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Biomedical subjects

M J Groh

Publications and source records attributed to M J Groh.

36 records · Page 2Linked to original sources
PubMed1998

[Cataract surgery in patients with retinitis pigmentosa].

BACKGROUND: Because of the retinal alterations visual acuity of patients with retinitis pigmentosa is more affected by loss of contrast than in normal persons. Therefore cataract in retinitis pigmentosa (mostly posterior subcapsular cataract) leads earlier to decreasing visual acuity than is expected from the lens opacity. In a retrospective study we have looked up all patients with retinitis pigmentosa and cataract which were operated between 1989 and 1997 at our department. PATIENT AND METHODS: Between 1989 and 1997 50 eyes of 36 patients (21 female, 15 male; mean age 51 +/- 11.4 years) with the diagnosis of retinitis pigmentosa and cataract underwent extracapsular cataract extraction and IOL-implantation. In a retrospective study we studied all case histories of these patients. Mean follow up time was 1.2 +/- 1.2 years. RESULTS: Preoperative visual acuity was 0.1 +/- 0.1, best postoperative visual acuity was 0.3 +/- 0.2. Visual field was not affected by cataract-surgery. Postoperative complications were not found. 2/3 of all patients were satisfied with the postoperative visual acuity, 1/3 of all patients did not give comments. CONCLUSION: In patients with retinitis pigmentosa cataract surgery leads to significant increase of visual acuity. Cataract extraction should not be with held from patients with retinal dystrophy.

Adult↗
PubMed1998

[Outcomes after penetrating keratoplasty in congenital hereditary corneal endothelial dystrophy (CHED). Report on 13 eyes].

BACKGROUND: Congenital hereditary endothelial dystrophy (CHED) is a rare bilateral corneal disease. The stromal opacity is supposed to result from terminal misdifferentiation of the endothelial cells. In this study we present the morphological and functional results after penetrating keratoplasty in children with CHED who were operated in our department between 1981 and 1997. PATIENTS AND METHODS: In a retrospective clinical cross-sectional study we looked up case histories of 13 eyes from 8 children (7 female, 1 male) with a mean age of 6.0 +/- 3.1 years (ranged from 3 to 14 years). In all children penetrating keratoplasty was performed by one surgeon (GOHN), in 3 eyes using nonmechanical excimer laser trephination. The graft-diameter was in 7 eyes 7.0/7.1 mm, in 2 eyes 7.0/7.2 mm, in 2 eyes 6.5/6.6 mm (resp. 6.8 mm), in 2 eyes 6.0/6.1 mm (resp. 6.2 mm). Fixation of grafts was achieved in 2 eyes by single running suture, in 8 eyes by double running suture and in 3 eyes by multiple interrupted sutures. RESULTS: During a mean follow-up of 4.0 +/- 2.4 years visual acuity increased in all patients (from light perception to 6/20 preoperatively to 2/200 to 14/20 postoperatively). In one patient corneal endothelial-epithelial-decompensation occured (both eyes unterwent previous antiglaucomatous surgery elsewhere), and in 1 patient loosening of one suture happened after 10 month. No immunological graft reaction occurred during follow-up. After excimer laser trephination (3 eyes from 2 patients) visual acuity and corneal astigmatism after surgery was favorable in comparison to all other patients. CONCLUSION: In children with CHED penetrating keratoplasty results not only in a clear cornea but also in a satisfactory functional outcome. Postoperatively periodical morphological controls and assessment of refraction as well as means to prevent amblyopia are indispensable before age 7.

Adolescent↗
PubMed1997

[Idiopathic episcleral venous stasis with secondary open-angle glaucoma (Radius-Maumenee syndrome)].

BACKGROUND: Dilated episcleral vessels may be observed in patients with orbital tumors, carotid-cavernous-sinus fistula and other orbital obstructive lesions. As an idiopathic phenomenon dilated episcleral vessels may be associated with secondary open-angle glaucoma. PATIENT: We report on a 59-year-old patient with a history of secondary open-angle glaucoma and dilated episcleral vessels for 5 years (Radius-Maumenee syndrome). RESULTS: In these patients, the pressure of the episcleral vessels is elevated and therefore the outflow from Schlemm's Canal is reduced. This leads to elevated intraocular pressure and secondary glaucoma. CONCLUSION: Treatment options in this condition include medication to lower the intraocular pressure or microsurgical sinusotomy to reduce the pressure-gradient from Schlemm's Canal to the episcleral vessels.

