Reducing Central Nervous System-Active Medications to Prevent Falls and Injuries Among Older Adults: A Cluster Randomized Clinical Trial.

Importance: High-risk medications that contribute to adverse health outcomes are frequently prescribed to older adults. Deprescribing interventions reduce their use, but studies are often not designed to examine effects on patient-relevant health outcomes.

Objective: To test the effect of a health system-embedded deprescribing intervention targeting older adults and their primary care clinicians for reducing the use of central nervous system-active drugs and preventing medically treated falls.

Medication Error Management around the Globe: An Overview.

Medical mistakes that include medication errors have raised concerns about medication safety. Due to high consumption of medicines and self-treatment by all, especially the aging population, the issue of proper medication use and safety is at the forefront of public health concerns globally. Each country has a different approach towards medication event monitoring that is compliant with its own health care system.

Toward Continuous Primary Care in the United States: Differences in Patient Satisfaction Between First and Return Visits to Primary Care Physicians/Analysis of DrScore--The National e-Survey Data.

Background: As stated by Donabedian, the father of quality assurance, satisfaction is an integral component of quality in medical care. Patient satisfaction is an important predictor of health-related behaviors, use of medical services, and health outcomes. Impressive literature exists in examining various aspects of patient satisfaction, however, no study thus far has examined differences in patient satisfaction between first and return visits to primary care physicians.

Racial/ethnic disparities in emergency department waiting time for stroke patients in the United States.

Emergency department waiting time (EDWT), the time from arrival at the ED to evaluation by an emergency physician, is a critical component of acute stroke care. We assessed racial/ethnic differences in EDWT in a national sample of patients with ischemic or hemorrhagic stroke. We identified 543 ED visits for ischemic stroke (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 433.

Psoriasis and its treatment with adalimumab.

Importance Of The Field: Psoriasis is an immune-mediated skin condition affecting 2 - 3% of world's population. It affects patients' health-related quality of life (HRQOL) and results in a significant financial burden. Adalimumab is the first fully human monoclonal antibody approved in the US and European countries for the treatment of psoriasis along with other immunomediated diseases.

Prescribing patterns for topical retinoids: analyses of 15 years of data from the national ambulatory medical care survey.

Objective: To examine the prescribing patterns of topical retinoids in the United States.

Methods: A retrospective, cross-sectional study was employed. Data from the National Ambulatory Medical Care Survey (1990-2004) were used.

Prior authorization for topical psoriasis treatments: is it cost-beneficial for managed care?

Objective: The introduction of novel therapeutic options for psoriasis has raised managed care's interest in controlling costs associated with dermatological treatments. Prior authorization (PA) can be a successful way of managing costs. However, experience with topical treatments for acne suggests that PA may not be cost-effective.

The Medication Assessment Program: comprehensive medication assessments for persons taking multiple medications for chronic diseases.

Objective: To describe the development, implementation, and evaluation of a pharmacist patient care program for persons taking multiple medications for chronic diseases.

Design: Pilot study.

Setting: Services were provided in Michigan within community pharmacies and through home and work-site visits, between October 2004 and September 2006.

Effect of pharmacy practice residency training on residents' knowledge of and interest in clinical research.

Purpose: The effect of pharmacy practice residency training on subjectively and objectively assessed research knowledge, skills, and interests of residents was studied.

Methods: A preintervention versus post-intervention design was used. Residency year 2004- 05 residents were administered a validated Web-based survey at the beginning of residency and again at the end of residency.

Patient-reported underuse of prescription medications: a comparison of nine surveys.

Nine national surveys documenting patient underuse of prescription medications were examined to describe the variation and trends in that underuse and identify possible reasons for the substantially different rates that were reported. Underuse includes unfilled prescriptions, delayed therapy, reduced frequency, and lowered dosage. Rates of cost-related patient underuse in the studies ranged from 1.

Sex disparity in the management of dyslipidemia among patients with type 2 diabetes mellitus in a managed care organization.

Objective: To determine whether there were sex-related differences in the management of dyslipidemia among managed care enrollees with diabetes mellitus.

Study Design And Methods: Retrospective analyses were conducted using medical and pharmacy claims data from a health maintenance organization during 2000 and 2001. Patients with type 2 diabetes mellitus were identified through a validated algorithm of medication and diagnosis codes.

The intensification of drug therapy for diabetes and its complications: evidence from 2 HMOs.

Objectives: To identify trends in the utilization of multidrug therapy for glycemic control, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs), and lipid-modifying agents for persons with diabetes from 1997 to 2001. The trends in drug and total expenditures for diabetes patients also were examined.

Study Design: Cross-sectional analysis for each year from 1997 through 2001.

Association between hospital size and quality improvement for pharmaceutical services.

Purpose: The relationship between hospital size and quality improvement (QI) for pharmaceutical services was studied.

Methods: A questionnaire on QI was sent to hospital pharmacy directors in Michigan and Florida in 2002. The questionnaire included items on QI lead-team composition, QI tools, QI training, and QI culture.

Statistical comparison of consumer drug expenditures and discretionary purchases to assess drug affordability.

Background: Affordability may be defined as the absence of economic barriers to a good or service. There are 2 frequently observed measures of affordability: a consumer's ability to pay and his or her physical access to a good or service. Thus, most programs designed to subsidize consumers' health care costs, especially state programs that address prescription drug expenditures for people aged > or =65 years, base eligibility on measures of income as a proxy for a consumer's ability to pay.