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A Vora, Amit Bhargava
INTRODUCTION: Cough is significant health problem with greater implication for impaired quality of life. Acute and chronic cough due to infective (viral/bacterial), allergic conditions or bronchial asthma including cough variant asthma are often treated with combination of mucolytics, expectorants and bronchodilators. Bronchodilators reduces cough sensitivity, promotes clearance of cough secretions while reducing protrusive inflammatory mediator release. AIMS AND OBJECTIVES: To further understand the clinical utility and safety of Bronchodilatory cough formulations (BCF) containing Levosalbutamol in real world settings...
September 2016: Journal of the Association of Physicians of India
Y H Liu, Y Zhen
A manuscript of Tibetan medicine, P. t.1054, written on 4 pattra-leaf-like rectangular papers connected together, is collected in the Volume 10 of Dunhuang Tibetan Manuscripts Preserved in France Scroll. The contents on the front pages of the whole set is on pulse-taking of Tibetan medicine, and the back pages, on prescriptions containing 5 recipes of cathartics and medicinal oils, are included in 16 lines on the remained Scroll dealing with its ingredients, processing method, function and indications which can be differentiated into 5 units...
July 28, 2016: Zhonghua Yi Shi za Zhi, Chinese Journal of Medical History
Gorden Muduma, Isaac Odeyemi, Richard Fulton Pollock
BACKGROUND: As of 2014, there were approximately 8300 patients with a functioning liver transplant in the UK Transplant Registry, with 880 liver transplants performed in 2013-2014 alone. Tacrolimus, typically used in combination with steroids and mycophenolate mofetil, currently represents the cornerstone of post-transplant immunosuppression in liver transplant recipients. OBJECTIVES: The objective of the present study was to evaluate the cost-effectiveness of prolonged-release (PR) tacrolimus (Advagraf(®), Astellas Pharma Inc...
March 2016: Drugs—Real World Outcomes
Perica Davitkov, Apoorva Krishna Chandar, Amy Hirsch, Anita Compan, Marina G Silveira, Donald D Anthony, Suzanne Smith, Clare Gideon, Robert A Bonomo, Yngve Falck-Ytter
BACKGROUND: Clinicians often face dilemmas with decisions related to formulary choices when two similar drugs are simultaneously available in the market. We studied the comparative safety, effectiveness, and treatment costs of the two first generation direct-acting antiviral agents (DAA), boceprevir and telaprevir as uncertainty existed regarding the drug of choice between these two seemingly equally Hepatitis-C treatment options. METHODS: We randomly assigned 50 patients in an open-label, pragmatic randomized controlled trial (RCT) at a VA Medical Center to either boceprevir or telaprevir in combination with peginterferon and ribavirin, stratified by the presence of cirrhosis and prior treatment experience...
2016: PloS One
Priya Sahadeo, Robert J Weber
On March 28, 2014, The United States Pharmacopeia and The National Formulary (USP-NF) published USP General Chapter <800> Hazardous Drugs-Handling in Healthcare Settings, as open for public comment in the USP Pharmacopeial Forum (PF) 40(3). Pharmacy directors must be proactive in understanding the impact that USP <800> will have on their processes for preparing sterile products. USP General Chapter <797> pertains to the compounding of both hazardous and nonhazardous drugs. USP <800> serves as a new standard to guide the handling of hazardous drugs in order to protect patients, health care personnel, and the environment...
November 2015: Hospital Pharmacy
Danial E Baker, Kyle T Ingram
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line...
November 2015: Hospital Pharmacy
Steven Jarrett, Theodor Dingermann
BACKGROUND: Pharmacists are the recognized experts in pharmacotherapy. With the recent introduction of biosimilar agents into the US market, pharmacists are poised to play a pivotal role in evaluating their risks versus benefits within the framework of cost containment. PURPOSE: This article provides hospital pharmacists with the necessary information on the principles surrounding the development, approval process, and use of biosimilars. METHODS: Information contained in this article enables hospital pharmacists to identify concerns relating to biosimilars, implement educational components, and successfully evaluate biosimilars for the addition to the formulary...