Female↗
PubMed1997

Effect of breathing 100% oxygen on retinal and optic nerve head capillary blood flow in smokers and non-smokers.

AIM: The effect of breathing 100% oxygen on retinal and optic nerve head capillary blood flow in smokers and non-smokers was investigated using scanning laser Doppler flowmetry (SLDF) as a new non-invasive method to visualise and quantify ocular blood flow. METHOD: 10 eyes of 10 young healthy non-smoking volunteers (mean age 26 (SD 3) years) and nine eyes of nine young healthy smoking volunteers (mean age 26 (4) years) were investigated. All participants were asked not to smoke or consume caffeine containing drinks for at least 4 hours before the measurements. Blood flow measurements were performed before and after 100% oxygen was applied to the subjects through a mask over a period of 5 minutes (6 litres per minute). Juxtapapillary retinal and optic nerve head blood flow were determined in arbitrary units using SLDF representing a combination of laser Doppler flowmetry and a scanning laser system allowing visualisation and quantification of the retinal and optic nerve head blood flow. Blood flow was determined in an area of 100 microns x 100 microns. The level of carboxyhaemoglobin was determined in all subjects. A Wilcoxon matched pairs signed ranks test (non-parametric) was used for statistical evaluation. RESULTS: In the non-smoking group, retinal 'flow' was reduced by 33% (p = 0.005), optic nerve head 'flow' by 37% (p = 0.005). In the smoking group retinal flow was reduced by 10% (p = 0.01), optic nerve head flow by 13% (p < 0.008). The difference in reactivity to oxygen breathing between smokers and non-smokers was highly significant (p < 0.00001). Increased carboxyhaemoglobin levels were not found in either of the groups. A significant reduction of the mean arterial blood pressure of 6% (5%) (p < 0.02) was observed in the non-smoking group after administration of oxygen. CONCLUSION: These results indicate that hyperoxia leads to a decrease in capillary blood flow of the retina and optic nerve head secondary to vasoconstriction, and that smokers do not respond to oxygen breathing as non-smokers do. The findings might be based on factors such as long term effects of nicotine on the sympathetic and parasympathetic nervous system.

Adult↗
PubMed1996

Influence of age on retinal and optic nerve head blood circulation.

PURPOSE: To quantify the influence of age on the retinal perfusion, the authors investigated the microcirculation of the retina and optic nerve head (ONH) and the blood flow velocity in the central retinal artery (CRA). METHOD: The authors examined two groups of healthy volunteers. In group 1 (n=36 eyes of 36 subjects; mean age, 41.5 +/- 14.9 years), retinal and ONH microcirculation was analyzed by scanning laser Doppler flowmetry. In group 2 (n=49 eyes from 49 subjects; mean age, 44.4 +/- 15.4 years), CRA blood flow velocity was examined using pulsed Doppler sonography. RESULTS: Blood flow velocity of the CRA showed a negative correlation to age (systolic velocity, r= -0.47, P=0.001; diastolic velocity r= -0.49, P=0.001). The slope of the linear regression was -0.62 cm/second per 10 years for systolic blood velocity and -0.51 cm/second for diastolic blood velocity. Resistivity index (RI) (RI=[systolic velocity--diastolic velocity]/systolic velocity) as a marker of the rigidity of the vessel increased significantly with age (r=0.40, P=0.004). The slope was 0.03 per 10 years. Retinal microcirculation (flow omega-ret) decreased significantly with age (r= -0.63, P=0.00001). The slope was -34.9[AU] per 10 years. Optic nerve head blood flow showed no significant correlation to age (r= -0.30, P=0.071). CONCLUSION: The authors' data indicate that there is a significant decrease of retinal and CRA blood flow of approximately 6% to 11% per decade. Optic nerve head blood flow seems not to be influenced by age.

Adult↗
PubMed1996

Perfusion of the juxtapapillary retina and the neuroretinal rim area in primary open angle glaucoma.

