Perceived diabetes status is independently associated with glucose monitoring behaviour among type 2 diabetes mellitus patients.

Aims: To investigate if patients' perceptions of their diabetes status is related to blood glucose self-monitoring (SMBG) behaviour, independent of self-reported disease severity.

Methods: The setting of this study was a cross-sectional study among 1561 patients, 18 years or older, who filled at least two prescriptions for any glucose lowering drug between March 2002 and 2003 in the Netherlands. Using a 30-item self-administered questionnaire, data on self-monitoring behaviour (frequency of test strip use and objective of self-monitoring), perceived diabetes status and disease severity were gathered.

Differences in the association between structural factors and diabetes self-monitoring support.

Objective: To determine if the association between the level of community pharmacy diabetes services and six of its reported determinants is influenced by the definition of these services.

Method: Cross-sectional survey among 97% of all Dutch community pharmacies (1,642) registered in 2004. Seven definitions of self-monitoring support (support to patients performing self-monitoring of blood glucose) were constructed: one based on the Dutch pharmacy practice guideline (containing five activities related to patient counselling, calibration and dispensing), one based on patient counselling activities only and five definitions based on each separate activity.

Effect of drug combinations on admission for recurrent myocardial infarction.

Objective: To determine the effect of the number of different drugs with adherence to medication of at least 70% on recurrent admission for myocardial infarction (MI) in patients with a history of MI.

Design: Nested case-control study in a dynamic cohort.

Setting: PHARMO database that contains pharmacy dispensing records and hospital discharge records of 350,000 Dutch citizens.

Regional influences on the dispensing of glucose test strips in Dutch community pharmacies.

Background: Pharmacy practice guidelines promote the role of community pharmacies in self-monitoring of blood glucose. However, variations between Dutch pharmacies exist in the proportion of patients to whom test strips are dispensed.

Objective: To assess whether variations between community pharmacies in dispensing of blood glucose test strips can be explained by differences in patient characteristics and the region in which the pharmacy is located.

Improving pharmacotherapy after myocardial infarction by group academic detailing using feedback data on a patient level.

Study Objective: To develop and evaluate a peer review group (PRG) meeting using feedback data on a patient level to improve the quality of drug therapy for prevention of recurrent myocardial infarction.

Design: Prospective follow-up study.

Data Source: General practitioners' computerized patients records (intervention patients) and the PHARMO record linkage system (controls).

Preventive drug use in patients with a history of nonfatal myocardial infarction during 12-year follow-up in The Netherlands: a retrospective analysis.

Background: Myocardial infarction (MI) is a common cause of death in developed countries. Long-term preventive pharmacotherapy has been shown to decrease mortality and morbidity after MI. Based on a literature search, studies of these therapies to date have estimated the use of monotherapy, whereas many patients are prescribed combination therapy.

Collaborative services among community pharmacies for patients with diabetes.

Background: Patients performing self-monitoring of blood glucose (SMBG) may benefit from community pharmacy services. However, wide-scale implementation of these services is limited. Many pharmacy characteristics (eg, physical layout of the pharmacy, knowledge and competence of the pharmacy team) are reported to be relevant when implementing these services.

Dispensing glucose test materials in Dutch community pharmacies.

Objective: To assess the proportion of diabetic patients who collect self-monitoring equipment for glucose testing in Dutch community pharmacies.

Methods: Data were used from the PHARMO-Record Linkage System, containing pharmacy dispensing records from 1991 to 1998. The study population consisted of patients who received at least two prescriptions of insulin and/or oral hypoglycemic agents.

Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies.

Aim: To establish the percentage hospital admission related to adverse drug reactions (ADRs) from the data available in the literature.

Method: Literature search in the Medline database, meta-analysis.

Results: From the literature it is revealed that a considerable part of all hospital admissions are related to adverse drug reactions.

Hospital prescribing errors: epidemiological assessment of predictors.

Aims: To demonstrate an epidemiological method to assess predictors of prescribing errors.

Methods: A retrospective case-control study, comparing prescriptions with and without errors.

Results: Only prescriber and drug characteristics were associated with errors.

The quality of Dutch hospital drug formularies: evaluation of technical features and organisational information.

