/5/6/e007070.long">bmjopen.bmj.com</a></p>
<p><strong>OBJECTIVE:</strong> To examine the prevalence and secular trends in benzodiazepine (BZD) prescribing in the Irish paediatric population. In addition, we examine coprescribing of antiepileptic, antipsychotic, antidepressant and psychostimulants in children receiving BZD drugs and compare BZD prescribing in Ireland to that in other European countries.</p> <p><strong>SETTING:</strong> Data were obtained from the Irish General Medical Services (GMS) scheme pharmacy claims database from the Health Service Executive (HSE)--Primary Care Reimbursement Services (PCRS).</p> <p><strong>PARTICIPANTS:</strong> Children aged 0-15 years, on the HSE-PCRS database between January 2002 and December 2011, were included.</p> <p><strong>PRIMARY AND SEC...
https://epubs.rcsi.ie/gpart/138
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Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials.
(2013)
Abdulkarim, Ali; Ellanti, Prasad; Motterlini, Nicola; Fahey, Tom; O'Byrne, John M
Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials.
(2013)
Abdulkarim, Ali; Ellanti, Prasad; Motterlini, Nicola; Fahey, Tom; O'Byrne, John M
Abstract:
The optimal method of fixation for primary total hip replacements (THR), particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We con...
http://hdl.handle.net/10147/324302
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Characterizing Potentially Inappropriate Prescribing of Proton Pump Inhibitors in Older People in Primary Care in Ireland from 1997 to 2012.
(2016)
Moriarty, Frank; Bennett, Kathleen; Cahir, Caitriona; Fahey, Tom
Characterizing Potentially Inappropriate Prescribing of Proton Pump Inhibitors in Older People in Primary Care in Ireland from 1997 to 2012.
(2016)
Moriarty, Frank; Bennett, Kathleen; Cahir, Caitriona; Fahey, Tom
Abstract:
<p>This is the peer reviewed version of the following article: Moriarty, F., Bennett, K., Cahir, C., and Fahey, T. Characterizing Potentially Inappropriate Prescribing of Proton Pump Inhibitors in Older People in Primary Care in Ireland from 1997 to 2012. J Am Geriatr Soc. 2016; 64(12): e291-e296, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/jgs.14528/abstract. This article may be used for noncommercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.</p>
<p>OBJECTIVES: To characterize prescribing of proton pump inhibitors (PPIs) and medicines that increase gastrointestinal bleeding risk (ulcerogenic) in older people from 1997 to 2012 and assess factors associated with maximal-dose prescribing in long-term PPI users.</p> <p>DESIGN: Repeated cross-sectional study of pharmacy claims data.</p> <p>SETTING: Eastern Health Board region of Ireland.</p> <p>PARTICIPANTS...
https://epubs.rcsi.ie/gpart/105
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Clinical prediction rules in practice: review of clinical guidelines and survey of GPs
(2014)
Plüddemann, Annette; Wallace, Emma; Bankhead, Claire; Keogh, Claire; Van der Windt, Dan...
Clinical prediction rules in practice: review of clinical guidelines and survey of GPs
(2014)
Plüddemann, Annette; Wallace, Emma; Bankhead, Claire; Keogh, Claire; Van der Windt, Danielle; Lasserson, Daniel; Galvin, Rose; Moschetti, Ivan; Kearley, Karen; O'Brien, Kirsty K.; Sanders, Sharon; Mallett, Susan; Malanda, Uriell; Thompson, Matthew; Fahey, Tom; Stevens, Richard
Abstract:
Background The publication of clinical prediction rules (CPRs) studies has risen significantly. It is unclear if this reflects increasing usage of these tools in clinical practice or how this may vary across clinical areas. Aim To review clinical guidelines in selected areas and survey GPs in order to explore CPR usefulness in the opinion of experts and use at the point of care. Design and setting A review of clinical guidelines and survey of UK GPs. Method Clinical guidelines in eight clinical domains with published CPRs were reviewed for recommendations to use CPRs including primary prevention of cardiovascular disease, transient ischaemic attack (TIA) and stroke, diabetes mellitus, fracture risk assessment in osteoporosis, lower limb fractures, breast cancer, depression, and acute infections in childhood. An online survey of 401 UK GPs was also conducted. Results Guideline review: Of 7637 records screened by title and/or abstract, 243 clinical guidelines met inclusion criteria. C...
http://hdl.handle.net/10344/4762
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Clinical prediction rules in primary care: what can be done to maximise their implementation?
(2010)
Keogh, Claire; Fahey, Tom
Clinical prediction rules in primary care: what can be done to maximise their implementation?