PURPOSE: The objective of this study is to evaluate capillary blood flow of the juxtapapillary retina and neuroretinal rim area in primary open angle glaucoma (POAG) by a new noninvasive method performing a high-definition topography of perfused vessels of the retina and the optic nerve head with simultaneous evaluation of blood flow. METHODS: Juxtapapillary retinal and neuroretinal rim area blood flow were measured by scanning laser Doppler flowmetry (SLDF). This new technique is a combination of a laser Doppler flowmeter with a scanning laser system by which the retinal perfusion is simultaneously quantified in 16,000 sites of a retinal area of 2.7 x 0.7 mm. In study I, retinal and optic nerve head blood flow were evaluated by SLDF in 43 patients with POAG and 43 healthy individuals. The mean age of the POAG group was 56 +/- 12 years and of the control group 42 +/- 15 years. In study II, age-matched normals (n = 21) were compared with glaucoma eyes with topical therapy (n = 30) and with glaucoma eyes without topical therapy (n = 16). RESULTS: In study I, the eyes with POAG had an average cup/disc ratio (C/D) of 0.75 +/- 0.20, with an average mean defect of the visual field of 5.3 +/- 5.4 dB. The actual intraocular pressure was 17.8 +/- 4.18 mm Hg in the POAG group and 15.45 +/- 1.82 mm Hg in the control group. For statistical analysis, two age-matched groups of 28 normal eyes of 28 persons with 27 glaucomatous eyes of 27 patients were compared. In normals the blood flow of the neuroretinal rim area was significantly higher than that of the juxtapapillary retinal area (+7.73%, p < 0.01). In POAG both juxtapapillary retinal blood flow and neuroretinal rim area blood flow were significantly decreased compared to an age-matched control group: neuroretinal rim area flow -71% and juxtapapillary retina flow -49%. The decrease of neuroretinal rim area blood flow did significantly correlate with C/D. We found no correlation between reduction of juxtapapillary retinal blood flow and C/D or mean defect. Both glaucoma eyes with and glaucoma eyes without topical therapy showed significant decreased juxtapapillary blood flow compared to normals. We found no significant difference in the juxtapapillary blood flow between glaucoma eyes with and without topical therapy. CONCLUSIONS: In POAG, optic nerve head blood flow and juxtapapillary blood flow were significantly decreased.

Adult↗
PubMed1996

Principle, validity, and reliability of scanning laser Doppler flowmetry.

PURPOSE: The objective of this study is to present the reliability and validity of scanning laser Doppler flowmetry (SLDF) performing a high-definition topography of perfused vessels of the retina and the optic nerve head with simultaneous evaluation of blood flow. METHODS: The examination of blood flow by SLDF is based on the optical Doppler effect. The data acquisition and evaluation system is a modified laser scanning device; the wavelength of the laser source is 670 mm, with a power of 100 microW (Heidelberg Engineering, HRF). The reliability of SLDF was estimated by performing five separate measurements in 10 eyes on 5 days. The validity of the method was tested by two experiments. First, in an experimental set-up, the capability of SLDF to measure the velocity of a moving plane in absolute units was estimated. Second, comparative measurements were performed of retinal blood flow in normal eyes and in 33 glaucomatous eyes with SLDF and a commercially available single-point laser Doppler flowmeter (Oculix). RESULTS: We found SLDF to produce a high reliability. The reliability coefficients r1 of flow, volume, and velocity were 0.82, 0.81, and 0.83, respectively. Comparative measurements of the retinal blood flow by SLDF and a single-point laser Doppler flowmeter of corresponding retinal points showed a linear and significant relationship between flow (r = 0.83, p < 0.0001), volume (r = 0.51, p < 0.0001), and velocity (r = 0.59, p < 0.0001). In the experimental set-up, SLDF was able to quantitatively measure velocity in absolute units. CONCLUSIONS: SLDF enables the visualization of perfused vessels of the juxtapapillary retina and the optic nerve head in high resolution by two-dimensional mapping of the optical Doppler shift and a reproducible evaluation of capillary blood flow.

Evaluation Studies as Topic↗
PubMed1996

Perfusion of the juxtapapillary retina and optic nerve head in acute ocular hypertension.

