TY - JOUR T1 - Risk of drug-related mortality during periods of transition in methadone maintenance treatment: a cohort study JF - J Subst Abuse Treat Y1 - 2011 A1 - Cousins, G A1 - Teljeur, C A1 - Motterlini, N A1 - McCowan, Colin A1 - Dimitrov, B A1 - Fahey, T KW - Adolescent KW - Adult KW - Cohort Studies KW - Databases, Factual KW - Female KW - Humans KW - Lung Diseases KW - Male KW - Medical Records KW - Methadone KW - Middle Aged KW - Opiate Substitution Treatment KW - Opioid-Related Disorders KW - Patient Dropouts KW - Prescriptions KW - Risk KW - Time Factors KW - Young Adult AB - This study aims to identify periods of elevated risk of drug-related mortality during methadone maintenance treatment (MMT) in primary care using a cohort of 3,162 Scottish drug users between January 1993 and February 2004. Deaths occurring during treatment or within 3 days after last methadone prescription expired were considered as cases "on treatment." Fatalities occurring 4 days or more after leaving treatment were cases "off treatment." Sixty-four drug-related deaths were identified. The greatest risk of drug-related death was in the first 2 weeks of treatment (adjusted hazard ratio 2.60, 95% confidence interval 1.03-6.56). Risk of drug-related death was lower after the first 30 days following treatment cessation, relative to the first 30 days off treatment. History of psychiatric admission was associated with increased risk of drug-related death in treatment. Increasing numbers of treatment episodes and urine testing were protective. History of psychiatric admission, increasing numbers of urine tests, and coprescriptions of benzodiazepines increased the risk of mortality out of treatment. The risk of drug-related mortality in MMT is elevated during periods of treatment transition, specifically treatment initiation and the first 30 days following treatment dropout or discharge. VL - 41 UR - http://www.sciencedirect.com/science/article/pii/S0740547211000973 IS - 3 ER - TY - JOUR T1 - Proton pump inhibitors: potential cost reductions by applying prescribing guidelines JF - BMC Health Services Research Y1 - 2012 A1 - Cahir, C A1 - Fahey, T A1 - Tilson, L A1 - Teljeur, C A1 - Bennett, K KW - Cost-effective KW - Generic KW - Guidelines KW - Proton pump inhibitors AB - Background There are concerns that proton pump inhibitors (PPI) are being over prescribed in both primary and secondary care. This study aims to establish potential cost savings in a community drug scheme for a one year period according to published clinical and cost-effective guidelines for PPI prescribing. Methods Retrospective population-based cohort study in the Republic of Ireland using the Health Services Executive (HSE) Primary Care Reimbursement Services (PCRS) pharmacy claims database. The HSE-PCRS scheme is means tested and provides free health care including medications to approximately 30% of the Irish population. Prescription items are WHO ATC coded and details of every drug dispensed and claimants’ demographic data are available. Potential cost savings (net ingredient cost) were estimated according to UK NICE clinical guidelines for all HSE-PCRS claimants on PPI therapy for ≥3 consecutive months starting in 2007 with a one year follow up (n=167,747). Five scenarios were evaluated; (i) change to PPI initiation (cheapest brand); and after 3 months (ii) therapeutic switching (cheaper brand/generic equivalent); (iii) dose reduction (maintenance therapy); (iv) therapeutic switching and dose reduction and (v) therapeutic substitution (H2 antagonist). Results Total net ingredient cost was €88,153,174 for claimants on PPI therapy during 2007. The estimated costing savings for each of the five scenarios in a one year period were: (i) €36,943,348 (42% reduction); (ii) €29,568,475 (34%); (iii) €21,289,322 (24%); (iv) €40,505,013 (46%); (v) €34,991,569 (40%). Conclusion There are opportunities for substantial cost savings in relation to PPI prescribing if implementation of clinical guidelines in terms of generic substitution and step-down therapy is implemented on a national basis. VL - 12 UR - http://www.ncbi.nlm.nih.gov/pubmed/23163956 IS - 1 ER - TY - JOUR T1 - Prescriber variation in potentially inappropriate prescribing in older populations in Ireland JF - BMC Family Practice Y1 - 2014 A1 - Cahir, C A1 - Fahey, T A1 - Teljeur, C A1 - Bennett, K KW - General Practice KW - older populations KW - potentially inappropriate prescribing KW - Prescriber variation KW - STOPP AB - Abstract Background Health care policy-makers look for prescribing indicators at the population level to evaluate the performance of prescribers, improve quality and control drug costs. The aim of this research was to; (i) estimate the level of variation in potentially inappropriate prescribing (PIP) across prescribers in the national Irish older population using the STOPP criteria; (ii) estimate how reliably the criteria could distinguish between prescribers in terms of their proportion of PIP and; (iii) examine how PIP varies between prescribers and by patient and prescriber characteristics in a multilevel regression model. Methods 1,938 general practitioners (GPs) with 338,375 registered patients’ ≥70 years were extracted from the Health Service Executive Primary Care Reimbursement Service (HSE-PCRS) pharmacy claims database. HSE-PCRS prescriptions are WHO ATC coded. Demographic data for claimants’ and prescribers’ are available. Thirty STOPP indicators were applied to prescription claims in 2007. Multilevel logistic regression examined how PIP varied between prescribers and by individual patient and prescriber level variables. Results The unadjusted variation in PIP between prescribers was considerable (median 35%, IQR 30-40%). The STOPP criteria were reliable measures of PIP (average >0.8 reliability). The multilevel regression models found that only the patient level variable, number of different repeat drug classes was strongly associated with PIP (>2 drugs v none; adjusted OR, 4.0; 95% CI 3.7, 4.3). After adjustment for patient level variables the proportion of PIP varied fourfold (0.5 to 2 times the expected proportion) between prescribers but the majority of this variation was not significant. Conclusion PIP is of concern for all prescribers. Interventions aimed at enhancing appropriateness of prescribing should target patients taking multiple medications. VL - 15 UR - http://www.biomedcentral.com/1471-2296/15/59 IS - 59 ER - TY - JOUR T1 - Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score JF - BMC Med Y1 - 2011 A1 - Aalbers, Jolien A1 - O'Brien, K A1 - Chan, Wai-Sun A1 - Falk, G A1 - Teljeur, C A1 - Dimitrov, B A1 - Fahey, T KW - Adult KW - Diagnosis, Differential KW - Humans KW - Pharyngitis KW - Predictive Value of Tests KW - Primary Health Care KW - Streptococcal Infections KW - Streptococcus pyogenes AB - BACKGROUND: Stratifying patients with a sore throat into the probability of having an underlying bacterial or viral cause may be helpful in targeting antibiotic treatment. We sought to assess the diagnostic accuracy of signs and symptoms and validate a clinical prediction rule (CPR), the Centor score, for predicting group A β-haemolytic streptococcal (GABHS) pharyngitis in adults (> 14 years of age) presenting with sore throat symptoms. METHODS: A systematic literature search was performed up to July 2010. Studies that assessed the diagnostic accuracy of signs and symptoms and/or validated the Centor score were included. For the analysis of the diagnostic accuracy of signs and symptoms and the Centor score, studies were combined using a bivariate random effects model, while for the calibration analysis of the Centor score, a random effects model was used. RESULTS: A total of 21 studies incorporating 4,839 patients were included in the meta-analysis on diagnostic accuracy of signs and symptoms. The results were heterogeneous and suggest that individual signs and symptoms generate only small shifts in post-test probability (range positive likelihood ratio (+LR) 1.45-2.33, -LR 0.54-0.72). As a decision rule for considering antibiotic prescribing (score ≥ 3), the Centor score has reasonable specificity (0.82, 95% CI 0.72 to 0.88) and a post-test