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Biomedical subjects

A I Wertheimer

Publications and source records attributed to A I Wertheimer.

At least 19 recordsLinked to original sources
PubMed2001

Evaluation of studies investigating the effectiveness of pharmacists' clinical services.

A quantitative evaluation of randomized trials of counseling, education, and other clinical services provided by pharmacists was performed. Data sources were MEDLINE and the bibliographies of published articles. Pharmacists' services were categorized as counseling of patients, counseling of physicians, counseling of both patients and physicians, and patient care. The outcomes extracted were measures of patient behavior, disease, symptoms, and patient knowledge. Thirty-two trials met the inclusion criteria. The pharmacists were specified as clinical pharmacists in 24 trials and as community pharmacists in 2. In six unblinded trials of patient counseling, the outcomes favored the counseled patients over control patients in every trial, and the effects were statistically significant in five trials (the outcome was medication adherence in these five trials). In seven trials of counseling of both patients and their physicians, patient outcomes were significantly better in the intervention group in six trials, four of which were single blind. Two trials in which patients were randomized to either physician counseling or control groups yielded inconsistent results. In one trial in which physicians were randomized to receive counseling from pharmacists, the proportion of prescriptions meeting guidelines was higher in the counseling group than in the control group. Four trials of patient care by pharmacists were inconclusive. These trials demonstrated that counseling of patients and their physicians by pharmacists can improve patient outcomes. The evidence that counseling of patients alone improved patient outcomes was good, though weaker because of suboptimal trial design.

Data Collection↗
PubMed2001

Indirect cost of ischemic heart disease to employers.

BACKGROUND: The management of healthcare programs by employers requires accurate information about the indirect and direct costs of important chronic diseases. OBJECTIVE: To determine the indirect costs of ischemic heart disease from the perspective of the employer in private industry in the United States. DESIGN: Indirect cost of illness analysis using the human capital approach, taking the perspective of the employer rather than that of society. METHODS: Ischemic heart disease was identified in a proprietary claims database of 3.1 million insured persons using an algorithm based on administrative codes. Economic data were derived from the Bureau of Labor Statistics, the Employment Management Association, and published sources. Work-loss data were taken from the National Center for Health Statistics' Health Interview Survey. The indirect cost was calculated as the sum of the costs due to morbidity and mortality. From the perspective of the employer, morbidity costs come from lost productivity, idle assets, and nonwage factors resulting from absenteeism and mortality costs are expenditures for replacing and retraining workers. This differs from calculations from the societal perspective, in which indirect costs are the value of an individual's lost income--both current and potential. RESULTS: The total indirect cost of ischemic heart disease to employers in private industry was $182.74 per enrollee. Ninety-five percent of the indirect cost was the consequence of work loss due to morbidity rather than of mortality costs. CONCLUSION: From the perspective of the employer, the indirect cost of ischemic heart disease is overwhelmingly due to morbidity costs.

Adult↗
PubMed1999

Compliance with prescribed drugs: challenges for the elderly population.

Compliance with prescribed drug regimens is particularly important among the elderly because of their increased vulnerability and greater burden of chronic disorders. This narrative review discusses the factors that are important to compliance, with particular reference to the elderly. These factors are the patient's perceptions of his disease and it's treatment, the physician's perceptions, the manner the physician assumes and the language he uses to communicate with the patient, the patient's living situation, regular medication review, and a continuity of health care provision. Since it is the patient who decides how to use the therapy, his or her involvement in the process of explaining and understanding it is the key to improved compliance.

Aged↗
PubMed1998

Outcomes research: collaboration among academic researchers, managed care organizations, and pharmaceutical manufacturers.

Medical and pharmaceutical outcomes research has been of increasing interest in the past 10 to 15 years among healthcare providers, payers, and regulatory agencies. Outcomes research has become a multidisciplinary field involving clinicians, health services researchers, epidemiologists, psychometricians, statisticians, psychologists, sociologists, economists, and ethicists. Collaboration among researchers in different organizations that offer different types of services and various research expertise is the essential element for any successful outcomes project. In this article we discuss collaboration on outcomes research among academic researchers (mainly those who work in colleges of pharmacy), managed care organizations, and research-based pharmaceutical manufacturers, with a focus on the opportunities and challenges facing each party. The pharmaceutical industry needs information to make product and promotion decisions; the managed care industry has data to offer but needs analysis of these data; and pharmacy schools, among other academic institutions, have skilled researchers and data-processing capacity but require projects for revenue, research training, experience, and publications. Challenges do exist with such endeavors, but collaboration could be beneficial in satisfying the needs of the individual parties.