(2010)
Keogh, Claire; Fahey, Tom
Abstract:
<p>Editorial commentary from Clinical Evidence. Also available from http://clinicalevidence.bmj.com/downloads/05-10-10.pdf.</p>
<p>Clinical prediction rules (CPRs) have become more prevalent in the published literature in recent years. Known by an array of synonymous terms including risk score, scorecard, algorithm, guide, and model, CPRs are clinical tools that quantify the contribution of a patient’s history, physical examination, and diagnostic tests to stratify patients in terms of the probability of having a specific target disorder. Outcomes of CPRs can be presented as diagnosis, prognosis, referral, or treatment. Although not designed to replace clinical knowledge and experience, CPRs do offer a way to assist with the overall diagnostic and prognostic process.[1] Despite the value of these clinical tools, relatively few CPRs have been quantified and their utility validated. One CPR that has gained widespread acceptance is the Centor score,[2] which is ba...
https://epubs.rcsi.ie/gpart/6
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Comparison of count-based multimorbidity measures in predicting emergency admission and functional decline in older community-dwelling adults: a prospective cohort study.
(2016)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Comparison of count-based multimorbidity measures in predicting emergency admission and functional decline in older community-dwelling adults: a prospective cohort study.
(2016)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Abstract:
<p>This article is also available at <a href="http://bmjopen.bmj.com/content/bmjopen/6/9/e013089.full.pdf">http://bmjopen.bmj.com/content/bmjopen/6/9/e013089.full.pdf</a></p>
<p><strong>OBJECTIVES</strong>: Multimorbidity, defined as the presence of 2 or more chronic medical conditions in an individual, is associated with poorer health outcomes. Several multimorbidity measures exist, and the challenge is to decide which to use preferentially in predicting health outcomes. The study objective was to compare the performance of 5 count-based multimorbidity measures in predicting emergency hospital admission and functional decline in older community-dwelling adults attending primary care.</p> <p><strong>SETTING</strong>: 15 general practices (GPs) in Ireland.</p> <p><strong>PARTICIPANTS</strong>: n=862, ≥70 years, community-dwellers followed-up for 2 years (2010-2012). Exposure at bas...
https://epubs.rcsi.ie/gpart/107
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Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study.
(2009)
Toar, Magzoub; O'Brien, Kirsty K; Fahey, Tom
Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study.
(2009)
Toar, Magzoub; O'Brien, Kirsty K; Fahey, Tom
Abstract:
<p>This article is available at http://www.biomedcentral.com/1471-2458/9/214</p>
<p>BACKGROUND: Adult refugees and asylum seekers living in Western countries experience a high prevalence of mental health problems, especially post traumatic stress disorder (PTSD), depression and anxiety. This study compares and contrasts the prevalence of health problems, and potential risk factors as well as the utilisation of health services by asylum seekers and refugees in the Irish context. METHODS: Cross sectional study using validated self reported health status questionnaires of adult asylum seekers (n = 60) and refugees (n = 28) from 30 countries, living in Ireland. Outcome measures included: general health status (SF-36), presence of PTSD symptoms and anxiety/depression symptoms. Data on chronic conditions and pre or post migration stressors are also reported. The two groups are compared for utilisation of the health care system and the use of over the counter medicati...
https://epubs.rcsi.ie/gpart/2
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Computer-based clinical decision support for general practitioners.
(2014)
Murphy, Mark E; Fahey, Tom; Smith, Susan M
Computer-based clinical decision support for general practitioners.
(2014)
Murphy, Mark E; Fahey, Tom; Smith, Susan M
Abstract:
<p>This is a pre-copyedited, author-produced PDF of an article accepted for publication in Family Practice following peer review. The version of record Murphy ME, Fahey T, Smith SM. Computer-based clinical decision support for GP. Family Practice. 2014;31(5):497-498<em> </em>is available online at:</p> <p><a href="http://fampra.oxfordjournals.org/content/31/5/497">http://fampra.oxfordjournals.org/content/31/5/497</a></p>
https://epubs.rcsi.ie/gpart/69
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Concurrent use of alcohol interactive medications and alcohol in older adults: a systematic review of prevalence and associated adverse outcomes.
(2017)
Holton, Alice E; Gallagher, Paul; Fahey, Tom; Cousins, Grainne
Concurrent use of alcohol interactive medications and alcohol in older adults: a systematic review of prevalence and associated adverse outcomes.
