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Biomedical subjects

D S Pathak

Publications and source records attributed to D S Pathak.

At least 37 records · Page 2Linked to original sources
PubMed1994

Establishing value through pharmacoeconomics: the emerging third objective in clinical trials.

Establishing the value of a new medicine by applying the tools and methods of pharmacoeconomics has become an important third objective in many clinical trials. The pharmacoeconomic investigator conducting research in clinical trials must understand and conform to the rules and procedures governing the clinical trial process. This article addresses some of the vital yet often overlooked details associated with conducting pharmacoeconomic research in clinical trials. The protocol, the informed consent form, the data collection instruments, the study initiation, and the final study report are all discussed. Additionally, limitations of the study results are reviewed.

Clinical Protocols↗
PubMed1993

An overview of total quality management: applications for health care systems.

Unless we are willing to take a long-term look in terms of the implementation of TQM in our health care system, TQM will not work. QI is badly needed in health care, but quality is a slippery concept and requires continuous monitoring and commitment from all of us who embrace it. However, the suggestions provided in this article may assist in adopting and implementing such programs. Furthermore, the articles that follow in this issue will show how the concepts incorporated in the implementation of the TQM process can be successfully applied to a health care setting.

Awards and Prizes↗
PubMed1992

Overview of health-related quality-of-life measures.

Quality of life (QOL) as a measurable health-care outcome is discussed, and an overview of the field of QOL assessment is provided. QOL assessments can be used to evaluate drugs in clinical trials, to evaluate provider performance, and to monitor the progress of patients receiving drug therapy. QOL information is most useful in evaluating drug therapy when the primary purpose of a drug is palliative rather than curative, when a drug is somewhat effective but also fairly toxic, when lifelong therapy is administered to prevent complications of a relatively asymptomatic disease, and when there are several equally effective therapies for a specific condition but the adverse-effect profiles differ. Contemporary QOL questionnaires are completed by patients, and they most commonly include dimensions of physical function, mental or cognitive function, emotional or psychological function, social and role function, disease symptoms, and perceptions of well-being. The keys to successful QOL assessment in clinical practice will be selection of instruments that are practical to administer and are capable of detecting small changes in health, selective application of those instruments to patient populations most likely to benefit from this more intensive form of monitoring, and efficient use of data management systems. The consumer of QOL literature must assess the validity of QOL data obtained in a given study and their applicability to his or her practice setting.

Disease↗
PubMed1991

Drug-usage evaluation: traditional versus outcome-based approaches.

The use of outcome assessment with DUE can provide more detailed information on the impact of drug therapy on the overall health status of the patient, rather than just the narrow view of the drug-prescribing process within the institution. These studies may justify additional pharmacists to help in the selection of drugs and their potential to affect overall quality patient care. In addition, the Joint Commission is recommending that measurement of health outcomes is important in QA. The Joint Commission has stated in their Agenda for Change program "that patient outcomes are influenced by all activities of a health care program." The Joint Commission plans to develop standards that "describe in functional terms what the key jobs are that need to be done to produce good patient outcomes." The major problem with adding outcome measures in the assessment of DUE programs is the evolutionary nature of the available technology to measure these patient outcomes. Incorporation of outcome measures into DUE programs can provide measures of the impact of drug therapy on the patients' HQOL. This HQOL is potentially a better reflection of patient outcomes and the assessment of quality of care.

Drug Utilization↗
PubMed1990

Segmenting the antihistamine market: an investigation of consumer preferences.

The authors combine conjoint analysis and contingent valuation into a single model to estimate the value of product attributes for antihistamine drugs. One hundred forty-three allergic rhinitis suffers were examined. The results show evidence of validity in the data. Cluster analysis reveals five segments of patients with various patterns of preference for product attributes.

Cluster Analysis↗
PubMed1989

Use of the strategic-planning process by hospital pharmacy directors.

The extent to which hospital pharmacy directors use strategic planning was assessed. The strategic-planning process was divided into six steps: (1) specification of goals and objectives, (2) identification of threats and opportunities and strengths and weaknesses, (3) generation of alternatives, (4) evaluation of alternatives, (5) alternative selection and implementation, and (6) monitoring and obtaining feedback. Eight questions about these steps made up one part of a questionnaire mailed to the pharmacy directors of 1100 hospitals. In another part of the questionnaire, each director was asked to rate on a scale of 0 (low) to 100 (high) the level of the pharmacy department's performance in the areas of patient, employee, physician, and hospital administrator satisfaction; financial management; professional image; employee turnover and productivity; and clinical programs. The questionnaire was mailed on July 1, 1987, with a second mailing on August 1, 1987. A total of 343 questionnaires were returned with usable responses, for a response rate of 31.2%. Based on responses to the eight strategic-planning questions, hospital pharmacy directors were classified into seven levels of planning sophistication. Results indicated that the number of directors classified in each level increased significantly as the level of planning sophistication increased. The majority of respondents considered the scope and quality of services and the department character, quality, and reputation during the strategic-planning process, whereas less than 50% considered profitability and future needs. Pharmacy directors with a high level of planning sophistication rated their departments significantly higher in terms of hospital administrators' satisfaction, professional image among hospital administrators, number of clinical programs, and quality of clinical programs.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacy Service, Hospital↗
PubMed1988

Commercial drug compendium information: a First World/Third World comparison.