November 2015: Hospital Pharmacy
S N Thiyahiny, M G Sathiadas, K Sanchayan, C Vamadevan, R Balasubramaniam, S Sri Ranganathan
INTRODUCTION: Challenges in rational use of medicines (RUM) in children are different from that of adults. In Sri Lanka, data on RUM in children are limited. OBJECTIVE: To assess the current status and to investigate effectiveness of an intervention in improving RUM in children. METHODS: Non-randomised controlled before and after study design was employed. Study settings were one paediatric unit in two Teaching Hospitals one for intervention (IU) and the other as a control (CU) unit...
2016: Ceylon Medical Journal
Lamiece Hassan, Jane Senior, Roger T Webb, Martin Frisher, Mary P Tully, David While, Jenny J Shaw
BACKGROUND: Mental illness is highly prevalent among prisoners. Although psychotropic medicines can ameliorate symptoms of mental illness, prescribers in prisons must balance clinical needs against risks to safety and security. Concerns have been raised at the large number of prisoners reportedly receiving psychotropic medicines in England. Nonetheless, unlike for the wider community, robust prescribing data are not routinely available for prisons. We investigated gender-specific patterns in the prevalence and appropriateness of psychotropic prescribing in English prisons...
October 10, 2016: BMC Psychiatry
Rahil Sanatinia, Violet Cowan, Kirsten Barnicot, Krysia Zalewska, David Shiers, Stephen J Cooper, Mike J Crawford
BACKGROUND: Users of mental health service are concerned about changes in clinicians providing their care, but little is known about their impact. AIMS: To examine associations between changes in staff, and patient satisfaction and quality of care. METHOD: A national cross-sectional survey of 3379 people aged 18 or over treated in secondary care for schizophrenia or schizoaffective disorder. RESULTS: Nearly 41.9% reported at least one change in their key worker during the previous 12 months and 10...
September 2016: BJPsych Open
L Cortejoso, R A Dietz, G Hofmann, M Gosch, A Sattler
BACKGROUND: Inappropriate pharmacotherapy among older adults remains a critical issue in our health care systems. Besides polypharmacy and multiple comorbidities, the age-related pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug reactions and medication errors. OBJECTIVE: The main target of this study was to describe the characteristics of pharmaceutical interventions in two geriatric wards (orthogeriatric ward and geriatric day unit) of a general teaching hospital and to evaluate the clinical significance of the detected medication errors...
2016: Clinical Interventions in Aging
Christopher L Bowlus, James T Kenney, Gary Rice, Robert Navarro
BACKGROUND: Chronic liver disease and cirrhosis are a leading cause of morbidity and mortality in the United States. Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis and which has been designated an orphan condition, is a chronic autoimmune disease resulting in the destruction of the small bile ducts in the liver. Without effective treatment, disease progression frequently leads to liver failure and death. Until May 2016, the only FDA-approved treatment for PBC was ursodiol (UDCA), an oral hydrophilic bile acid, which can slow progression of liver damage due to PBC...
October 2016: Journal of Managed Care & Specialty Pharmacy
Dennis J Cada, Anne P Kim, Danial E Baker
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers...
September 2016: Hospital Pharmacy
Matthew Sussman, Jeffrey Yu, Siddhesh A Kamat, Ann Hartry, Susan Legacy, Ruth Duffy, Myrlene Sanon Aigbogun
BACKGROUND: Major depressive disorder (MDD) is a debilitating psychiatric illness with a high cost burden. This analysis evaluates the cost-effectiveness of adjunctive brexpiprazole versus comparator branded adjunctive treatment for MDD and background antidepressant therapy (ADT) alone from a US payer perspective. METHODS: An economic model was developed to assess the cost-effectiveness of brexpiprazole versus comparator adjunctive treatment and ADT alone on total direct medical costs using a 6-week cycle time frame for a total of 48 weeks, with treatment response and remission as primary outcomes...
September 20, 2016: Journal of Affective Disorders
José Luis Calleja Rivero, Franklin Zerpa, Loreto Rivera
INTRODUCTION: Hypertension requires effective interventions to reduce cardiovascular morbidity and mortality. Drug therapies have achieved optimal blood pressure levels in affected patients. Recent clinical guidelines suggest drug combinations a fact that has led to the development of various fixed-dose combinations. OBJECTIVE: To find the best available evidence about the effectiveness of antihypertensive drugs in fixed-dose combinations compared with separate dose combinations for blood pressure control, treatment adherence and reducing cardiovascular morbidity and mortality...