probability of 12% to 40% based on a prior prevalence of 5% to 20%. Pooled calibration shows no significant difference between the numbers of patients predicted and observed to have GABHS pharyngitis across strata of Centor score (0-1 risk ratio (RR) 0.72, 95% CI 0.49 to 1.06; 2-3 RR 0.93, 95% CI 0.73 to 1.17; 4 RR 1.14, 95% CI 0.95 to 1.37). CONCLUSIONS: Individual signs and symptoms are not powerful enough to discriminate GABHS pharyngitis from other types of sore throat. The Centor score is a well calibrated CPR for estimating the probability of GABHS pharyngitis. The Centor score can enhance appropriate prescribing of antibiotics, but should be used with caution in low prevalence settings of GABHS pharyngitis such as primary care. VL - 9 UR - http://www.biomedcentral.com/1741-7015/9/67 ER - TY - JOUR T1 - Potentially inappropriate prescribing and vulnerability and hospitalization in older community-dwelling patients. JF - Annals of Pharmacotherapy Y1 - 2014 A1 - Cahir, C A1 - Moriarty, F A1 - Teljeur, C A1 - Fahey, T A1 - Bennett, K KW - Beers 2012 criteria; STOPP; functional decline; health care use; older populations; potentially inappropriate prescribing; vulnerability AB - BACKGROUND: The predictive validity of existing explicit process measures of potentially inappropriate prescribing (PIP) is not established. OBJECTIVE: To determine the association between PIP, and vulnerability and hospital visits in older community-dwelling patients. METHODS: This was a retrospective cohort study of 931 community-dwelling patients aged ≥70 years in 15 general practices in Ireland in 2010. PIP was defined by the Beers 2012 criteria and the Screening Tool of Older Person's Potentially Inappropriate Prescriptions (STOPP). Vulnerability was measured by the Vulnerable Elders Survey (score ≥3). The number of hospital visits was measured using patients' medical records and self-report for the previous 6 months. Multilevel logistic and Poisson regression was used to examine the association between PIP, and vulnerability and hospital visits after adjusting for patient and practice level covariates, socioeconomic status, comorbidity, number of drug classes, social support, and adherence. RESULTS: The prevalence of PIP determined by the Beers 2012 and STOPP criteria was 28% (n = 246) and 42% (n = 377), respectively. Patients with ≥2 PIP indicators were almost twice as likely to be classified as vulnerable (Beers adjusted odds ratio [OR] = 1.80; 95% CI = 1.08, 3.01; P < 0.05; STOPP adjusted OR = 1.86; 95% CI = 1.13, 3.04; P < 0.05). Patients with ≥2 STOPP indicators had an increased risk in the expected rate of hospital visits (adjusted incidence rate ratio = 1.32; 95% CI = 1.14, 1.54; P < 0.01). The Beers 2012 criteria were not associated with increased hospital visits. CONCLUSION: STOPP is a more sensitive measure of PIP than the Beers 2012 criteria and of clinical benefit in primary care settings. VL - 48 UR - http://www.ncbi.nlm.nih.gov/pubmed/25248541 IS - 12 ER - TY - JOUR T1 - Potentially inappropriate prescribing and cost outcomes for older people: a national population study JF - Br J Clin Pharmacol Y1 - 2010 A1 - Cahir, C A1 - Fahey, T A1 - Teeling, Mary A1 - Teljeur, C A1 - Feely, John A1 - Bennett, K KW - Aged KW - Aged, 80 and over KW - Cohort Studies KW - Costs and Cost Analysis KW - Drug Prescriptions KW - Female KW - Humans KW - Inappropriate Prescribing KW - Ireland KW - Male KW - Medication Errors KW - Polypharmacy KW - Treatment Outcome AB - AIMS: Optimization of drug prescribing in older populations is a priority due to the significant clinical and economic costs of drug-related illness. This study aimed to: (i) estimate the prevalence of potentially inappropriate prescribing (PIP) in a national Irish older population using European specific explicit prescribing criteria; (ii) investigate the association between PIP, number of drug classes, gender and age and; (iii) establish the total cost of PIP. METHODS: This was a retrospective national population study (n= 338 801) using the Health Service Executive Primary Care Reimbursement Service (HSE-PCRS) pharmacy