Benefits Improvement and Protection Act's impact on transplantation rates among elderly MEDICARE beneficiaries with end-stage renal disease.

Background: The Benefits Improvement and Protection Act (BIPA) expanded Medicare coverage for posttransplantation immunosuppresants for elderly patients and others eligible for Medicare beyond their end-stage renal disease (ESRD) status yet retained the 3-year limit for patients eligible solely because of ESRD status. Our objective was to determine BIPA's impact on renal transplantation among elderly patients (age ≥65 years) affected by BIPA.

Methods: Medicare claims and the U.

A qualitative study to identify reasons for discharges against medical advice in the cardiovascular setting.

Background: Cardiovascular disease (CVD) is responsible for the largest number of discharges against medical advice (AMA). However, there is limited information regarding the reasons for discharges AMA in the CVD setting.

Objective: To identify reasons for discharges AMA among patients with CVD.

Barriers to self-management of diabetes: a qualitative study among low-income minority diabetics.

Objectives: Diabetes self-management is a key element in the overall management of diabetes. Identifying barriers to disease self-management is a critical step in achieving optimal health outcomes. Our goal was to explore patients' perceptions about barriers to self-management of diabetes that could possibly help explain poor health outcomes among minority patients.

Racial/ethnic and age disparities in chemotherapy selection for colorectal cancer.

Objectives: To test the hypotheses that African American patients and older patients with stage IV colorectal cancer were less likely to receive newer chemotherapy agents.

Study Design: Retrospective cohort design.

Methods: Among 5068 Surveillance, Epidemiology, and End Results-Medicare patients diagnosed as having stage IV colorectal cancer between 2000 and 2002, a total of 2466 received chemotherapy and were included in the analysis.

Reasons for discharges against medical advice: a qualitative study.

Background: There is limited information in the literature about reasons for discharges against medical advice (DAMA) as supplied by patients and providers. Information about the reasons for DAMA is necessary for identifying workable strategies to reduce the likelihood and health consequences of DAMA. The objective of this study is to identify the reasons for DAMA based on patient and multicategory provider focus-group interviews (FGIs).

Outcomes of irinotecan-based chemotherapy regimens in elderly Medicare patients with metastatic colorectal cancer.

Background: Several population-based studies have confirmed the benefits of adjuvant chemotherapy with 5-fluorouracil/leucovorin for treatment of colorectal cancer. Few population-based studies have evaluated other chemotherapies that are now available for colorectal cancer management.

Objective: This study primarily sought to evaluate the survival benefit of first-line irinotecan use in a group of Medicare patients with stage IV (metastatic) colorectal cancer.

Short-term impact of an educational program promoting live donor kidney transplantation in dialysis centers.

Context: Given the shortage of kidneys available for transplantation, a community-based intervention trial was implemented to assess the impact of an educational program on patients' access to live donor kidney transplantation (LDKT).

Objective: To compare the short-term impact of a basic intervention and an enhanced intervention on patients' readiness to pursue LDKT. DEGISN: Baseline data and data from 1 week after interventions were analyzed.

Haemodialysis patients' readiness to pursue live donor kidney transplantation.

Background: Despite the benefits of live donor kidney transplantation (LDKT) over deceased donor kidney transplantation, patients hesitate to pursue this option.

Methods: A total of 324 transplant-eligible haemodialysis patients attending 14 dialysis facilities in Maryland, Northern Virginia and Southern Pennsylvania were asked about their stages of readiness to pursue LDKT, attitudes towards LKDT and demographics. Logistic regressions were used to test the effect of patients' attitudes and demographics on their stages of readiness to pursue LDKT.

A survey of nephrologists' views on preemptive transplantation.

Background And Objectives: Despite emerging evidence that preemptive transplantation is the best treatment modality for patients reaching end-stage renal disease (ESRD), it is underutilized. Nephrologists' views on preemptive transplantation are explored herein.

Design, Setting, Participants, & Measurements: A web-based survey elicited barriers to preemptive transplantation as perceived by nephrologists as well as demographic and practice variables associated with a favorable attitude toward preemptive transplantation.

Factors affecting pharmacists' pediatric asthma counseling.

Objective: To explore various factors that may influence community pharmacists' pediatric asthma counseling.

Design: Cross-sectional.

Setting: Maryland from September 2002 through March 2003.

Health plans' strategies for managing outpatient specialty pharmaceuticals.

Balancing increased spending for specialty pharmaceuticals while providing affordable and equitable coverage for consumers is a key issue for public and private payers. Health plans rely on an array of strategies, including both medical management and those used for more traditional pharmaceuticals. To explore specific management strategies for outpatient specialty pharmaceuticals, a survey was administered to thirty-eight Blue Cross and Blue Shield plans, focused on identifying core strategies.

Open and laparoscopic living donor nephrectomy in Switzerland: a retrospective assessment of clinical outcomes and the motivation to donate.

Background: Laparoscopic living kidney nephrectomy is thought to be associated with reduced morbidity, when compared to open nephrectomy. The purpose of this study was to explore the impact of these techniques on donors' clinical outcomes, satisfaction and motivation to donate.

Methods: Clinical outcomes were retrospectively compared in 152 open (n = 71) or laparoscopic (n = 81) donor procedures.

White paper: value of specialty certification in pharmacy.

Objective: To address the value of Board of Pharmaceutical Specialties (BPS) certification, particularly as perceived by different stakeholders (pharmacists, employers, government, and academia), and to draw a parallel between specialization and certification in pharmacy and in medicine.

Data Sources: Electronic databases (Medline, International Pharmaceutical Abstracts, Sociological Abstracts), associations/health care organizations Web sites, outside reports, and clinical pharmacists involved in certification processes.

Study Selection: Studies and reports that addressed the value of specialty certification were selected by the authors.

Exploring donors' and recipients' attitudes about living donor kidney transplantation.

Context: There is a growing interest in living donor kidney transplantation because of its potential to reduce the current kidney shortage.

Objective: To explore the experience of potential recipients, recipients, potential donors, and donors with regard to living donor kidney transplantation and laparoscopic living donor nephrectomy.

Method: Twenty-five patients participated in a series of focus group interviews.

The economic impact of laparoscopic living-donor nephrectomy on kidney transplantation.

Background: End-stage renal disease accounts for $17.9 billion annually in direct medical costs in the United States. This study assessed the flow of expenditures from a Medicare perspective for laparoscopic donor nephrectomy compared with living and cadaveric transplantation and continued dialysis.

Patients' attitudes about living donor transplantation and living donor nephrectomy.

Background: The growing shortage of organs available for transplantation has resulted in an increased use of living donors for kidney transplantation. The laparoscopic nephrectomy is a new procedure used to remove kidneys from donors. The study objective was to explore the attitudes of recipients and donors toward living donor kidney transplantation and the impact of the laparoscopic donor nephrectomy on donors' and recipients' acceptance of living donor kidney transplantation.