Chronically elevated intraocular pressure (IOP) is often associated with glaucomatous optic nerve atrophy. Impaired blood flow may play a role in the pathogenesis of this disease. We present data concerning juxtapapillary retinal and optic nerve-head blood flow during acute increases in IOP. With the combination of a laser Doppler flowmeter and a scanning-laser system (Scanning Laser Doppler Flowmeter, SLDF; Heidelberg Engineering) the perfusion of the retina and the optic nerve head was quantified and visualized. Juxtapapillary retinal and optic nerve-head blood flow was measured simultaneously by SLDF during variations in IOP induced by a suction cup in nine healthy volunteers. The ocular pressure was increased for 2 min to IOP +15 mmHg, then to IOP +30 mmHg, and finally, to IOP +45 mmHg. Ocular perfusion pressure (PP) was calculated as the mean arterial blood pressure minus the IOP. The declines in juxtapapillary retinal flow as expressed in present per 10-mmHg IOP elevation ranged from 3.6% to 14.1% (median 7.4%). Over all measurements we found a significant linear relationship between juxtapapillary retinal blood flow and PP (r = 0.55, P < 0.0001). The observed decrease in optic nerve-head blood flow with increasing IOP was significantly greater as compared with the retinal blood flow decrease (8.4%/10 mmHg versus 7.4%/10 mmHg, P < 0.05). SLDF enables the quantification and visualization of perfused capillaries of the retina and the optic nerve head in high resolution. Acute elevations of IOP led to a decreases in juxtapapillary retinal and optic nerve-head blood flow of 7.4% and 8.4%/ 10-mmHg IOP increase, respectively.

Acute Disease↗
PubMed1995

Advanced primary open-angle glaucoma is associated with decreased ophthalmic artery blood-flow velocity.

Recent findings indicate that low-tension glaucoma is associated with impaired ocular blood flow. In the present study we evaluated the blood-flow in the ophthalmic artery in regulated open-angle glaucoma. Using pulsed Doppler sonography (4 MHz), the blood-flow velocity in the ophthalmic artery of 183 eyes of 95 persons with open-angle glaucoma was examined (mean age, 66.6 +/- 14.5 years). The patients showed advanced glaucomatous optic-nerve atrophy (cup-to-disk ratio, 0.74 +/- 0.27) and regulated intraocular pressure (IOP: range, 8-25 mm Hg; mean, 16.4 +/- 3.9 mm Hg). The blood pressure (BP) was 140 +/- 22 (systolic) and 79 +/- 14 mm Hg (diastolic). The control group (84 eyes of 44 persons: mean age, 69.7 +/- 7.7 years; IOP range, 10-22 mm Hg; mean IOP, 15.2-2.6 mm Hg; BP, 143 +/- 20/81 +/- 9 mmHg was matched for age and circulatory risk factors. The vascular resistance index (RIO) was calculated by the equation RIO = (systolic blood velocity-diastolic blood velocity)/systolic blood velocity. We found that the blood velocity in the ophthalmic artery was significantly decreased in glaucomatous eyes in contrast to normal eyes: systolic peak velocity, 36.9 +/- 16.2 cm/s (normal, 40.2 +/- 10.9 cm/s; P < 0.001); diastolic peak velocity 9.9 +/- 4.4 cm/s (normal, 11.7 +/- 4.0 cm/s, P < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

Clinical investigation of the combination of a scanning laser ophthalmoscope and laser Doppler flowmeter.

In this report we present the clinical applications of a new noninvasive method of imaging in high definition the topography of perfused retinal vessels. By the combination of a laser Doppler Flowmeter with a scanning laser system the retinal circulation can be visualized and quantified. The principles of measuring blood flow by laser Doppler flowmetry are based on the laser Doppler effect: laser light scattered by a moving particle is shifted in frequency. The scanning laser system is a modified laser scanning tomograph (technical data: retinal area of measurement, 2.7 x 0.7 mm; 10 degrees field with 256 points x 64 lines; horizontal digital resolution, 10 microns; wave-length, 670 nm; light power, 100 micro W; data acquisition time, 2.048 s). Every line is scanned 128-times at a line-sampling rate of 4000 Hz. By the performance of discrete fast fourier transformation over 128 intensities of each retinal point the laser Doppler shift is calculated for each retinal point. With these data a 2-dimensional map of the retinal perfusion with 256 x 64-points is created. The brightness of the picture point is coded by the value of the Doppler shift. By this method we examined health eyes with normal intraocular pressure (IOP) and artificially increased IOP and eyes with glaucomatous optic nerve atrophy, proliferative diabetic retinopathy with areas of capillary occlusion, arterial hypertension with microinfarction of the retina, and central retinal artery occlusion. The application of "scanning laser Doppler flowmetry" (SLDF) leads to the visualization of perfused vessels and capillaries of the retina in high resolution. The examination of perfused retinal arterioles, veins, and capillaries by this method represents the anatomical situation. In SLDF the area of normal or impaired retinal circulation becomes visible (capillary nonperfusion, proliferative vascular structures), whereby the extent of the perfusion is proportional to the brightness of the imaged vessel; the brighter the vessels or capillaries, the higher the blood flow inside the vessels. Retinal areas with low capillary flow are "dark" and show no visible vessel. In imaging of an eye with central retinal artery occlusion, retinal arterioles, veins, or capillaries were invisible due to the lack of retinal perfusion. Only ciliary-source vessels of the optic nerve head were bright and visible, indicating normal ciliary circulation. SLDF facilitates the visualization of perfused retinal capillaries and vessels in high resolution. The representation of the function of the retinal circulation by SLDF leads to an image similar to the anatomical situation. The two-dimensional mapping of local blood flow leads to a physiological picture of the retinal perfusion with visible vessels and capillaries.