claims database. The HSE-PCRS uses the WHO Anatomical Therapeutic Chemical (ATC) classification system and details of every drug dispensed and claimants' demographic data are available. Thirty PIP indicators (STOPP) were applied to prescription claims for those >or=70 years in Ireland in 2007. STOPP is a physiological system based screening tool of older persons' potentially inappropriate prescriptions assessing drug-drug and drug-disease interactions, dose and duration. RESULTS: In our study population PIP prevalence was 36% (121 454 claimants). The main contributors to this were: 56 560 (17%) prescribed proton pump inhibitors at maximum therapeutic dose for >8 weeks, 29 691 (9%) prescribed non-steroidal anti-inflammatories for >3 months, 17 676 (5%) prescribed long-acting benzodiazepines for >1 month and 16 201 (5%) prescribed duplicate drugs. The main determinant of PIP was polypharmacy. The likelihood of PIP increased with a significant linear and quadratic trend (P < 0.0001) with the number of drug classes.The maximum net ingredient cost of PIP was estimated to be euro38 664 640. Total PIP expenditure was estimated to be euro45 631 319, 9% of the overall expenditure on pharmaceuticals in those >or=70 years in 2007. CONCLUSIONS: The findings identify a high prevalence of PIP in Ireland with significant cost consequences. VL - 69 UR - http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.2010.03628.x/abstract IS - 5 ER - TY - JOUR T1 - Potentially inappropriate prescribing and adverse health outcomes in community dwelling older patients JF - Br J Clin Pharmacol Y1 - 2014 A1 - Cahir, C A1 - Bennett, K A1 - Teljeur, C A1 - Fahey, T KW - adverse drug events KW - health care use KW - HRQOL KW - older populations KW - potentially inappropriate prescribing KW - STOPP AB - Abstract AIMS: This study aimed to determine the association between potentially inappropriate prescribing (PIP) and health related outcomes [adverse drug events (ADEs), health related quality of life (HRQOL) and hospital accident and emergency (A&E) visits] in older community dwelling patients. METHODS: A retrospective cohort study of 931 community dwelling patients aged ≥70 years in 15 general practices in Ireland in 2010. PIP was defined by the Screening Tool of Older Person's Prescriptions (STOPP). ADEs were measured by patient self-report and medical record for the previous 6 months and reviewed by two independent clinicians. HRQOL was measured by the EQ-5D. A&E visits were measured by patients' medical records and self-report. Multilevel logistic, linear and Poisson regression examined how ADEs, HRQOL and A&E visits varied by PIP after adjusting for patient and practice level covariates: socioeconomic status, co-morbidity, number of drug classes and adherence. RESULTS: The overall prevalence of PIP was 42% (n = 377). Patients with ≥2 PIP indicators were twice as likely to have an ADE (adjusted OR 2.21; 95% CI 1.02, 4.83, P < 0.05), have a significantly lower mean HRQOL utility (adjusted coefficient -0.09, SE 0.02, P < 0.001) and nearly a two-fold increased risk in the expected rate of A&E visits (adjusted IRR 1.85; 95% CI 1.32, 2.58, P < 0.001). The number of drug classes and adherence were also significantly associated with these same adverse health outcomes. CONCLUSIONS: Reducing PIP in primary care may help lower the burden of ADEs, its associated health care use and costs and enhance quality of life in older patients. VL - 77 UR - http://onlinelibrary.wiley.com/doi/10.1111/bcp.12161/abstract IS - 1 ER - TY - JOUR T1 - Optimized retrieval of primary care clinical prediction rules from MEDLINE to establish a Web-based register JF - J Clin Epidemiol Y1 - 2011 A1 - Keogh, C A1 - Wallace, E A1 - O'Brien, K A1 - Murphy, Paul J A1 - Teljeur, C A1 - McGrath, Brid A1 - Smith, SM A1 - Niall Doherty A1 - Dimitrov, B A1 - Fahey, T KW - Abstracting and Indexing as Topic KW - Databases, Bibliographic KW - Humans KW - Information Storage and Retrieval KW - MEDLINE KW - Primary Health Care KW - Sensitivity and Specificity KW - Subject Headings AB - OBJECTIVES: Identifying clinical