Use of Statins and the Risk of Incident Diabetes: A Retrospective Cohort Study.

Introduction: Even though several landmark statin trials have demonstrated the beneficial effects of statin therapy in both primary and secondary prevention of cardiovascular disease, several studies have suggested that statins are associated with a moderate increase in risk of new-onset diabetes. These observations prompted the US FDA to revise statin labels to include a warning of an increased risk of incident diabetes mellitus as a result of increases in glycosylated hemoglobin (HbA1c) and fasting plasma glucose. However, few studies have used US-based data to investigate this statin-associated increased risk of diabetes.

Web-based survey to assess the perceptions of managed care organization representatives on use of copay subsidy coupons for prescription drugs.

Background: Promotion of prescription drug coupons and vouchers by pharmaceutical manufacturers has increased in recent years. These coupons and vouchers usually subsidize patients' cost-sharing obligations. In other words, drug companies pay for a patient's portion of the drug cost, and the remaining cost is paid by the patient and the patient's health plan.

Examination of why some community pharmacists do not provide 72-hour emergency prescription drugs to Medicaid patients when prior authorization is not available.

Background: Existing federal law requires that a 72-hour emergency supply of a prescription drug be dispensed to Medicaid patients when prior authorization (PA) is not available and the medication is needed without delay. The pharmacist's role is to contact prescribers and inform them that PA is needed. If the prescriber cannot be reached, the pharmacist can dispense a 72-hour emergency supply.

Using the theory of planned behavior to examine pharmacists' intention to utilize a prescription drug monitoring program database.

Background: Prescription drug monitoring programs (PDMPs) are state-operated electronic databases that contain patients' controlled drug histories. Most states provide these data to pharmacists via online web portals to combat prescription drug abuse and diversion.

Objectives: The objectives of this study were to: 1) explore the theory of planned behavior's (TPB) utility in predicting Texas pharmacists' intention to utilize an online accessible PDMP; 2) to determine the contribution of each construct, attitude (A), subjective norm (SN) and perceived behavioral control (PBC) in predicting pharmacists' intention; and 3) test whether the addition of perceived obligation (PO) is significantly related to pharmacists' intention.

Comparison of the claim percent gross margin earned by Texas community independent pharmacies for dual-eligible beneficiary claims before and after Medicare Part D.

Objectives: To describe dual eligibles' claims before and after Medicare Part D and to evaluate the effect that Medicare Part D has had on the claim percent gross margin (CPGM) earned by Texas community independent pharmacies.

Design: Nonexperimental time series study.

Setting: Texas, October 2005 through September 2006.

Extended-release, once-daily morphine (Avinza) for the treatment of chronic nonmalignant pain: effect on pain, depressive symptoms, and cognition.

Objective: To evaluate the impact of an extended-release, once-daily morphine sulfate formulation on depressive symptoms and neurocognition in patients with chronic nonmalignant pain.

Design: Prospective, open-label, one-group trial with a pretest-posttest design.

Setting: Outpatient pain management clinic.

Use of a diagnosis-based risk adjustment model to estimate costs of indigent care in a community at Medicaid reimbursement rates.

Objectives: This study used a diagnosis-based risk adjustment model to estimate the annual costs of uninsured patients in Austin, Texas, and describe the prevalence and costs of their chronic conditions. The data were supplied by the Indigent Care Collaboration, a partnership of local safety-net hospitals and clinics.

Methods: This study used the Diagnostic Cost Groups prospective Medicaid All-Encounters model, which uses diagnoses, age and gender to assign relative risk scores to patients.

Comparison of mail-order with community pharmacy in plan sponsor cost and member cost in two large pharmacy benefit plans.

Background: Pharmacy benefit managers (PBMs) play a major role in administering prescription drug benefit programs for health plans and employers. PBMs have often encouraged the use of self-owned mail-order pharmacy services with the promise to plan sponsors of lower prescription drug costs compared with those of the community pharmacy network. Some plan sponsors have requested a higher degree of disclosure of contract relationships and transparency in pricing.

Improving health care systems following an incident investigation.

All health care is delivered to patients through an assemblage of minisystems. (A minisystem is the smallest system that can deliver a single clinical benefit.) It is the failure of these minisystems that reportedly results in between 44,000 and 98,000 iatrogenic deaths in the United States, annually.

