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Biomedical subjects

L P Jeffrey

Publications and source records attributed to L P Jeffrey.

At least 19 recordsLinked to original sources
PubMed1986

Effect of pharmacists' clinical interventions on nonformulary drug use.

The effect on drug costs of pharmacists' interventions in reducing the use of nonformulary medications was studied in a private teaching hospital. During a four-month period, nonformulary medication request forms and pharmacist consultation logs were reviewed to determine physicians' actions taken on requests for nonformulary medications. Cost avoidance of interventions (nonformulary medication cost) and the cost of pharmacist cost) and the cost of pharmacist time for the interventions were determined. The pharmacist was able to contact The pharmacist was able to contact the physician in 388 of 394 instances in which the use of a nonformulary medication was considered. Of 230 recommendations by pharmacists to change a nonformulary drug order to one for a formulary alternative, 64.8% (149) were accepted by physicians. Of pharmacists' recommendations that were accepted, 75.8% (113/149) were from decentralized areas, which was a significantly higher acceptance rate than that for the centralized areas (24.7% or 36/149). Cost avoidance resulting from acceptance of pharmacists' recommendations during the four-month study was $2,645, or $13,573 per year; this was more than the cost of pharmacist time required to perform interventions. Pharmacist interventions to decrease use of nonformulary drugs can be cost-effective and appear to be more successful in decentralized pharmacy service areas than in areas served by a central pharmacy.

Costs and Cost Analysis↗
PubMed1985

Drug stop: newer beta-lactam antimicrobials.

The newer beta-lactam antimicrobials offer an expanded spectrum of activity and a similar safety profile compared to their older counterparts. The penicillins appear to be useful in the combination treatment of systemic Pseudomonal infections, and cefuroxime and the third generation cephalosporins may be valuable in the management of meningitis caused by susceptible organisms. However, to avoid the emergence of resistance and to help contain the cost of antimicrobial therapy, these newer agents should be reserved for those clinical situations where older beta-lactams would not be indicated.

Anti-Bacterial Agents↗
PubMed1985

Management seminar miniseries for training pharmacy residents.

A management seminar miniseries for training hospital pharmacy residents is described. A series of lectures and workshops on the administrative aspects of hospital pharmacy practice are an integral part of a 2400-hour residency training program. Hospital pharmacy practice, clinical pharmacy practice, communication skills, and pharmacy administration and personnel management are the four major areas covered by the program. The section on pharmacy administration and personnel management is initiated in the middle of program after the residents have gained an appreciation of the intricacies of the department. The management workshops emphasize role playing and actual case-study analyses. The program's faculty members are members of the professional staff who have received formal training in the topics they teach. Twenty-two of this program's 53 graduates have assumed management positions. The management miniseries described can provide residents with the managerial skills they need to become effective pharmacy leaders.

Education, Pharmacy, Graduate↗
PubMed1984

Cephalosporin-use restrictions in teaching hospitals.

A survey of pharmacy directors in teaching hospitals was conducted in March 1983 to ascertain policies for management of cephalosporin use. Surveys were sent to 298 institutions in each of the United States except Alaska. Respondents were asked various questions regarding hospital policies on cephalosporin use. Responses were received from 179 hospitals that had formularies; 99 of these had formal restriction policies, more frequently for second- and third-generation agents than for first-generation agents, and 13 planned to institute restriction policies. In 68% of hospitals with restriction policies, restricted drugs were released only after consultation with the infectious disease service. Chart review was the most frequently reported method of monitoring use of restricted cephalosporins. Approximately 40% of respondents had therapeutic equivalence policies, and more than 40% had recently deleted one or more cephalosporins from the formulary. The percentage of hospitals with formal restriction policies (55%) was greater than in a 1979 survey (32%). Many teaching hospitals have initiated policies to curb rising drug costs associated with the use of cephalosporin antibiotics.

Cephalosporins↗
PubMed1984

Two methods for estimating body surface area in adult amputees.

Two methods for estimating body surface area (BSA) in adult amputees were developed. BSA in sq m was determined in 42 healthy, nonamputee men and women by summing the surface areas of individual body parts obtained using geometric measurements (BSAmeas) and by an equation using height and weight (BSAcalc). Linear regression analysis was used to determine correlations between BSAmeas and BSAcalc and between BSAmeas and surface-area measurements of individual body parts (SApart). The percentages of total BSA contributed by individual body parts in each subject were determined by the ratio of SApart to BSAmeas, and these percentages were compared with the corresponding percentages for body parts using the "Rule of Nines." BSAcalc and BSAmeas were significantly correlated, as were SApart and BSAmeas. Regression analysis of SApart versus BSAmeas yielded an equation for each measured body part that allowed calculation of SApart without direct measurement. SApart expressed as a percentage of total BSA differed from the percentage of BSA used in the "Rule of Nines" by a mean of 12.4-32% depending on the body part. Two methods of estimating BSA in amputees were proposed based on deduction of the surface area of the amputated part (calculated from the regression equation for SApart or as a percentage of total BSA) from total BSAcalc in adult amputees. The two methods developed in this study for estimating BSA may be useful in determining drug dosages in adult amputees and may provide more accurate information in burn therapy. Further studies are needed to validate the clinical application of these methods.

Adult↗
PubMed1983

Monitoring the hospital activities of medical service representatives.

A comprehensive program to monitor and regulate the activities of medical service representatives (MSRs) in a large teaching hospital is described. The MSR program consists of written policies and procedures for regulating the activities of MSRs within the hospital, an orientation program for MSRs, and quarterly MSR committee meetings. In addition, MSRs are involved in planning and implementing an annual drug fair for all hospital personnel and biannual continuing-education sessions for physicians. Compliance with policies and procedures is monitored using a MSR visitation roster in the pharmacy department. This organized program has resulted in an optimum exchange of information between the hospital and the pharmaceutical industry.

Drug Industry↗
PubMed1982

Career goals and expectations of men and women pharmacy residents.

Personal and professional characteristics of men and women hospital pharmacy residents were studied to identify differences that could affect future hospital pharmacy practice. Residents in 111 ASHP-accredited pharmacy residency programs received a survey containing questions on demographic information, reasons for selecting a residency, areas of professional interest, postresidency career goals, responsibilities to home and family, and advantages and disadvantages associated with gender. Of 286 residents receiving questionnaires, 226 responded; the percentages of men and women responding corresponded to the ratio of men and women in hospital pharmacy residencies. While men and women expressed educational goals that were not significantly different, more men than women had earned or were in the process of earning advanced degrees. No significant differences were evident between men's and women's plans for marriage and children, but 73% of the women indicated that they would take time out from their practice to raise children, compared with only 9% of the men. The majority of residents did not think their gender affected them in their residency programs, but in professional interactions more men saw gender as an advantage and more women as a disadvantage. Significantly more than women aspired to be hospital pharmacy directors. The results suggest that men are obtaining advanced training closer to the time they graduate from pharmacy school and that in the future women competing for promotions may be older than men competing for comparable positions. Those planning pharmacy staffing should consider the needs of women, and men, who expect to take time out from their careers for family responsibilities and possibly seek part-time positions when they return to the work force.

Adult↗