prediction rules (CPRs) for primary care from electronic databases is difficult. This study aims to identify a search filter to optimize retrieval of these to establish a register of CPRs for the Cochrane Primary Health Care field. STUDY DESIGN AND SETTING: Thirty primary care journals were manually searched for CPRs. This was compared with electronic search filters using alternative methodologies: (1) textword searching; (2) proximity searching; (3) inclusion terms using specific phrases and truncation; (4) exclusion terms; and (5) combinations of methodologies. RESULTS: We manually searched 6,344 articles, revealing 41 CPRs. Across the 45 search filters, sensitivities ranged from 12% to 98%, whereas specificities ranged from 43% to 100%. There was generally a trade-off between the sensitivity and specificity of each filter (i.e., the number of CPRs and total number of articles retrieved). Combining textword searching with the inclusion terms (using specific phrases) resulted in the highest sensitivity (98%) but lower specificity (59%) than other methods. The associated precision (2%) and accuracy (60%) were also low. CONCLUSION: The novel use of combining textword searching with inclusion terms was considered the most appropriate for updating a register of primary care CPRs where sensitivity has to be optimized. VL - 64 UR - http://www.sciencedirect.com/science/article/pii/S0895435610004233 IS - 8 ER - TY - JOUR T1 - Multimorbidity in a cohort of patients with type 2 diabetes JF - European Journal of General Practice Y1 - 2013 A1 - Teljeur, C A1 - Smith, SM A1 - Paul, G A1 - Kelly, Alan A1 - O'Dowd, T KW - Diabetes KW - patient involvement AB - ABSTRACT Background: People with type 2 diabetes frequently have a variety of related and unrelated chronic conditions. These additional conditions have implications for patient education, treatment burden and disease management. Objectives: The aim of this study was to examine the nature of multimorbidity, and its impact on GP visits, polypharmacy and glycaemic control as measured by HbA1c, in a cohort of patients with type 2 diabetes attending general practice in Ireland. Methods: A cohort of 424 patients with type 2 diabetes enrolled in a cluster randomized controlled trial based in Irish general practice was examined. Patient data included: medical conditions, HbA1c, health service utilization, socio-economic status and number of prescribed medications. Results: 90% of patients had at least one additional chronic condition and a quarter had four or more additional chronic conditions. 66% of patients had hypertension; 25% had heart disease; and 16% had arthritis. General practitioner visits and polypharmacy increased significantly with increasing numbers of chronic conditions. When comparing patient self-report with medical records, patients who reported a higher proportion of their conditions had better glycaemic control with a significantly lower HbA1c score. Conclusion: There was a high prevalence of multimorbidity in these patients with type 2 diabetes and the results suggest that glycaemic control is related to patients’ awareness of their chronic conditions. The variety of conditions emphasizes the complexity of illness management in this group and the importance of maintaining a generalist and multidisciplinary approach to their clinical care. Read More: http://informahealthcare.com/doi/abs/10.3109/13814788.2012.714768 VL - 19 UR - http://informahealthcare.com/doi/abs/10.3109/13814788.2012.714768 IS - 1 ER - TY - JOUR T1 - Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer JF - Br J Cancer Y1 - 2010 A1 - Olde Bekkink, M A1 - McCowan, Colin A1 - Falk, G A1 - Teljeur, C A1 - Van de Laar, F A A1 - Fahey, T KW - Adenocarcinoma KW - Adult KW - Aged KW - Anemia KW - Barium Sulfate KW - Cohort Studies KW - Colonoscopy KW - Colorectal Neoplasms KW - Enema KW - Family Practice KW - Female KW - Gastrointestinal Hemorrhage KW - Humans KW - Male KW - Middle Aged KW - Pain KW - Primary Health Care KW - Prospective Studies KW - Rectum KW - Reference Standards KW - Risk KW - Sensitivity and Specificity KW - Sigmoidoscopy KW - Weight Loss AB - BACKGROUND: Rectal bleeding is a recognised early symptom of colorectal cancer. This study aimed to assess the diagnostic accuracy of symptoms, signs and diagnostic tests in patients with rectal bleeding in relation to risk of colorectal cancer in primary care. METHODS: Diagnostic accuracy systematic review. Medline (1966 to May 2009), Embase (1988 to May 2009), British Nursing Index (1991 to May 2009) and PsychINFO (1970 to May 2009) were searched. We included cohort studies that assessed the diagnostic utility of rectal bleeding in combination with other symptoms, signs and diagnostic tests in primary care. An eight-point quality assessment tool was produced to assess the quality of included studies. Pooled positive likelihood ratios (PLRs), sensitivities and specificities were calculated. RESULTS: Eight studies incorporating 2323 patients were included. Average weighted prior probability of colorectal cancer was 7.0% (range: 3.3-15.4%, median: 8.1%). Age > or = 60 years (pooled PLR: 2.79, 95% confidence interval (CI) 2.00-3.90), weight loss (pooled PLR: 1.89, 95% CI: 1.03-3.07) and change in bowel habit (pooled PLR: 1.92, 95% CI: 0.54-3.57) raise the probability of colorectal cancer into the range of referral to secondary care but do not conclusively 'rule in' the diagnosis. Presence of severe anaemia has the highest diagnostic value (pooled PLR: 3.67, 95% CI: 1.30-10.35), specificity 0.95 (95% CI: 0.93-0.96), but still only generates a post-test probability of 21.6%. CONCLUSIONS: In patients with rectal bleeding who present to their general practitioner, additional 'red flag' symptoms have modest diagnostic value. These findings have implications in relation to recommendations contained in clinical practice guidelines. VL - 102 UR - http://www.nature.com/bjc/journal/v102/n1/full/6605426a.html IS - 1 ER - TY - JOUR T1 - Chronic respiratory disease and multimorbidity: prevalence and impact in a general practice setting JF - Respir Med Y1 - 2011 A1 - O'Kelly, Siobhan A1 - Smith, SM A1 - Lane, S A1 - Teljeur, C A1 - O'Dowd, T KW - Adolescent KW - Adult KW - Aged KW - Chronic Disease KW - Comorbidity KW - Cross-Sectional Studies KW - Female KW - General Practice KW - Humans KW - Ireland KW - Lung Diseases KW - Male KW - Middle Aged KW - Prevalence KW - Socioeconomic Factors KW - Urban Health Services KW - Young Adult AB - BACKGROUND: Multimorbidity is defined as two or more co-existing chronic conditions in an individual and is common in general practice. It is associated with poorer outcomes for patients. This study aimed to establish the prevalence of multimorbidity in patients with chronic respiratory disease in general practice and to describe its impact on health service use. METHODS: Cross-sectional study based in general practice in Dublin. Drug and disease code searches were performed to identify adult patients with a diagnosis of chronic respiratory disease. Medical records were reviewed for chronic respiratory diagnosis, other chronic conditions, demographic characteristics, General Practitioner (GP) and practice nurse utilisation rates, and numbers of medications. RESULTS: In a general practice population of 16,946 patients 3.9% had chronic respiratory disease and 60% of these had one or more co-existing chronic condition(s). GP and practice nurse utilisation rates, and number of medications were significantly higher among those with multimorbidity compared with those with respiratory disease alone. Multivariate analysis showed that increasing age and low socio-economic status were significantly associated with multimorbidity. CONCLUSION: The majority of patients with chronic respiratory disease have multimorbidity. Clinical guidelines based on single disease entities and outcomes are not as easy to implement and may not be as effective in this group. VL - 105 UR - http://www.sciencedirect.com/science/article/pii/S0954611110003409 IS - 2 ER - TY - Generic T1 - Medication adherence and adverse health outcomes in community dwelling older patients. International Society for Pharmacoeconomics and Outcomes Research (ISPOR), 16th Annual European Congress, Dublin, November 2013 (Best general poster research presentati Y1 - 2013 A1 - Cahir, C A1 - Fahey, T A1 - Teljeur, C A1 - Bennett, K ER - TY - Generic T1 - GP variability in the prescribing of potentially inappropriate medication in older populations in Ireland. 