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The aims were to develop an integrated electronic medication reconciliation (ieMR) platform, evaluate its effects on preventing potential duplicated medications, analyze the distribution of the potential duplicated medications by the Anatomical Therapeutic and Chemical (ATC) code for all inpatients, and determine the rate of 30-day medication-related hospital revisits for a geriatric unit. The study was conducted in a tertiary medical center in Taiwan and involved a retrospective quasi pre-intervention (July 1–November 30, 2015) and post-intervention (October 1–December 31, 2016) study design. A multidisciplinary team developed the ieMR platform covering the process from admission to discharge. The ieMR platform included six modules of an enhanced computer physician order entry system (eCPOE), Pharmaceutical-care, Holistic Care, Bedside Display, Personalized Best Possible Medication Discharge Plan, and Pharmaceutical Care Registration System. The ieMR platform prevented the number of potential duplicated medications from pre (25,196 medications, 2.3%) to post (23,413 medications, 3.8%) phases (OR 1.71, 95% CI, 1.68–1.74; p <.001). The most common potential duplicated medications classified by the ATC codes were cardiovascular system (28.4%), alimentary tract and metabolism (26.4%), and nervous system (14.9%), and by chemical substances were sennoside (12.5%), amlodipine (7.5%), and alprazolam (7.4%). The rate of medication-related 30-day hospital revisits for the geriatric unit was significantly decreased in post-intervention compared with that in pre-intervention (OR = 0.12; 95% CI, 0.03–0.53; p <.01). This study indicated that the ieMR platform significantly prevented the number of potential duplicated medications for inpatients and reduced the rate of 30-day medication-related hospital revisits for the patients on the geriatric unit. [ABSTRACT FROM AUTHOR]

Background: Lung cancer has been the leading cause of cancer-related mortality worldwide among both men and women in recent years. There is an increase in the incidence of nonsmoking-related lung cancer in recent years. The purpose of the present study was to investigate multiple potential risk factors for nonsmoking-related lung cancer among Asian Ethnic Groups.Methods: We used a propensity score-mated cohort analysis for this study. We retrospectively review the medical record of 1975 asymptomatic healthy subjects (40 ~ 80 years old) who voluntarily underwent low-dose chest CT from August 2013 to October 2014. Clinical information and nodule characteristics were recorded.Results: A propensity score-mated cohort analysis was applied to adjust for potential bias and to create two comparable groups according to family history of lung cancer. For our primary analysis, we matched 392 pairs of subjects with family history of lung cancer and subjects without history. Logistic regression showed that female gender and a family history of lung cancer were the two most important predictor of lung cancer in the endemic area with high prevalence of nonsmoking-related lung cancer (OR = 11.199, 95% CI = 1.444-86.862; OR = 2.831, 95% CI = 1.000136-8.015). In addition, the number of nodules was higher in subjects with family history of lung cancer in comparison with subjects without family history of lung cancer (OR = 1.309, 95% CI = 1.066-1.607).Conclusions: In conclusion, risk-based prediction model based on the family history of lung cancer and female gender can potentially improve efficiency of lung cancer screening programs in Taiwan. [ABSTRACT FROM AUTHOR]

Background: Previous studies investigating the relationship between pregnancy-induced hypertension (PIH) and breast cancer risk have yielded inconsistent results. Unlike numerous Western studies, studies have reported that PIH may be a risk factor for breast cancer in Western Asian women. To confirm these results, we designed a retrospective population-based cohort study to assess the relationship between PIH and subsequent risk for breast cancer in Taiwan.Methods: Patients with newly diagnosed PIH were selected from the Taiwan National Health Insurance Research Database (NHIRD), and a 1:4 matched cohort of women without PIH based on age and the year of delivery was randomly selected from the same database as the comparison group. The incidence of new-onset breast cancer was assessed in both cohorts.Results: Among the 23.3 million individuals registered in the NHIRD, 26,638 patients with PIH and 106,552 matched controls were identified. The incidence rate of breast cancer was higher in patients with PIH than in the matched controls (incidence rate ratio = 1.09, 95% confidence interval [CI] = 1.09-1.10, p < 0.0001). However, the Kaplan-Meier analysis revealed a similar cumulative incidence rate of breast cancer between the PIH and comparison cohorts (log-rank p = 0.4303). Moreover, results from a multivariate analysis indicated that PIH was not a statistically significant independent risk factor for breast cancer (adjusted hazard ratio = 1.10, 95% CI = 0.87-1.39, p = 0.4247).Conclusions: The present study demonstrated no significant temporal relationship between PIH and risk for subsequent breast cancer in Eastern Asian women. [ABSTRACT FROM AUTHOR]

Objectives: Osteoradionecrosis of the jaws (ORNJ) is painful for patients and relatively difficult to treat clinically. The high risk of ORNJ for post radiotherapy R/T dental extraction is known; however, many patients still have to have teeth extracted after head and neck R/T. The objective of the present study is to review post R/T dental extraction and determine the ORNJ risk.Materials and Methods: We preformed a retrospective cohort study of 1759 patients with head and neck cancer s/p R/T from a random sample of 1,000,000 insurants in the National Health Insurance Research Database during 2000-2013 in Taiwan. Statistical methods included two-proportion Z-test.Results: We evaluated two cohorts: 522 patients with post R/T dental extraction and 1237 patients without post R/T extraction. Overall moderate-to-severe ORNJ after R/T was 2.22% (39/1759), and a total of 39 ORNJ cases were noted during an average of 3.02years (range: 0.62-8.89years, ±2.07). ORNJ prevalence in the overall post R/T extraction-exposed cohort (5.17%, 27/522) was significantly greater than that in the unexposed cohort (0.97%, 12/1237). In a group of patients with ⩽5 post R/T dental extractions (n=373), the ORNJ risk was 2.4% (ORNJ case n=9); in a group of patients with >5 dental extractions (n=149), the ORNJ risk was 12.1% (ORNJ case n=18) (Z-score=4.5062; p-value<0.0001). In the extraction-exposed cohort, the ORNJ risk is higher if the index day to first extraction day was ⩽0.5year (n=103) compared with the group with the index day to first extraction day >0.5year (n=419) (Z-score=-2.1506; p-value=0.0315).Conclusion: A tooth extraction time less than half a year after R/T or during the head and neck R/T period, and extraction tooth number ⩽5 would significant lower the ORNJ prevalence. [ABSTRACT FROM AUTHOR]