A proposed partnership for investigating device-related accidents.

The quality of a device-related, accident investigation is largely determined by the clinical and technical data available to the investigators. After an event, traditional legal conflicts have tended to prevent full information sharing between the manufacturer and the risk manager of the healthcare facility. We propose that, under the guidance of a risk manager, a healthcare clinical engineer partner with an engineer from the manufacturer and each partner provide maximum information and focused attention on the investigation.

Product-line extensions and pricing strategies of brand-name drugs facing patent expiration.

Objective: This study proposed an alternative to brand loyalty as the explanation for the continued price rigidity of patent-expired brand-name prescription drugs despite the increase in market entry of generic drugs facilitated by the 1984 Drug Price Competition and Patent Term Restoration Act. Study hypotheses were to test (1) whether market entries of new-product extensions are associated with market success of original brand-name drugs before generic drug entry, and (2) whether original brand-name drugs exhibit price rigidity to generic entry only when they are extended.

Methods: The design is a retrospective follow-up study for the prescription drug brands that lost their patents between 1987 and 1992.

Family support, diet, and exercise among older Mexican Americans with type 2 diabetes.

Purpose: The purpose of this study was to examine the relationship between diabetes-specific family support and other psychosocial factors with regard to diet and exercise self-care behavior among older Mexican Americans with type 2 diabetes.

Methods: Adults aged 55 years and older who presented for care in a primary care clinic for type 2 diabetes (N=138) completed a survey to assess family support specific to diabetes, barriers to self-management, self-efficacy, and diabetes self-care activities. Multivariate regression analyses were conducted to evaluate the relationship between family support and self-care activities for diet and exercise.

Family support and diet barriers among older Hispanic adults with type 2 diabetes.

Background And Objectives: Diet plays an important role in the management of diabetes, and a suboptimal diet is a commonly identified problem. Family support may be important in overcoming barriers to good diet. We conducted this study to examine the role of the family in overcoming barriers to diet self-care among older Hispanic patients with diabetes.

Prescription drugs marketed in the United States should be approved by the FDA.

Prescription Drugs Marketed in the United States Should Be Approved by the FDA. Two events in the drug regulatory approval process in recent years warrant the attention of managed care pharmacists and should prompt reassessment of assumptions regarding drugs marketed in the United States. The first event, involving levothyroxine, received considerable public attention from 1999 through 2002.

Analysis of the movement of prescription drugs to over-the-counter status.

Background: The transition of prescription drugs (Rx) to over-the-counter (OTC) status is a very complex and multifaceted process involving many parties and many issues. This article examines the regulatory history and process and presents a review of the issues involved, using recent Rx-to-OTC conversions as examples.

Findings: Data are presented on the growth of the OTC market and the impact recently switched products have had on this market growth.

Provision of pharmacy services in community health centers and migrant health centers.

Objectives: To assess the frequency with which pharmacy services are provided in community health centers (CHCs) and migrant health centers (MHCs), the importance of these services in these settings, and pharmacists' preparedness to provide these services and to determine whether pharmacist- and site-specific characteristics are related to the provision of pharmacy services.

Design: A self-administered mail survey was used to collect information on the provision of traditional pharmacy services and on the provision of pharmaceutical care services in four domains: collecting, organizing, and evaluating information; formulating a course of action; providing medications and counseling patients; and monitoring and managing patient outcomes. Data were also gathered on pharmacist- and site-specific characteristics.

Secretin treatment for autistic disorder: a critical analysis.

We assessed evidence of the effects of secretin on behavior in individuals with autistic disorder. Articles were obtained through a MEDLINE search of the English-language literature from January 1966-November 2001; all investigations and case reports on the topic were included. Press releases obtained from the World Wide Web also were included.

Relationship between direct-to-consumer advertising and physician diagnosing and prescribing.

The relationships between direct-to-consumer advertising expenditures and the monthly frequencies of diagnoses and prescriptions written associated with the products advertised are examined. The analyses utilized quasi-experimental time-series techniques. Data from the National Ambulatory Medical Care Survey and Competitive Media Reporting were used to calculate monthly levels of the dependent and independent variables.