2016: Medwave
Nandita Kachru, Sneha Sura, Satabdi Chatterjee, Rajender R Aparasu
BACKGROUND: Antimuscarinic medications are the first-line pharmacological treatment for overactive bladder (OAB); however, little is known about the utilization pattern of antimuscarinic agents in elderly patients with OAB. OBJECTIVE: This study examined the prevalence and predictors of antimuscarinic medication prescribing in elderly patients with OAB, using national ambulatory survey data. METHODS: This cross-sectional study utilized the 2009-2010 National Ambulatory Medical Care Survey and the outpatient component of the National Hospital Ambulatory Medical Care Survey...
September 28, 2016: Drugs & Aging
B Peters, E G P M de Bont, J W L Cals
Amoxicillin and paracetamol are the two most widely prescribed and recommended medicines in children. Due to lack of scientific evidence of the most effective dosage, dosing instructions of both medicines are often unclear. In this article we challenge general practitioners, paediatricians, child-health clinic physicians, ENT specialists, pharmacists and guideline committees to critically evaluate the current dosing instructions of these two medicines. The Netherlands paediatric formulary, the Kinderformularium, should become the primary formulary for children in the Netherlands, but it has to be more in line with daily practice, and basic dosing instructions should be less ambiguous: (a) dosing instructions based on body weight instead of age; b) in case of pain, paracetamol should be given 60 mg/kg/day in four divided doses; (c) in case of common uncomplicated infections, amoxicillin should be given orally 60 mg/kg/day in two divided doses; (d) the following should be mentioned on the antibiotic prescription: the daily dose, the number of divided doses, the duration of therapy, the indication for the prescription, and the child's weight...
2016: Nederlands Tijdschrift Voor Geneeskunde
David J T Campbell, Marcello Tonelli, Brenda Hemmelgarn, Chad Mitchell, Ross Tsuyuki, Noah Ivers, Tavis Campbell, Raj Pannu, Eric Verkerke, Scott Klarenbach, Kathryn King-Shier, Peter Faris, Derek Exner, Vikas Chaubey, Braden Manns
BACKGROUND: Chronic diseases result in significant morbidity and costs. Although medications and lifestyle changes are effective for improving outcomes in chronic diseases, many patients do not receive these treatments, in part because of financial barriers, patient and provider-level knowledge gaps, and low patient motivation. The Assessing outcomes of enhanced chronic disease care through patient education and a value-based formulary study (ACCESS) will determine the impact of two interventions: (1) a value-based formulary which eliminates copayment for high-value preventive medications; and (2) a comprehensive self-management support program aimed at promoting health behavior change and medication adherence, combined with relay of information on medication use to healthcare providers, on cardiovascular events and/or mortality in low-income seniors with elevated cardiovascular risk...
September 26, 2016: Implementation Science: IS
Tarita N Collins, Joshua B Avondoglio, Linda M Terry
Mentally ill patients are entering the criminal justice system at alarming rates, representing a significant percentage of those incarcerated. Correctional facilities are mandated to provide mental health treatment to inmates. The increasing number of inmate patients has made psychiatry an important part of institutional operations. Psychiatrists are called to provide psychopharmacological interventions to aid in the safe operation of institutions and provide effective treatment to those with mental illness...
September 27, 2016: International Review of Psychiatry
Nancy M Holekamp
Diabetic retinopathy (DR) is both the leading cause of blindness among adults aged 20 to 74 in the United States, and the leading ocular complication associated with diabetes mellitus (DM). An estimated 4.4% of adults with DM over 40 years of age have the more advanced form of DR: diabetic macular edema (DME), which significantly increases the risk of blindness. Medical costs for Medicare patients with DME are a third higher than for patients without DME. The majority of these costs stem from other DM-related complications, as DME is a marker for poorly controlled DM overall...
July 2016: American Journal of Managed Care
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