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The purpose of this paper is to show how a clinical decision support system can help in prescription and knowledge acquisition processes.

An integrated electronic medical records system (iEMRS) is designed to enhance the decision support quality in prescription.

By evaluating the system performance through 135 prescription records collected from a Hong Kong medical organization, iEMRS shows a satisfactory result in suggesting medicines that is properly the same as the decisions made by the physicians.

Compared with the static clinical guidelines built (manually) in the traditional clinical decision support system, knowledge in iEMRS is generated by the knowledge discovery result from professional experiences of various physicians and patient histories, which are more dynamic in nature. A treatment algorithm, designed in data mining technique, is introduced to improve information management in medical organizations by integration of decision support capability and EMRS, and supplement the deficiencies of traditional clinical decision support system.

The aim of this paper is to call for an increased focus on the ethics of direct-to-consumer (DTC) prescription drug advertising. This is important, not only to improve DTC prescription drug advertising, but also to inform DTC advertising of future medical advances.

This conceptual paper discusses two examples of medical advances – personal genetic testing services and surgically implanted medical devices – to explain how investigating the research of DTC prescription drug advertising can set the stage for more ethical advertising of future medical advances.

Specific issues related to health literacy, at-risk populations impacted by health disparities, and medicalization of issues common to aging relate to the DTC advertising of prescription drugs and other medical advances. Creative approaches to investigating these issues in the context of prescription drug advertising can enrich the debate about drug advertising, but also prepare researchers, policymakers, and consumers for future advertising of new medical developments.

The value of this paper is its call for increased focus on the ethics of DTC prescription drug advertising, to improve the current marketing environment but also lay the foundation for other healthcare marketing in the future.

The paper's aim is to analyze the functional relationships between factors related to the prescription of medical drugs in Brazil.

A survey was conducted among 232 medical doctors in Brazil. Data were collected using a structured questionnaire. Five hypotheses on the factors impacting drug prescription were proposed, and the constructs were validated using a set of techniques pertaining to the calculation of structural equations.

The process of medical drug prescription in Brazil is positively correlated with all the presented constructs. However, the study found that the five proposed hypotheses demonstrated varying degrees of positive effect levels, ranging from strong to weak. Particularly, factors such as the characteristics of the drug and information available on a drug have the weakest effect, while the cost‐benefit ratio of a drug has a moderate effect. The drug's brand and its related advertising have the strongest effect.

The results demonstrate the success of specific applications of advertising tools and brand construction in pharmaceutical marketing strategies targeting Brazilian physicians.

The study provides a broad map to understand the influences on drug prescriptions. Despite a prior study that found the behavior of physicians to be impacted by a different set of factors, this new research clearly shows that, in the Brazilian context, branding and advertising remain the major influences.

This paper aims to explore the misuse of prescription opioids, associated consumption cultures and the emergence of “informal governing images” among young men in Nigeria.

Using a qualitative research approach involving purposive sampling: six in-depth interviews, one focus group discussion and key informant interviews with two health-care professionals using the transgressive theory approach, this paper explores consumption cultures, motivations and the resultant “informal governing images” associated with the misuse of prescription opioids among young local street high-risk users in Nigeria.

Findings show complex expressions of diverse consumption practices, such as grinding, sniffing and concoction of tramadol (TM)with other opioids. The “puff-puff pass” practice serves as induction for new users of opioids commonly accessed through street drug dealers and pharmacists sold via backdoors. Codeine mixtures with different brands of soft drinks for dilution are used to achieve a “lower high” while a concoction of different opioids, with alcohol, and spirits obtains a “higher high”. Manufacturers’ indelible colouring and bottling discourage the non-medical use of opioids. Desiring to be awake for nocturnal activities, mostly “yahoo-yahoo” (internet fraud), sexual enhancement and dosage competitions, are motivations for the non-medical use of prescription opioids. These consumption cultures create “misuse circuits”, leading to the emergence of “informal governing images” triggered by threats from formal controls.

This paper, therefore, concludes that pharmaceutical industries should also add colourings to TM and codeine just like they did in rophinol to discourage the non-medical use of prescription opioids among young people in Nigeria.

This paper concludes that rather than branding and packaging in such a way that concealability is difficult for high-risk users as the best way to discourage the non-medical consumption of prescription opioids in Nigeria, the focus should be on addressing youth poverty and unemployment and improving access to treatment for drug use disorders, instead of calling for more enforcement-based measures.

This is an original research.

This study examined how youth would mitigate non-medical use of prescription medication among their peers.

The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) was conducted as an interview comprising 11,048 youth of 10–18 years of age between 2008 and 2011 from entertainment venues of 10 US urban, suburban, and rural areas. Using a mixed-methods approach, participants completed a survey culminating in open-ended questions asking: (1) How should kids your age be informed about prescription drugs and their effects? (2) If you ran the world, how would you stop kids from taking other people’s prescription medicines? (3) Why do people use prescription stimulants without a prescription? Responses from a random sample of 900 children were analyzed using qualitative thematic analyses.

The random sample of 900 youth (52 percent female, 40 percent white, with a mean age of 15.1 years) believed they should be educated about prescription drugs and their negative effects at schools, at home by parents, through the media, and health professionals. Youth would stop kids from using other people’s prescription drugs through more stringent laws that restricted use, and providing education about negative consequences of use. Peer pressure was the most common reason the youth gave for using other’s pills, though some reported taking them out of curiosity.

The importance of considering youth’s opinions on non-medical use of prescription medications is often overlooked. This evidence, from a peer perspective, could end the illicit use of prescription drugs among today’s youth.