Conflict of Interest↗
PubMed1994

Psychometric evaluation of measures of organizational commitment and intention to quit among pharmaceutical scientists.

This study utilized different statistical techniques to evaluate the reliability (internal consistency) and the discriminant validity of the most widely used measures of organizational commitment and intention to quit (the employing organization). Data were obtained from a national mail survey of members of the American Association of Pharmaceutical Scientists (AAPS) working in the pharmaceutical industry. Both instruments had high Cronbach alpha values in this sample of pharmaceutical scientists. There was a substantial correlation between the scale designed to measure organizational commitment and that for intention to quit. Factor analysis revealed that there was only one common factor underlying the 20 items that were originally designed to measure two distinct constructs. The findings in this study suggested that the most widely used instruments designed to measure organizational commitment and intention to quit may be actually measuring one construct, or the theoretical constructs named as organizational commitment and intention to quit may not be empirically distinct.

Adult↗
PubMed1993

Essential drugs should be accessible to all people.

In Rwanda some 70% of the people do not have regular access to essential drugs and there are chronic drug shortages in government health facilities where drugs are provided free of charge. The cost recovery system recommended by the Bamako Initiative Programme can be expected to increase the availability of essential drugs, but access to them will undoubtedly remain difficult for many people unless they receive financial assistance enabling them to pay for prescribed medicines.

Developing Countries↗
PubMed1990

Impact of a drug-use review program intervention on prescribing after publication of a randomized clinical trial.

The effect of a drug-use review (DUR) program intervention on physician prescribing after the results of a randomized clinical trial were published was studied. A Veterans Administration (VA) cooperative study published in June 1986 showed that congestive heart failure (CHF) patients who had hydralazine and isosorbide added to their drug therapy had less mortality than patients given digoxin and diuretics with or without prazosin. Physicians with at least one CHF patient who was receiving the less effective therapy were randomly assigned to intervention and control groups. In September 1986, intervention-group physicians (n = 288) were mailed a letter and questionnaire from the DUR program coordinator, the journal article, and a drug history profile of a CHF patient who might benefit from the information. Control physicians received no mailing. The questionnaire asked whether the physicians already knew about the VA study, intended to alter their prescribing, and could identify factors that would affect their decision. Two thirds of intervention-group physicians were already aware of the VA study. One third indicated that they intended to alter drug therapy based on the study results; factors significantly associated with the intent to adopt a change were physician training and experience, comments by peers, new drug availability, and the size of the reduction in mortality. During four months after the intervention, only 5 physicians in the two groups switched their patients to both hydralazine and isosorbide (full change); 23 switched them to at least one of the drugs or discontinued prazosin (partial change). There was no significant difference in the number of full or partial changes between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1988

Quality control and drug utilization review.

The impact of drug utilization review on quality control is outlined. Special attention is given to a drug utilization review at the individual patient level for which the methodology for implementation and maintenance are described, with special emphasis on the cyclic character of the process.

Drug Utilization↗
PubMed1987

Predictors of patient satisfaction with pharmacy services in a health maintenance organization.

In a study of Health Maintenance Organization (HMO) patients, five variables were shown to be predictive of patient satisfaction with pharmacy services through multiple regression analysis. The variables of satisfaction with the HMO in general, convenience of prescription filling, self-assessed positive health status, communication between provider and patient, and the view of prescription drugs as being inexpensive accounted for 26.4% of the variance in patient satisfaction with HMO pharmacy services. The results suggest areas in which attention should be directed toward maintenance of patient satisfaction with pharmacy services, especially when considering that patients may have the option of utilizing in-house or out-of-plan pharmacies for services. The authors suggest administrators of HMOs, pharmacy directors, and out-of-plan vendor pharmacists should periodically assess HMO pharmacy patient satisfaction.

Consumer Behavior↗