Evaluating Medication Day-Supply for Improving Adherence and Clinical Biomarkers of Hemoglobin A1c, Blood Pressure, and Low-Density Lipoprotein.

To compare a 90-day-supply and a less than 90-day-supply of medication on adherence to refilling prescriptions and clinical biomarkers for hemoglobin A1c (HbA1c), blood pressure (BP), and low-density lipoprotein (LDL). A retrospective chart review was completed for a cohort of patients prescribed an oral hypoglycemic agent (OHA), angiotensin-converting enzyme inhibitor (ACEI), or angiotensin II receptor blocker (ARB), and/or a statin. Data were categorized into 90-day-supply and less than 90-day-supply and on the minimum value for control determined by the CMS Star Ratings system.

VA CMOPs: producing a pattern of quality and efficiency in government.

Objective: To describe the modern, highly efficient, and effective production of prescriptions in a contemporary pharmacy practice setting using large-scale automated dispensing systems.

Setting: 83,000-square-foot Department of Veterans Affairs Consolidated Mail Outpatient Pharmacy (VA CMOP) facility in Tucson, AZ.

Practice Description: The Tucson VA CMOP is one of seven highly automated, large-volume mail service pharmacy operations that prepare, dispense, and mail approximately 100 million prescriptions annually to veterans throughout the United States.

Reasons provided by prescribers when overriding drug-drug interaction alerts.

Objectives: To investigate prescribers' rationales for overriding drug-drug interaction (DDI) alerts and to determine whether these reasons were helpful to pharmacists as a part of prescription order verification.

Study Design: An observational retrospective database analysis was conducted using override reasons derived from a computerized system at 6 Veterans Affairs medical centers.

Methods: Data on DDI alerts (for interactions designated as "critical" and "significant") were obtained from ambulatory care pharmacy records from July 1, 2003, to June 30, 2004.

Therapeutic rationale of combining therapy with gemfibrozil and simvastatin.

Objectives: To examine specific indications for patients receiving therapy with gemfibrozil plus simvastatin at doses of more than 10 mg daily and determine whether these patient-specific indications met Adult Treatment Panel (ATP) III criteria for combination therapy; and secondarily to identify any complications occurring between August 30, 2002, and May 1, 2003.

Design: Retrospective cohort study.

Setting: Tertiary care, university-affiliated, Southern Arizona Veterans Affairs Healthcare System from August 30, 2002, to May 1, 2003.

Practitioners' views on computerized drug-drug interaction alerts in the VA system.

Objectives: To assess Veterans Affairs (VA) prescribers' and pharmacists' opinions about computer-generated drug-drug interaction (DDI) alerts and obtain suggestions for improving DDI alerts.

Design: A mail survey of 725 prescribers and 142 pharmacists from seven VA medical centers across the United States.

Measurements: A questionnaire asked respondents about their sources of drug and DDI information, satisfaction with the combined inpatient and outpatient computerized prescriber order entry (CPOE) system, attitude toward DDI alerts, and suggestions for improving DDI alerts.

Comparing hyperlipidemia control with daily versus twice-weekly simvastatin.

Background: Costs associated with the use of hydroxymethylglutaryl coenzyme A reductase inhibitors are increasing. Finding ways to manage hyperlipidemia at lower costs is critical to all healthcare systems.

Objective: To assess effectiveness, safety, cost, and patients' satisfaction when converting hyperlipemic patients taking simvastatin daily to simvastatin twice weekly.

Dosage of beta-adrenergic blockers after myocardial infarction.

Dosages of beta-adrenergic blockers prescribed after myocardial infarction (MI) in a Veterans Affairs medical center were reviewed to determine if dosages were adjusted to target dosages used in clinical trials. The medical records of all patients with a discharge diagnosis of MI were reviewed. The target dosage, selected from major clinical trials, was atenolol 100 mg/day p.