This study aims to explore the dynamics involved in the non-medical use of tramadol among manual labourers in Nigeria.

Using the phenomenological approach, we conducted in-depth interviews with forty (40) manual labourers (age: 19–36 years). These participants were selected through purposive and snowball sampling techniques from two cities in Anambra state, Nigeria, and the data was analysed with thematic analysis.

The results revealed that most of the participants were introduced to tramadol use by their friends. They used tramadol for pain relief, euphoric feeling, energy for work and sexual performance. Unfortunately, most of them may have gradually become dependent on this drug to function well in life without knowing the possible medical and psychological implications.

The sample choice may limit the generalization of the findings; however, the study indicates a need to improve working condition, access to healthcare and awareness of the negative effects of non-medical use of tramadol.

Non-medical use of tramadol may have started as an attempt to help self in performing the daily routine. This action can jeopardize an individual’s mental health and, at the extreme state, hinder performance of daily routine. Friends and the quality of information they provide play a significant role in the onset of this action. The strong point is that many people who are involved in the non-medical use of tramadol are unaware of the possible risks. Improving working conditions and access to healthcare for chronic pain could help reduce these risks.

The purpose of this paper is to investigate the changing legal landscape associated with the growth of advertising of prescription drugs directly to the consumer, and makes recommendations designed to assist advertisers in avoiding legal liability based on those advertisements.

This study investigates the phenomenal growth of DTC advertising since 1997, when a profound change in the FDA regulations took effect. These changes permitted advertisers significantly more flexibility in providing information about the advertised drug directly to the consumer. Since then, however, DTC advertising has repeatedly come under attack. A review of the literature, changing law, and other factors, reveals the primary criticisms of DTC advertising, and its tendency to expose pharmaceutical advertisers to legal liability.

The paper recounts the development of the law concerning pharmaceutical advertising, and particularly, the application of the Learned Intermediary Rule. Previously, this Rule operated to shield pharmaceutical companies for liability by passing liability on to the physician who wrote the prescription for the drug. Now, that law is changing, with resulting liability for pharmaceutical advertisers.

The study recounts the primary criticisms of DTC advertising, and provides a number of steps that can be taken to help avoid legal liability for pharmaceutical companies that engage in DTC advertising.

The study looks at DTC advertising from both a marketing and a legal perspective, and combines those disciplines to draw conclusions helpful to DTC advertisers.

The purpose of this paper is to examine rates of potentially inappropriate prescribing in a population dually eligible for Medicare and Medicaid using the new 2003 Fick update, which revises the previous 1997 Beers list.

Cross sectional retrospective review of 2003 Centers for Medicare and Medicaid Service (CMS) Medicaid Pharmacy claims data. Claims data submitted for outpatient and nursing home residents for elderly enrollees dually eligible for Medicare and Medicaid were analyzed. Potentially inappropriate drug use was assessed using the 2003 Fick update to the previous 1997 Beers list. Inappropriate use was identified based on these criteria for drugs independent of diagnosis.

Of enrollees with drug use, 34 percent received an inappropriate drug per the 1997 Beers list; 47 percent per the 2003 Fick update. Hispanics had the highest percentage of drug recipients receiving an inappropriate drug in the Northeast region per the 2003 Fick update. Within therapeutic category, the number of inappropriate genitourinary products dispensed to total genitourinary products ranked the highest at 20 percent per the 2003 Fick update.

This study examines variations in Beers drug use in the elderly dually eligible Medicare and Medicaid population in 2003 by applying the 2003 Fick et al. update of the 1997 Beers list to one of the nation's largest sources of person‐specific data on prescribed drugs. Inappropriate use was identified for drugs independent of diagnosis. Of enrollees with drug use, 34 percent received an inappropriate drug per the 1997 Beers list; 47 percent per the 2003 Fick update. Within therapeutic category, the number of inappropriate genitourinary products dispensed to total genitourinary products ranked the highest at 20 percent per the 2003 Fick update. The paper's findings provide evidence that the potential use of inappropriate drugs in Hispanics should be considered separately from other ethnicity groups.

A markedly higher rate of potentially inappropriate drug use in the elderly Medicaid population exists following the Fick update. These findings provide evidence that the potential use of inappropriate drugs in Hispanics should be considered separately from other ethnicity groups. By comparing drug use based on therapeutic category, genitourinary products were found to have the highest potential for inappropriate prescribing.

The purpose of this paper is to identify the types of patients most likely to visit physicians in response to direct to consumer prescription drug advertising (DTCA).

The study used data from a national telephone survey, “Public Health Impact of Direct‐to‐Consumer Advertising of Prescription Drugs, July 2001‐January 2002: [United States].” It included data on respondents' health status and utilization, experience with DTCA, demographic and socio‐economic information, and three types of DTCA‐prompted physician visits: visits to discuss a prescription drug, a new health condition, or a change in treatment. A conceptual model was developed to identify consumers most likely to respond to DTCA by visiting a physician.

Five variables were related to all three types of visits. The most important were viewing media as the most important source, prompting one to talk with a physician and believing that DTCA improved discussion with health professionals. Believing that DTCA increased awareness of new treatments was less important, followed by having anxiety, then having arthritis. Taking medications regularly, having allergies, getting information from pamphlets in physicians' offices, and getting information from TV or radio advertisements were related to two types of visits.

Patients having positive beliefs about DTCA, preferring media information sources, and more susceptible to diseases treatable with prescription drugs were more likely to respond to DTCA by visiting physicians.

The study advances the literature on DTCA by examining a range of DTCA‐prompted physician visit behaviors using a conceptual model that has not previously been applied to DTCA.