Services provided by a clinical pharmacokinetics laboratory were evaluated in terms of an accepted cost-benefit model, and a model to evaluate clinical services provided by the pharmacist is presented. A retrospective...
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Services provided by a clinical pharmacokinetics laboratory were evaluated in terms of an accepted cost-benefit model, and a model to evaluate clinical services provided by the pharmacist is presented. A retrospective study was conducted to evaluate the impact, in terms of patient outcomes, of individualizing dosage regimens in severely burned patients. Analysis was conducted using multivariate statistical techniques and appropriate non-parametric and parametric tests to determine significant differences. This analysis provided the necessary data to quantify the impact of the pharmacokinetic service. Significant differences may exist in comparing individually dosed patients against those who were not, based upon discriminant and multiple regression analyses and/or non-parametric tests. The results may be useful for insurance companies, 3rd-party payers, and government agencies in deciding which innovative clinical services should be reimbursed.
Objective: To assess adherence to antiretroviral therapy with the use of Medicaid pharmacy claims data for human immunodeficiency virus (HIV)-infected pregnant women and to identify associated maternal and health care...
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Objective: To assess adherence to antiretroviral therapy with the use of Medicaid pharmacy claims data for human immunodeficiency virus (HIV)-infected pregnant women and to identify associated maternal and health care factors. Methods: We retrospectively studied a cohort of 2714 HIV-infected women in New York State who delivered live infants from 1993-96;Among 682 women prescribed antiretroviral therapy in the last two trimesters, we studied 549 who started therapy more than 2 months before delivery. Adherence was defined as adequate if the supplied drug covered at least 80% of the days from the first prescription in the last two trimesters until delivery. Multivariable analyses were used to examine associations between maternal and health care factors and adherence. Results: Only 34.2% of 549 subjects had at least 80% adherence based on pharmacy data, a rate that remained stable over time. The adjusted odds ratios (ORs) of adherence for black (OR 0.47, 95% confidence interval [CI] 0.30, 0.75) and Hispanic (OR 0.49, 95% CI 0.29, 0.82) women were nearly 50% lower than for white women. The OR of adherence was 0.32 (95% CI 0.12, 0.90) for teenagers compared with women aged 25-29 years and 0.56 (95% CI 0.34, 0.92) for women in New York City versus those residing elsewhere. Women on antiretroviral therapy before pregnancy were more likely to adhere (OR 1.55, 95% CI 1.02, 2.35). Conclusion: Teenagers, women of minority groups, and women living in New York City had greater risks of poor antiretroviral adherence, whereas women already prescribed antiretrovirals before pregnancy had better adherence. Our conservative pharmacy data-based measure showed that most HIV -infected women adhered poorly and adherence did not improve over the 4-year study. (C) 2000 by The American College of Obstetricians and Gynecologists.
The Notes section welcomes the following types of contributions: (1) practical innovations or solutions to everyday practice problems, (2) substantial updates or elaborations on work previously published by the same a...
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The Notes section welcomes the following types of contributions: (1) practical innovations or solutions to everyday practice problems, (2) substantial updates or elaborations on work previously published by the same authors, (3) important confirmations of research findings previously published by others, and (4) short research reports, including practice surveys, of modest scope or interest. Notes should be submitted with AJHP's manuscript checklist. The text should be concise, and the number of references, tables, and figures should be limited.
OBJECTIVES: (1) Present conceptual support for a type of pharmacy network, a pharmacy service alliance (PSA), (2) describe the development of a PSA in eastern Iowa, and (3) discuss how other types of PSAs can be devel...
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OBJECTIVES: (1) Present conceptual support for a type of pharmacy network, a pharmacy service alliance (PSA), (2) describe the development of a PSA in eastern Iowa, and (3) discuss how other types of PSAs can be developed. DESIGN AND PARTICIPANTS: 12 independent pharmacies in eastern Iowa. SETTING: Community pharmacy practice. MAIN OUTCOME MEASURES: Formation of a PSA. RESULTS: Pharmacy members of the Certified Pharmaceutical Care Network, a PSA, have jointly developed new pharmacy services. Collaborative efforts have involved disease state management programs, group marketing activities, and a quality improvement process. CONCLUSION: PSAs offer an organizational model that pharmacies could use to successfully develop new pharmacy services.
This survey studied the satisfaction of university employees with the mail-service pharmacy option of their major health insurance provider. Nearly 92% reported good or excellent satisfaction with the mail order servi...
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This survey studied the satisfaction of university employees with the mail-service pharmacy option of their major health insurance provider. Nearly 92% reported good or excellent satisfaction with the mail order service. Of the 76.5% who reported receiving drug information brochures with some or all of their prescriptions, 91.5% rated the information excellent or good. When asked what sources they used to get additional information, 31.2% used a mail service pharmacist. These data suggest that mail order pharmacies, which have increased volume 50% per year since 1981, can expect to maintain and expand their market share. All pharmacy sectors should use this information to determine ways to enhance their competitive position.
An explosive development of private pharmacies in the Lao People's Democratic Republic (Lao P.D.R.) has led to 80% of pharmaceuticals being provided by the private sector. In order to achieve the goal of access to...
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An explosive development of private pharmacies in the Lao People's Democratic Republic (Lao P.D.R.) has led to 80% of pharmaceuticals being provided by the private sector. In order to achieve the goal of access to good quality health care for all citizens, the Lao government is making an effort to regulate the private pharmaceutical sector using the emerging legal system of laws, decrees, and regulations. The aim of this paper is to describe and analyze the system of drug regulation in Lao P.D.R. in relation to the public social goals. Relevant official documents at the central, provincial and district levels have been reviewed, interviews were held with 30 key informants and 15 pharmacies were surveyed. The public social goals have been expressed in terms of equity and quality of care. However, total drug expenditure may be as low as US$1 per person per year which is far below any minimum standard and does not make it possible to achieve reasonable access to drugs for all. The regulatory system has so far been focused on entry into the pharmaceutical retail market and dealing with basic issues of product quality and conditions of sate. An enforcement system including sanctions is being developed;other policy instruments such as information and economic means are hardly being used at all. The government presently faces a trade-off between quality of pharmaceutical services and geographical equity of access. The study shows that regulation is strongly influenced by the general socioeconomic context.
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