41st Annual Scientific Meeting of the Society of Academic Primary Care. 2 – 4 October 2012, Glasgow, Scotland Y1 - 2012 A1 - Cahir, C A1 - Bennett, K A1 - Teljeur, C A1 - Fahey, T ER - TY - Generic T1 - Workshop: Using routine health data for medical research. 13th Annual Scientific Meeting of the Association of University Departments of General Practice in Ireland, 19 March 2010, RCSI, Dublin, Ireland Y1 - 2010 A1 - Cousins, G A1 - Teljeur, C A1 - McCowan, Colin ER - TY - Generic T1 - A Systematic Review of the diagnostic accuracy of signs and symptoms and the validation of the Centor score in predicting group A β-haemolytic streptococcal pharyngitis in adults in primary care. SAPC Conference, 8-10 July 2009, University of Dundee, UK Y1 - 2009 A1 - O'Brien, K A1 - Aalbers, Jolien A1 - Chan, Wai-Sun A1 - Dimitrov, B A1 - Falk, G A1 - Teljeur, C A1 - Fahey, T UR - http://www.hrbcentreprimarycare.ie/ppt/AalbersJ/Presentation%20Sore%20Throat%2015%20Jan.ppt ER - TY - Generic T1 - Risk of overdose mortality during the initial two weeks after entering or re-entering methadone treatment in Scotland: Retrospective cohort study. The Society for Social Medicine, 6-8 September 2010, Belfast Y1 - 2010 A1 - Cousins, G A1 - Teljeur, C A1 - Motterlini, N A1 - McCowan, Colin A1 - Dimitrov, B A1 - Fahey, T ER - TY - Generic T1 - Potentially inappropriate prescribing and cost outcomes for older people: a national population study. HRB Centre for Primary Care Research seminar on older people. Winter Scientific Meeting of the Faculty of Public Health Medicine, 9 December 2009, RCSI Y1 - 2009 A1 - Cahir, C A1 - Fahey, T A1 - Teeling, Mary A1 - Teljeur, C A1 - Feely, John A1 - Bennett, K UR - http://www.hrbcentreprimarycare.ie/ppt/CahirC/PrescribingOlderPopCC-10Sept09.ppt ER - TY - Generic T1 - Chronic Respiratory Disease and Multimorbidity: Prevalence and impact in a General Practice Setting. Irish Thoracic Society Annual Scientific Meeting 2009, 5 November 2009, Irish Thoracic Society, Galway, Ireland Y1 - 2009 A1 - O'Kelly, Siobhan A1 - Smith, SM A1 - Lane, S A1 - Teljeur, C A1 - O'Dowd, T UR - http://www.hrbcentreprimarycare.ie/ppt/OKellyS/SOKellyITS09.pdf ER - TY - Generic T1 - Systematic review of the diagnostic accuracy of signs & symptoms and validation of the Centor Score in predicting group A b-haemolytic streptococcal pharyngitis in adults in Primary Care. International Forum for Diagnostic, HRB Centre, Dublin Y1 - 2010 A1 - O'Brien, K A1 - Aalbers, Jolien A1 - Chan, Wai-Sun A1 - Dimitrov, B A1 - Teljeur, C A1 - Falk, G A1 - Fahey, T UR - http://www.hrbcentreprimarycare.ie/default.aspx?ID=124 ER - TY - Generic T1 - Potentially inappropriate prescribing and cost outcomes for older people: a national population study. HRB Centre for Primary Care Research seminar on older people, 10 September 2009, HRB Centre for Primary Care Research, Dublin Y1 - 2009 A1 - Cahir, C A1 - Fahey, T A1 - Teeling, Mary A1 - Teljeur, C A1 - Feely, John A1 - Bennett, K UR - http://www.hrbcentreprimarycare.ie/ppt/CahirC/PrescribingOlderPopCC-10Sept09.ppt ER - TY - Generic T1 - International Register and Clinical Domains in Primary Care. Clinical Prediction Rules – International Forum for Diagnostic and Prognostic Strategies in Primary Care, 4 June 2010, HRB Centre for Primary Care Research, Dublin Y1 - 2010 A1 - Keogh, C A1 - Wallace, E A1 - O'Brien, K A1 - Murphy, Paul J A1 - Teljeur, C A1 - McGrath, Brid A1 - Smith, SM A1 - Niall Doherty A1 - Dimitrov, B A1 - Fahey, T UR - http://www.hrbcentreprimarycare.ie/default.aspx?ID=124 ER - TY - Generic T1 - Chronic respiratory disease and multimorbidity: prevalence and impact in a general practice setting. October 2009, EGPRN Dubrovnik, Croatia Y1 - 2009 A1 - O'Kelly, Siobhan A1 - Smith, SM A1 - Lane, S A1 - Teljeur, C A1 - O'Dowd, T ER -