Adult↗
PubMed1994

Dipivefrin reduces blood flow in the ciliary body in humans.

PURPOSE: Adrenergic substances are used widely for lowering intraocular pressure in the treatment of glaucoma. The hypothetic mechanisms for lowering the intraocular pressure by adrenergic drugs are decreased blood flow in the ciliary body and direct receptor-related reduction of aqueous humor production. The aim of this study is to measure noninvasively the blood flow in the anterior uvea in humans after topically administered dipivefrin. METHOD: The blood flow of iris and ciliary body was measured by laser Doppler flowmetry. Laser Doppler flowmetry blood flow and results of the electrocardiogram were simultaneously measured and stored over a period of 3 minutes. In the authors' setup, laser light was projected by a fiber optic transcorneally onto the iris or 2 mm transscerally from the limbus into the ciliary body. For improvement of the signal-to-noise ratio, a statistical averaging procedure was performed by averaging 100 sweeps of 2 seconds of the digitalized laser Doppler flowmetry signals triggered by the R-onset of the electrocardiogram (averaging laser Doppler flowmetry). Using this method, reproducible pulse curves of blood flow of iris and ciliary body were established with systolic maxima and diastolic minima. In a double-blind study design involving 33 young, healthy persons (mean age, 25 +/- 7 years), the effect of topically administered dipivefrin, naphazoline, and NaCl solution (0.9%) on the blood flow of iris and ciliary body was examined. RESULTS: Dipivefrin reduces significantly (average, 49%) the mean blood flow in the ciliary body. Naphazoline and NaCl solution do not change the blood flow in the ciliary body. Dipivefrin, naphazoline, and 0.9% NaCl show no significant effect on the iridal blood flow. CONCLUSION: The observed data suggest that dipivefrin decreases ciliary body blood flow.

Administration, Topical↗
PubMed1994

Ocular macro- and microcirculation after topical application of clonidine and metipranolol.

We investigated the effect of clonidine (Isoglaucon, an alpha-agonist) and metipranolol (Betamann, a beta-antagonist) on the blood flow in the ophthalmic artery and the anterior uvea of 40 young, healthy volunteers (mean age, 23.5 +/- 2 years) in a prospective, randomized simple blind study. The blood flow in the iris and ciliary body was detected by laser-Doppler flowmetry (bpm, 403a; TSI; wavelength, 780 nm; power, < 1.6 mW). The blood flow in the ophthalmic artery was measured by pulsed Doppler sonography (4 MHz, EME). The blood pressure, pulse respiration, and intraocular pressure (IOP) were recorded. Vascular resistance (RF) was calculated by the equation RF = (RRmean--IOP)/blood flow. Group 1 was treated with a single drop of Betamann (3 mg/ml) applied topically, and group 2 was treated with Isoglaucon (2.5 mg/ml). Measurements were made before and 30 min after application. Both drugs significantly lowered the IOP by about 7% (P = 0.01). Clonidine did not affect the blood velocity in the ophthalmic artery. In group 2 (metipranolol) we found a significant increase in the blood velocity in the ophthalmic artery during the diastolic period (from 11.0 +/- 3.7 to 11.9 +/- 2.2 cm/s, P = 0.05). Both clonidine and metipranolol decreased the iridal blood flow [clonidine, from 9.3 +/- 3.9 to 7.6 +/- 3.1 (flux), P = 0.05; metipranolol, from 7.5 +/- 2.9 to 6.5 +/- 2.6 (flux), P = 0.05]. Vascular resistance in the iris increased under the effect of clonidine (P = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗
PubMed1988

Cost analysis of a home intravenous antibiotic program.