The purpose of this study was to determine what differences exist in the content of commercial drug compendium monographs available in First World and Third World countries. A content model representing First World information was developed from monographs contained in the Physicians' Desk Reference, ABPI Data Sheet Compendium, and the Rote Liste. The content of the three First World compendia was found to be variable, with the Physicians' Desk Reference consistently more comprehensive than either the ABPI or Rote Liste. This result suggests that there is a lack of agreement among industrialized countries regarding what amount of information is necessary or appropriate for inclusion in a commercial drug compendium. A sample of 58 monographs was selected from four Third World compendia and evaluated in terms of comprehensiveness and accuracy. These monographs represented five commonly prescribed drugs from the World Health Organization's Essential Drugs List. The monographs were found to be less comprehensive than any of the three monographs contained in the First World compendia. Approximately 5 percent of the information contained in the sampled monographs was determined to be inaccurate. The sampled monographs for drugs supplied by multi-national pharmaceutical firms were found to contain the same amount of information as those for drugs supplied by domestic firms.

Data Collection↗
PubMed1988

Formulary decision making: identifying factors that influence P&T committee drug evaluations.

This study identifies outcomes related to hospital formulary decision making and estimates the importance of 16 specific types of data to five P & T Committees during the formulary decision making process. The two most important outcomes, according to the Committee members involved in this study, were the effects of the potential formulary addition on the quality of drug treatments available in the hospital followed by its impact on hospital costs. Information about the therapeutic advantage of the potential drug addition, the relative adverse effect profile, and cost information were viewed as especially important. On the other hand, promotional literature provided by pharmaceutical companies and letters of evaluation from respected physicians at hospitals other than their own, were not viewed as important. By understanding the factors involved in hospital formulary decision making, strategies encouraging optimal formulary decisions may be developed.

Data Collection↗
PubMed1988

Predicting enrollment decisions in a preferred provider organization: a comparison of models--features versus benefits.

Five attitudinal models are compared on their ability to explain and predict the enrollment decisions of university employees toward a preferred provider organization. In the comparison of models, a distinction is maintained between the relatively objective attributes of the plan (features) and the relatively subjective attributes of the plan (benefits). The model that best predicts the enrollment decisions of enrollees is found to be different from the model that best predicts the decisions of nonenrollees. A "best" overall predictive model is selected and a method to aid managerial interpretation of the determinant attributes identified is developed.

Community Participation↗
PubMed1988

Program planning of a biomedical communications center: an implementation-oriented approach.

This article illustrates application of (1) Nominal Group Technique and (2) Importance-Performance Analysis, both commonly used planning strategies, to the programmatic planning of a university-based biomedical communications center. The method described may prove useful when successful implementation of such a plan depends upon cooperation between diverse client groups within the organization.

Academic Medical Centers↗
PubMed1988

Opinions of pharmacy, medicine, and pharmaceutical industry leaders about hypothetical therapeutic-interchange legislation.

The beliefs of representatives of organized pharmacy and medicine and the pharmaceutical industry about the effect of hypothetical therapeutic-interchange legislation on various health-care issues were studied. Questionnaires designed to gauge respondents' beliefs about the impact of two hypothetical bills (A and B) concerning selection of therapeutic alternates by pharmacists were mailed to the directors of 307 organizations in April 1986. Bill A would permit pharmacists in any setting to select therapeutic alternates. Bill B would permit therapeutic interchange by pharmacists within organized health-care settings in accordance with guidelines approved by physicians. Issues addressed included the efficient delivery of health care, professional liability, interprofessional and pharmacist-patient relationships, and competition and profitability in the pharmaceutical industry. The response rate was 63% (194 usable responses). Bill A received some support from representatives of state pharmaceutical associations only. However, bill B was supported by respondents from state pharmaceutical associations, state hospital pharmacy societies, boards of pharmacy, and generic manufacturers. Respondents from medical associations and member companies of the Pharmaceutical Manufacturers Association (PMA) were concerned about the impact of the hypothetical bills on the quality of drug therapy and the efficiency of health-care delivery. Respondents from medical associations also were concerned about the impact of the bills on physician liability. The responses from the medical associations and the PMA-member companies suggest that a program should be developed to educate physicians about the process used by pharmacists and physicians to develop guidelines for therapeutic interchange in various practice settings.

Attitude of Health Personnel↗