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Biomedical subjects

J W Cooper

Publications and source records attributed to J W Cooper.

At least 37 records · Page 2Linked to original sources
PubMed1988

Routine laboratory tests: helpful or just costly?

The appropriate utilization of laboratory tests was studied by a consultant pharmacist in a 72-bed geriatric nursing home over a two-year period. There was a general underutilization of drug levels to detect digoxin, phenytoin, and theophylline effects; and occasional underuse of serum electrolytes and serum creatinine to monitor diuretic effects and determine appropriate use of drugs in renal impairment. Prescriber acceptance of 95 percent (40 of 42) consultant pharmacist recommendations for lab monitoring brought changes in drug therapy with 35 of 40 cases (87.5 percent). Thirty-two of 35 (91.4 percent) prescriber-authorized lab determinations resulted in significant results that changed drug therapy dose, schedule, or necessitated additional therapy. The total cost of the requested lab work was $2,560 over the two-year study period. On the other hand, the overuse of routine multiple lab tests on a monthly to bimonthly basis yielded new information in less than five percent of repeated determinations. Routine lab work, which was in excess of the federal "indicators" frequency and situation recommendations, produced $71,566 of excessive and perhaps unnecessary health-care costs over the two-year period.

Costs and Cost Analysis↗
PubMed1985

Effect of initiation, termination, and reinitiation of consultant clinical pharmacist services in a geriatric long-term care facility.

The effect of initiation, termination, and reinitiation of consultant clinical pharmacist services of drug regimen review and physician communication on patient drug use in a 72-bed geriatric long-term care facility was assessed at five points in time: initiation, termination, reinitiation, then 3 months and 3 years after reinitiation of services. Both times when the consultant was retained, drug use was cut almost in half (46.1% and 42.7%, respectively), with essentially the same number of established diagnoses per patient at each point in time. Conversely, before the consultant services were initiated, and when the consultants services were terminated, drug use was twice as great as when consultant pharmacist was retained. Regularly scheduled drugs increased 59%, and pro re nata (prn) drug increased 200% during the period between the termination and reinitiation of consultant services. There was also a lower admission, discharge, and death rate as well as higher hospitalization rate when the consultant was retained. It appears that the consultant clinical pharmacist has an impact on drug cost in long-term care facilities that is reversed when drug regimen review is removed and renewed when services are reinitiated.

Aged↗
PubMed1985

Home health care: drug-related problems detected by consultant pharmacist participation.

Consultant pharmacists conducted a drug history and regimen review on one-fourth of the patient population served by a community hospital-based home health department. About one-third of study patients had inappropriately stopped taking their medications; over one-fourth of the study patients had changed their schedule or dose without health professional consultation. Fifteen percent of all medications were duplications, and only 8% of prescription medications were correctly identified by name. Consultant pharmacist activities that could reduce drug-related problems were identified as drug therapy consultation with patients and staff, drug regimen review, drug information, and patient medication education.

Consultants↗
PubMed1985

Potential drug interactions in surgical patients.

The incidence and frequency of potentially serious drug interactions were evaluated in hospitalized surgical patients. Drug profiles of patients on the general surgical service of a tertiary-care teaching hospital were retrospectively reviewed for two six-month periods to determine how often drugs that are known for major interactions were prescribed concurrently. Interactions were studied that were relatively well documented and potentially harmful to the patients. A total of 1825 patient profiles were reviewed (21,888 patient days). At least one potential drug interaction was found in 17% of the patients. Interactions were found to occur at the rate of 1 for every 59 patient days. Digoxin and cimetidine were the potential interacting drugs in almost 90% of the cases. Hospitalized surgical patients require close monitoring because they frequently receive potentially interacting drugs.

Cimetidine↗
PubMed1984

Sex differences in plasma cortisol and growth in the bovine.

Tame, pubescent beef calves (six bulls; six heifers) were used to examine the relationship between sex, increase in body weight (BW) and plasma cortisol (C). In bulls (B), plasma testosterone (T) was also examined. The two groups were fed a concentrate to 1.5% BW and Coastal bermudagrass hay ad libitum. From 7 to 12 mo of age, at 28-d intervals, the animals were weighed and jugular vein blood was collected every 15 min for 6 h. Onset of puberty was determined weekly by measuring scrotal circumference in B and assaying for plasma progesterone in the heifers (H). Acceptable growth occurred in both B (.83 kg/d) and H (.67 kg/d). These growth rates were different (P less than .02). Plasma C concentrations were significantly different between the sexes over the time span examined. Whereas C remained between 1.6 and 1.8 ng/ml between 7 and 12 mo of age in B, C rose from 2.9 to 6.0 ng/ml in H. The experiment means for B and H were 2.8 +/- .3 (mean +/- SE) and 5.7 +/- .4 (P less than .01). There were significant correlations between plasma C and age or weight in H, but not in B. Mean plasma T in B was greatest at 9 and 10 mo of age (1.4 and 1.3 ng/ml) and lowest at 7 and 12 mo of age (.76 and .74 ng/ml). Plasma T was not correlated with plasma C or age. The lower plasma C concentrations in B compared with H is commensurate with the greater growth that occurred in B.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Consultant pharmacist impact on antihypertensive therapy in a geriatric long-term care facility.

Antihypertensive therapy of a group of elderly patients in a long-term care facility was compared before and after the addition of a consultant pharmacist to the health care team. Criterion variables were systolic and diastolic pressure and drug cost and use. Consultant pharmacist protocol included drug history and monthly use review and pertinent communications regarding problems. Statistical analysis employed a t test with two-tailed probability. Both systolic (128.5 to 135 mm Hg) and diastolic pressure (68.9 to 72.3 mm Hg) were increased after 1 year, the number of patients with hypotensive readings decreased, and the average antihypertensive drug cost was decreased. The cost of potassium supplements was increased, however, fewer patients had abnormal potassium levels.

Aged↗
PubMed1983

The effectiveness of auxiliary prescription labels: a pilot study.

Affixed auxiliary prescription labels are widely used in the practice of pharmacy because they supposedly provide the patient with pertinent information that is not contained within the prescription signature. Yet, whether the labels are effective is not known, nor is it known whether the label's elements, such as color, form, and logo, affect perception of the written text. Sound scientific analyses of these questions are limited. Therefore, a pilot study involving a series of experiments was designed to determine whether individual perception of pertinent information is affected by the use of affixed auxiliary prescription labels. The second objective of this study was to evaluate how color and logo differences affected perception of the label's written text. Participants were selected for the experiments after being screened for color blindness, corrected vision, and, in some cases, previous pharmacy employment. Subjects viewed labels affixed to prescription vials via a two-channel tachistoscope. The tachistoscopic methodology measured perception, and its accuracy was verified through a forced-choice instrument. Results from the pilot study were threefold: (1) a sound scientific analysis found affixed auxiliary labels to be effective, (2) significant variance could be attributed to both individual and subject differences, and (3) the unique effects of color and logo could not be determined.

Adult↗
PubMed1982

The drug cutbacks.

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Insurance, Pharmaceutical Services↗