A cost analysis of a home intravenous antibiotic program was performed, and the feasibility of the program was evaluated. All fiscal data related to the antibiotic therapy of the 10 study patients were collected from the patients' billing records and charts. Inpatient charges for antibiotics, supplies, laboratory tests, and the hospital room were identified from the patient's bill. Personnel costs were obtained from a log maintained by the home antibiotic team members. Charges accrued were converted to costs using the cost-to-charge ratio for each cost center. Fiscal analysis was performed using a subgroup of six patients with osteomyelitis. For all the patients, the mean duration of home therapy was 26 days. Inpatient treatment averaged 15.9 days. No major catheter-related problems were identified. For the osteomyelitis patients, the total cost of therapy, both inpatient and outpatient, was $57,854. If all of the therapy for this subgroup of patients had been provided on an inpatient basis, the total cost would have been $98,314. The home intravenous antibiotic program was determined to be feasible and cost-effective.

Adult↗
PubMed1980

Detection of affective disorders in family practice: 126 assessments.

Home visits provided the setting for interim assessments by a clinical psychiatrist and a research assistant between December 1978 and April 1979. Two instruments were used: a standardized 61-question interview and a self-rating checklist. Forty-seven cases of affective disorder, 47 age-sex-marital status matched compeers, and 32 spouses participated. Results show little agreement between family practice records (drug and problem lists) and assessment at home visits. Over 46 percent of adults showed signs of anxiety, depression, or both. Gaps in physician-patient communication account for some of the missed diagnoses. Prospective studies of these common disorders are handicapped by problems of: (1) definition and criteria, (2) fluctuations in sick/well status over time, (3) changing levels of severity and levels of detection, and (4) losses of the sicker persons from the population for follow-up study. A generally useful model for affective disorders emphasizes the interaction between intrinsic factors (subjective stress) and extrinsic factors (objective stress). A flow sheet is used to help the clinician assess the major components of stress, patient's ability to cope, and plan for management.

Adult↗
PubMed1980

Family pharmacy and family medicine: a viable private practice alliance.

The association of the new roles of the family physician and the family pharmacist in a model private practice is described. The pharmacist works closely with the family physician to offer personalized patient education and follow-up for therapeutic effectiveness. He also serves as a consultant to the physician for up-to-date drug information and assists in solving difficult therapeutic problems. Reimbursement for pharmacy services occurs for consultative time as well as by traditional methods. Initial response by the professionals themselves as well as the patients and staff has been very positive. An appropriate physical plant and ongoing communication between physician and pharmacist are mandatory for the success of this model. Some specifics of this practice at its present stage of development are included.

Family Practice↗
PubMed1978

Three approaches to the recognition of affective disorders in family practice: clinical, pharmacological, and self-rating scales.

No single approach to the recognition of affective disorders worked in a ten percent sample of a family practice population, screened in the summer of 1975. Among 298 adults followed prospectively for two years, about six percent developed an affective disorder (3.8 percent anxiety, 1.9 percent depression, and 0.4 percent episodes of both). The sex ratio was predominantly female (2.7:1). Most of the cases were recognized by clinical problem lists, but 23 percent of the cases would have been missed without a computerized search of prescribed drug profiles. Self-rating tests (Zung for depression and Reeder for anxiety) performed poorly at predicting cases prospectively, and unimpressively in retrospect. The burden of these disorders is considerable, with a prevalence in this population of at least 19 percent. Of these cases, 22 percent had "mixed" episodes of depression, anxiety, and combinations seen at various visits. Criteria for diagnosis need to be clarified for more precise diagnosis, proper medication, as well as better estimates of incidence and patient load.

Adult↗
PubMedDate not supplied

Underdocumentation of benzodiazepine prescriptions in a general medicine clinic.

During a three-month period the authors reviewed the charts of patients prescribed benzodiazepine and non-benzodiazepine medications by 73 housestaff practicing in an ambulatory medical clinic. Compared with non-benzodiazepine prescriptions, benzodiazepine name (p less than 0.001), instructions (p less than 0.001), and targeted problems (p less than 0.0001) were significantly underrecorded. In 11% of the records reviewed there was no indication that a mood disorder had been identified or a benzodiazepine prescribed (p less than 0.0001). Problems targeted for benzodiazepine management were found less frequently in the records of elderly patients than in those of patients less than 65 years of age (p less than 0.05). The authors conclude that many houseofficers significantly underdocument the prescriptions they write for benzodiazepine medications and that this may be a marker of their regard for managing mood disorders with benzodiazepines.

Ambulatory Care Facilities↗