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Biomedical subjects

J D Grabenstein

Publications and source records attributed to J D Grabenstein.

At least 37 records · Page 2Linked to original sources
PubMed1995

Prescribed medication use among troops deploying to Somalia: pharmacoepidemiologic analysis.

To describe the frequency of chronic ambulatory prescriptions dispensed to troops, pharmacists analyzed records of soldiers deploying to Somalia for Operation Restore Hope. Prescriptions recorded in the Fort Drum pharmacy data base for soldiers deploying between November 24, 1992, and January 12, 1993, were compared to the roster of troops deployed. Among 3,701 deploying soldiers, 273 patients (7.4%) received 425 prescriptions. For each 1,000 troops, 114.8 prescriptions were dispensed. Of 333 presumptive diagnoses, the most common diagnostic groups were contraceptive, musculoskeletal, dermatologic, respiratory, and cardiovascular. Of 425 prescriptions, the most common therapeutic classes of medication dispensed were oral contraceptives, anti-inflammatory drugs, acne treatments, and beta-adrenergic agonists. Generically, the common prescribed substances were contraceptives, ibuprofen, pirbuterol, temazepam, piroxicam, and beclomethasone. Although women represented 6.8% of troops, women represented 31.5% of prescription recipients and received 29.4% of prescriptions. Women were 6.5 times as likely to receive a prescription as men (p < 0.0001); this relative risk was 3.4 if contraceptives were omitted from analysis (p < 0.0001). Two hospitalizations in Somalia may have been related to medication use.

Adult↗
PubMed1995

Review of the 1995 Food and Drug Administration/National Institutes of Health Public Forum on informed consent in clinical research conducted in emergency circumstances.

We describe some of the deliberations and questions raised by the recent Food and Drug Administration/National Institutes of Health Forum on Informed Consent in Clinical Research Conducted in Emergency Circumstances. Consent will have to be waived in emergency medical research if such research is to be conducted, because it is virtually impossible to obtain meaningful informed consent in emergency circumstances. There is clearly a conflict between research subject autonomy and society's perceived need for answers about emergency medical care. Who will resolve this dilemma and how it will be resolved are important questions for modern medicine.

Emergencies↗
PubMed1992

Community pharmacists as immunization advocates. Cost-effectiveness of a cue to influenza vaccination.

To assess the cost-effectiveness of a cue to influenza vaccination provided by community pharmacists, a decision tree was constructed of the consequences of implementing a pharmacy-based vaccine-advocacy program, based on experience gained in an experiment involving three community pharmacies in Durham County, North Carolina. The model used morbidity and mortality assumptions derived from the infectious-disease literature and cost assumptions based on 1990-91 Medicare Part A and Part B reimbursement costs. This analysis suggests that if Medicare reimbursed pharmacists for advising 100,000 patients at risk to accept influenza vaccine through vaccine-advocacy messages, for an apparent expenditure of $110,000, the increased rate of influenza vaccinations would avert 139 hospitalizations and 63 deaths, and actually yield Medicare a net savings of $280,588. These calculations probably underestimate the benefit to society of a pharmacy-based vaccine-advocacy program, because only direct costs to the single government agency were computed and no cost was attributed to death or lost earnings.

Aged↗
PubMed1992

Pharmacoepidemiology and military medical automation: opportunity for excellence.

Fielding of the Composite Health Care System (CHCS) brings an unparalleled opportunity for medical research. This sophisticated automated medical record system promises pharmacoepidemiologic research of a quality and quantity never before possible. Pharmacoepidemiology provides answers about the validity of beneficial and adverse drug events and aids in individualizing drug therapy. When CHCS eventually encompasses an estimated 9.1 million patients at 166 military hospitals and 588 clinics around the world, it will provide a database capable of supporting sophisticated automated research. In addition to the unprecedented size of this resource, advantages of pharmacoepidemiology performed with the CHCS database include integration of inpatient and outpatient care records, the completeness of prescription and medical records, and the wide socioeconomic spectrum covered in a defined population. Limitations and potential biases of such a database include separate drug formularies at each medical treatment facility, only limited information about nonprescription drug use and single-dose drug orders in clinics, and the mobility of military service members and their families. Pharmacoepidemiology is a tool that will benefit individual members of the military family, as well as advancing the sciences of pharmacy and medicine. Using the CHCS database for this form of research is in the best tradition of military medical research.

Attitude to Health↗
PubMed1990

Drug interactions involving immunologic agents. Part II. Immunodiagnostic and other immunologic drug interactions.

This two-part review addresses pharmacists' need for information about immunologic drug interactions. Reports of interactions involving vaccines, immune globulins, and immunodiagnostic reagents are widely dispersed and, therefore, difficult to access. In the conclusion of this two-part article, immunodiagnostic drug interactions as well as interactions involving interferons and other biologic-response modifiers are discussed, as are epinephrine interactions that affect treatment of immunologic-induced anaphylaxis. Host factors of groups and individuals relating to the clinical significance of proposed interactions are covered, such as those involving influenza vaccine with theophylline, warfarin, or phenytoin, and other combinations. Vigilance by all pharmacists is needed to detect previously unreported immunologic drug interactions and further assess known interactions.

Drug Interactions↗
PubMed1990

A comparison of drug products available in Germany and the United States.

Health-care professionals practicing with the U.S. European Command frequently encounter drug products of their host nation. Confusion about the identity or use of these medications can slow emergency treatment or mislead the medical management of patients. This article compares drug products available in the Federal Republic of Germany (FRG) with those of the United States of America. Differences in nomenclature used for generic drug names are described, as well as prescription practices unique to the FRG, such as unusual drug combinations, additional dosage forms, and divergent labeling practices. Military pharmacies are effective resources for translation of host nation drug products.

Dosage Forms↗