(2017)
Holton, Alice E; Gallagher, Paul; Fahey, Tom; Cousins, Grainne
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p>BACKGROUND: Older adults are susceptible to adverse effects from the concurrent use of medications and alcohol. The aim of this study was to systematically review the prevalence of concurrent use of alcohol and alcohol-interactive (AI) medicines in older adults and associated adverse outcomes.</p> <p>METHODS: A systematic search was performed using MEDLINE (PubMed), Embase, Scopus and Web of Science (January 1990 to June 2016), and hand searching references of retrieved articles. Observational studies reporting on the concurrent use of alcohol and AI medicines in the same or overlapping recall periods in older adults were included. Two independent reviewers verified that studies met the inclusion criteria, critically appraised included studies and extracted relevant data. A narrative synthesis is provided.</p> <p>RESULTS: Twenty studies, all cross-sectional, were includ...
https://epubs.rcsi.ie/spharmart/38
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Consensus validation of the POSAMINO (POtentially Serious Alcohol-Medication INteractions in Older adults) criteria.
(2017)
Holton, Alice E; Gallagher, Paul J; Ryan, Cristín; Fahey, Tom; Cousins, Gráinne
Consensus validation of the POSAMINO (POtentially Serious Alcohol-Medication INteractions in Older adults) criteria.
(2017)
Holton, Alice E; Gallagher, Paul J; Ryan, Cristín; Fahey, Tom; Cousins, Gráinne
Abstract:
Older adults are particularly vulnerable to adverse effects from concurrent alcohol and medication use. However, there is limited evidence regarding the prevalence of these adverse outcomes among older adults, and there is a lack of consensus regarding what constitutes an alcohol-interactive medicine. The objective of this study was to develop an explicit list of potentially serious alcohol– medication interactions for use in older adults
Older adults are particularly vulnerable to adverse effects from concurrent alcohol and medication use. However, there is limited evidence regarding the prevalence of these adverse outcomes among older adults, and there is a lack of consensus regarding what constitutes an alcohol-interactive medicine. The objective of this study was to develop an explicit list of potentially serious alcohol-medication interactions for use in older adults.
Following a systematic review, review of drug compendia and clinical guidance documents, a two-round De...
http://hdl.handle.net/10147/622647
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Consensus validation of the POSAMINO (POtentially Serious Alcohol-Medication INteractions in Older adults) criteria.
(2017)
Holton, Alice E; Gallagher, Paul; Ryan, Cristín; Fahey, Tom; Cousins, Grainne
Consensus validation of the POSAMINO (POtentially Serious Alcohol-Medication INteractions in Older adults) criteria.
(2017)
Holton, Alice E; Gallagher, Paul; Ryan, Cristín; Fahey, Tom; Cousins, Grainne
Abstract:
<p>The original article is available at <a href="https://bmjopen.bmj.com/content/7/11/e017453">bmjopen.bmj.com</a></p>
<p><strong>OBJECTIVES:</strong> Older adults are particularly vulnerable to adverse effects from concurrent alcohol and medication use. However, there is limited evidence regarding the prevalence of these adverse outcomes among older adults, and there is a lack of consensus regarding what constitutes an alcohol-interactive medicine. The objective of this study was to develop an explicit list of potentially serious alcohol-medication interactions for use in older adults.</p> <p><strong>DESIGN:</strong> Following a systematic review, review of drug compendia and clinical guidance documents, a two-round Delphi consensus method was conducted.</p> <p><strong>SETTING:</strong> Ireland and the United Kingdom (UK), primary care and hospital setting.</p> <p><...
https://epubs.rcsi.ie/spharmart/54
Marked
Mark
Developing a rule-driven clinical decision support system with an extensive and adaptative architecture
(2012)
Hederman, Lucy; Xiao, Liang; Cousins, Gr?inne; Fahey, Tom; Dimitrov, Borislav D.
Developing a rule-driven clinical decision support system with an extensive and adaptative architecture
(2012)
Hederman, Lucy; Xiao, Liang; Cousins, Gr?inne; Fahey, Tom; Dimitrov, Borislav D.
Abstract:
Clinical guidelines are central to the implementation of clinical decision support systems (CDSSs). Addition or revision of clinical guidelines usually causes the (re-) development of new or existing CDSSs. The separate maintenance of clinical knowledge and their driving systems implies extra system development cost and low knowledge delivery efficiency. We propose, in this paper, an approach to liaise the two activities and support a complete knowledge-driven CDSS architecture. It will accommodate and disseminate new knowledge with minimum efforts required to make relevant changes to the systems, but make use of the new knowledge whenever it becomes available. A Multi-Agent System architecture and a rule-based knowledge repository are put together to realize this goal.
http://hdl.handle.net/2262/90265
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