Prevalence, trends, and factors associated with antipsychotic polypharmacy among Medicaid-eligible schizophrenia patients, 1998-2000.

Objective: To determine the prevalence, trends, and factors associated with antipsychotic polypharmacy categorized according to type of antipsychotic and duration of use and to contrast usage patterns with published treatment guidelines.

Method: A retrospective cohort study was designed, and Medicaid recipients > or = 16 years of age with a schizophrenia diagnosis (ICD-9-CM = 295.xx) between 1998 and 2000 were identified from the California (20% random sample) and Georgia Medicaid claims databases.

Prevalence and patterns of concomitant use of selective serotonin reuptake inhibitors and other antidepressants in a high-cost polypharmacy cohort.

Background: Concomitant antidepressant therapy for patients who do not respond to selective serotonin reuptake inhibitors (SSRIs) may be appropriate under close medical supervision. However, little is known about the prevalence or patterns of concurrent antidepressant therapy in a typical large health maintenance organization.

Objective: The purpose of this study was to determine the prevalence of concomitant SSRI-antidepressant therapy and to assess the relationship between concomitant SSRI therapy, patient demographic characteristics, and the use of multiple prescribers and pharmacies.

Assessing NSAID prescription use as a predisposing factor for gastroesophageal reflux disease in a Medicaid population.

Purpose: The purpose of the study was to determine the incidence of GERD associated with prescription NSAID consumption.

Methods: All Georgia Medicaid patients > 25 years of age and continuously eligible for 1996, 1997, and 1998 were included in the study. Patients were excluded if they received a GERD diagnoses during 1996 and 1997.

Antipsychotic prescription use and costs for persons with schizophrenia in the 1990s: current trends and five year time series forecasts.

Real advances in schizophrenia pharmacotherapy have been made over this decade with the development of more efficacious treatment options with fewer side-effects. These advances have high per-unit direct costs that may have a profound effect on drug budgets of systems caring for persons with schizophrenia. The objective of this study was to describe the changes in utilization and cost for antipsychotic prescriptions by atypical, clozapine, decanoate products, and traditional neuroleptics in a large naturalistic setting, i.

Isolating the cost of osteoporosis-related fracture for postmenopausal women. A population-based study.

Background: Osteoporosis is a condition that will pose an increasing burden on health systems as populations age.

Objective: The objective of this study was to estimate the net 'per case' direct medical cost of fracture of indigent women age 50 years or greater and describe the cost of fracture for Medicaid and Medicare payers by inpatient hospital, physician, long-term care, prescription and miscellaneous expenditures.

Methods: This study utilized a quasi-experimental retrospective interrupted time series design to isolate the economic impact of fracture.

The net cost of Alzheimer disease and related dementia: a population-based study of Georgia Medicaid recipients.

The objective of this study was to estimate the direct medical cost of Alzheimer disease (AD) and related dementia to the Georgia Medicaid program. A retrospective, cross-sectional, matched control group design was used. AD cases 50 years of age and older were identified by using International Classification of Diseases (9th edition, Clinical Modification) diagnosis codes from 1994 Georgia Medicaid administrative claims files.

The impact of race and fractures on mortality in a postmenopausal Medicaid population.

The purpose of this study was to model fractures and survival by age and race in a large postmenopausal Medicaid population. All Georgia Medicaid claims were abstracted for the years 1992, 1993, and 1994. Claims for postmenopausal women (> or =50 years of age) were retained, and patients with fractures were identified by International Classification of Diseases, Ninth Revision codes for fracture.

Formulary management of low molecular weight heparins.

Low molecular weight heparins (LMWHs) are increasingly being utilised as anticoagulants in healthcare settings. These agents offer several advantages over standard unfractionated heparin. Indications for LMWHs include deep vein thrombosis and pulmonary embolism prophylaxis, deep vein thrombosis treatment, use in coronary procedures associated with a high risk for bleeding, and in acute coronary syndromes.

Persistence with estrogen therapy in a postmenopausal Medicaid population.

We evaluated rates of persistence with estrogen replacement therapy in postmenopausal Georgia Medicaid recipients adjusted for age and race. Data files for 1992-1994 were examined to estimate 3-year conditional survival probabilities using the Kaplan-Meier model, and 3800 subjects were identified. Over 54% of women remained compliant over 29 months, and 17% continued therapy for the entire 35 months of observation.

Popliteal artery thrombosis in a patient with Cogan syndrome: treatment with thrombolysis and percutaneous transluminal angioplasty.

A 31-year-old woman with Cogan syndrome (a rare form of systemic vasculitis) was evaluated for a cold, painful left foot with diminished pulses. Arteriography demonstrated thrombosis of the left popliteal artery with evidence of vasculitis. Thrombolytic therapy was begun with initial success but eventual rethrombosis.

Health care triage alternatives and the influence of health insurance, education and race.

