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Biomedical subjects

P J Bush

Publications and source records attributed to P J Bush.

9 recordsLinked to original sources
PubMed1979

Evaluation of a drug therapy protocol in an HMO.

Effective means of affecting physician prescribing behavior must be developed if the quality of health care is to be improved. A drug therapy protocol for otitis media, containing a rationale for drugs, doses and days of therapy by patient age, was developed by a physician panel at one site (EI) of an HMO, and implemented at both EI and a second site (EII); a third site was a control. A comparison of prescribing during two phases, before and after implementation of the protocol, suggested that the protocol had a greater influence at site EI than site EII, and that it had a greater influence on the panel physicians than on other prescribers at site EI. Questionnaire responses indicated that clinical experience and personal involvement were the most important protocol use influences. If participation is critical to protocol compliance, the protocol method to improve the quality of health care is severely limited.

Adolescent↗
PubMed1976

Who's using nonprescribed medicines?

A household survey investigated the nonprescribed medicine use of 3,481 persons in the Baltimore SMSA in 1968-69. Of respondents, 30 per cent used a nonprescribed morbidity-related medicine in two days. Rates of use are higher for adults, females and whites in all economic classes, and do not increase with increasing severity of morbidity in any economic class. A hypothesis that nonprescribed substitute for prescribed medicines is supported: ill nonprescribed medicine users are less likely to use prescribed medicines or to have visited a physician than nonusers; rates of nonprescribed medicine use are lower for those with a physician visit, and use of both prescribed and nonprescribed medicines for the same purpose is negligible. Lower out-of-pocket costs for visits and prescribed medicines do not lower rates of use. Nonprescribed medicine use is high among healthy and ill suggesting that physicians should inquire into patients' use when evaluating symptoms and before prescribing.

Acute Disease↗
PubMed1975

Who's using medicines?

Data derived from 1968-69 household survey of 3,481 persons in the Baltimore Standard Metropolitan Statistical Area revealed rates of medicine use and characteristics of users. In the 2 days before interview, 56% of the study population used one or more medicines. Users of prescribed medicine (33%) averaged 1.8 different kinds, and users of nonprescribed medicine (36%) averaged 1.4 kinds. Among users of prescribed medicine, 39% were also self-medicating. Pain relivers, vitamins, and cough and cold medicines were the most frequently used types. Two-thirds of physician visits were associated with an injection, immunization, medicine, or prescription. Rates of use for both prescribed and nonprescribed medicine were higher in females and varied with age, with nonprescribed varying less than prescribed. Nonwhites were less likely than whites to use either prescribed or nonprescribed medicines in all social status categoreis. Use of prescribed medicine increased with the increasing severity of acute and chronic illness, but use of nonprescribed medicine varied little with morbidity. Use of prescribed or nonprescribed medicine did not vary with economic class. Differences in use by age, sex, and race could not be accounted for by differences in morbidity, physician visits, or use of oral contraceptives.

Adolescent↗