Introduction: Hospital drug formularies (HDFs) are widely used tools to help influence clinicians' prescribing behaviour. Besides the therapeutic quality of HDFs, the available information and the way in which this is presented are key factors in HDFs' success or failure to influence prescribing behaviour and enhance prescribing quality. This research evaluates the technical features and organisational information of Dutch HDFs.

Absorption of Etoposide (VP-16-213) from the Small Intestine of the Rat. The Potential Role of Mucus as an Absorption Rate Limiting Barrier.

The absorption of etoposide (VP-16-213) was investigated in a perfused intestinal loop. The absorbed amount of drug was determined by collecting the blood draining the loop via cannulation of the efferent jejunal vein. The absorption rate of VP-16-213 strongly depended on the composition of the perfusion medium.

Drug release from suppositories.

Many studies have been carried out over the past decades on suppositories and their drug release properties. The present state of knowledge is reviewed with the conclusion that our current understanding of the in vivo performance of suppositories is deficient. It is therefore not possible to rely on in vitro data to predict in vivo performance.

Dissolution at porous interfaces VI: Multiple pore systems.

With the aid of rapidly dissolving sodium chloride particles, cubic pores were made in the surface of a theophylline tablet. The influence of the pores on the dissolution rate of the surface was investigated in a rotating disk apparatus. Like the drilled pores used in earlier studies, downstream on the surface they caused a turbulent flow regimen with the development of a trough due to enhanced erosion.

Pulsed proton NMR and solid-liquid fat ratio determinations in suppository vehicles and aminophylline suppositories.

The physical state, melting behaviour and release rate of aminophylline suppositories were studied during storage. The fraction of non-crystallized fat, assessed by pulse NMR, varies between different vehicles. At room temperature several vehicles do not seem to be completely crystalline.

Rectal motility and bioavailability.

The contractile activity of the canine rectal wall exhibits a positive influence on the behaviour of fatty suppositories in vivo with respect to both spreading abilities and rate and extent of release of the readily water-soluble compound phenazone. This influence on bio-availability was marked when the drug was suspended in a large particle size (100-125 µm). When used in small particles (< 35µm), far less influence of contractile activity was found.

Prolonged storage of aminophylline suppositories. The impact on physical parameters and bioavailability.

Prolonged storage of aminophylline/cocoa butter suppositories at 30 degrees resulted in a marked decrease in bioavailability, after administration to a panel of human volunteers. Not more than 20% of the drug content was absorbed during the first 8 hours and the maximum plasma level was obtained 5-7 hours after administration. It was concluded that storage conditions should be considered well and storage instructions should be given to the patient.

A new approach of ordered mixing applied to digitoxin tablets.

In ordered mixing it is assumed that mixing very different amounts of two materials is improved by adsorption of small particles onto large carrier particles. This hypothesis could be confirmed with tablets of 120 mg containing 0.1 mg digitoxin, prepared by dry coating of particles.

Influence of bloodflow on the absorption of theophylline from the jejunum of the rat.

The influence of the jejunal bloodflow on the absorption of theophylline was investigated. The bloodflow through a segment under investigation was varied by changing the systemic blood pressure by means of a donor blood infusion into the jugular vein or by an infusion of isoprenaline or levarterenol into a femoral vein, and was measured by collecting the venous outflow from the intestinal segment. Above a bloodflow of approximately 0.

Non-enhancement of sodium cromoglycate intestinal absorption by quaternary ammonium ions. An effect of salt on ion-pair formation?

Studies on the nature of rat small intestine perfusates indicate that this environment is thermodynamically unfavourable for the production of ion pairs between cromoglycate and alkylbenzyldimethylammonium ions. This is suggested as being the reason why, unlike previously found for ocular absorption of cromoglycate, these quaternary ammonium ions do not alter cromoglycate intestinal absorption.

Dissolution at porous interfaces. IV. Pore effects in natural convection flow.

The dissolution rate of a nicotinic acid tablet surface was measured in a dissolution system where mass transport in the solvent is governed by a combination of natural and forced convection. While such experimental conditions were chosen that natural convection outweighted forced convection, the dissolution rate increasing effect of large pores in the tablet surface was studied. To that end cylindrical pores were drilled into the tablet.