The relationship between one of Andersen's enabling factors, health insurance status and the choice of a pharmacist as the initial contact in the health care system was examined via telephone surveys. Eighty-seven percent of the sample reported having some form of health insurance. Of all intended health care provider contacts, pharmacists were selected as the initial contact 21% of the time.

The ratio of AIDS to non-AIDS Medicaid medical costs from 1992 to 2000.

Our research objective was to calculate and forecast the monthly increase in medical and prescription costs for Medicaid patients with acquired immunodeficiency syndrome (AIDS) and compare these values with costs for non-AIDS patients. A retrospective analysis of AIDS patients and a control group of Georgia Medicaid beneficiaries was conducted between January 1, 1988, and December 31, 1991. AIDS patients were defined using the Keyes algorithm of combinations of International Classification of Diseases, 9th Revision, Clinical Modification codes.

OBRA '90: the impact on pharmacists and patients.

Two separate studies were conducted in Georgia for this investigation. The first study measured by observation, pharmacists' compliance with the mandates of the Omnibus Budget Reconciliation Act of 1990 (OBRA '90) before (December 1992) and after (June 1993) the law took effect in January 1993. The second assessed patient awareness, experience, and degree of cooperation with pharmacists in complying with OBRA '90.

Effect of dietary fat content on the bioavailability of a sustained release quinidine gluconate tablet.

Quinidine gluconate 324 mg sustained release tablets (Quinaglute) was administered as a single dose to 15 healthy male subjects following an overnight fast, immediately following a high fat (HF) breakfast or immediately following a low fat (LF) breakfast. Serum samples were obtained over a 48 h period and analyzed for quinidine content using a high performance liquid chromatographic assay. Under the conditions of the study, both the rate and extent of quinidine bioavailability was significantly affected by food.

Influence of age, sex, and race on prescription drug use among Georgia Medicaid recipients.

Interactions among patients' age, sex, and race that influence prescription drug use in a state Medicaid population are described. A database containing information about all 574,762 Medicaid prescriptions dispensed in Georgia during December 1985 was sorted and summarized so that each record represented one Medicaid recipient. The following data were included for each recipient: the total number of Medicaid prescriptions received by that patient during that month, the total payments made by the state for those prescriptions, and the patient's age, sex, and race.

A comparative study of current Medicaid prescription reimbursement (MAC/EAC) (maximum allowable cost/estimated acquisition cost) with prescription reimbursement based on a competitive market.

Many pharmacists have suggested that the current Maximum Allowable Cost/Estimated Acquisition Cost (MAC/EAC) program has departed from its intended purpose of generating savings by taking full but fair advantage of the competitive marketplace. The objective of this study was to compare Medicaid prescription reimbursement under current MAC/EAC regulations with prescription reimbursement based on a competitive market. Data representing the top selling single source and multiple source drug products for nine states were analyzed.

Estimating demand for health information: pharmacy counseling services.

Consumers want more information about their health care. Before giving more information, health care providers need valid, reliable estimates of the amounts consumers will pay for health information. Using the example of pharmacist counseling services, the authors demonstrate a method for developing, estimates of consumer demand for health information.

Polygraph testing--a comprehensive literature review of an ethical dilemma.

The purpose of this article is to provide pharmacy educators with knowledge regarding the polygraph. These facts are valuable in training and counseling students and are prerequisite to making informed decisions as leaders in the profession. Businesses lose six-billion dollars annually to employee theft.

Rotary pursuit, a measure of human performance, and plasma concentrations of promethazine.

Promethazine in doses of 50 mg has demonstrated detrimental effects upon the performance of visual tasks. The purpose of the study was to examine the relationship between the blood concentration levels of promethazine and two human performance tasks. Fifteen paid healthy male volunteers completed a randomized five-way crossover design which included a 25 mg and 50 mg dose of the innovator dosage form, a 50 mg dose of a generic dosage form, a 50 mg solution dosage form, and a placebo.

Bioequivalency and dose proportionality of three tableted promethazine products.

Data from a five-way crossover study in human subjects using four talented promethazine products and a promethazine solution are presented. All products were administered as a single oral dose. The five objectives of the study were to investigate bioequivalency, to estimate dose proportionality at two dose levels, to establish validity of a reference production solution for future bioequivalency studies, to estimate intersubject variation, and to compare bioavailability/tablet dissolution data.

In vitro and in vivo bioequivalence of commercial prednisone tablets.

The purpose of the study was to examine the bioequivalence of five commercially available oral prednisone products. The in vivo study utilized 18 healthy males, each of whom was administered 20 mg of prednisone as a reference solution or as a tablet in a 6-week, six-way crossover design. Blood was collected and serum was assayed, using an HPLC procedure specific for prednisone and prednisolone.

An in vivo single- and multiple-dose study of several marketed brands of conventional and controlled-release theophylline.

In a single-dose study, 18 healthy adult males consumed each of six dosage forms of theophylline. A conventional-release tablet, a syrup, and four competing brands of controlled-release theophylline were studied. Serial serum samples were obtained and analyzed via high pressure liquid chromatography (HPLC).