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S Sullivan

Publications and source records attributed to S Sullivan.

135 records · Page 8Linked to original sources

Patients' perceived benefit from and satisfaction with asthma-related pharmacy services.

OBJECTIVE: To determine whether patients targeted to receive intervention from an asthma management program reported receiving more services and had greater perceived benefit and satisfaction with those services compared with asthma patients not targeted by the program. DESIGN: Mailed survey. SETTING: Community pharmacy. PATIENTS: 471 community-based patients receiving asthma medications from 44 intervention pharmacies and 1,164 patients from 46 usual care (control) pharmacies. MAIN OUTCOME MEASURES: Five-point agreement scale measuring asthma services received, perceived value of the services, and satisfaction. RESULTS: Usable surveys were received from 39.0% of intervention patients and 42.4% of controls. There were no statistically significant differences between groups in the frequency of provision of listed services. Approximately 60% of respondents from both groups received written materials on asthma medications and 54% received inhaler counseling; both were rated high for perceived benefit. Fewer than 20% reported being counseled about asthma triggers. Fewer than 5% reported pharmacists talking to physicians on their behalf. General satisfaction with pharmacy services was high (78.2% agree or strongly agree), but not statistically different between groups. More than 65% believed that pharmacists spend enough time counseling patients. Several comments indicated that patients did not expect or ask for information because they were unaware that services were available and/or they had already been counseled by their physician. Responses to the statement "my asthma is better controlled because of help given to me by the pharmacist" were equivocal and not different between groups. CONCLUSION: Overall, there were few differences between groups. General satisfaction with pharmacy services is high, but patients' perceived benefit and satisfaction with cognitive services is lower. Increased public awareness of pharmacists' capabilities and a more proactive approach to providing cognitive services is needed.

Adrenergic beta-Agonists↗

Antagonistic effect of morphine on the positive inotropic response of ouabain on the isolated rabbit heart.

The antagonistic effect of morphine on the positive inotropic response of ouabain was studied in 96 isolated rabbit hearts, using a modified Langendorff preparation. Decreased calcium (Ca) in the perfusate resulted in increased depression of peak left ventricular dP/dt by morphine (10(-4) gm/ml), and the number of beats required to reach the depression was proportionally reduced with the reduction of calcium chloride from 2.16 mM to 0.54 mM. Likewise, the positive inotropic effect of ouabain (10(-6) gm/ml) was proportionally reduced by the same reduction of calcium chloride concentration in the perfusate, but the number of beats required to reach the cardiotonic effect was proportionally increased with Ca deficiency. The opposing effects of ouabain and morphine were mutually antagonistic regardless of the order of drug administration. When the hearts had been previously exposed to morphine, ouabain stimulation was no longer beat-dependent. Following prior exposure to ouabain, the beat-dependency of morphine depression on the heart also was partially antagonized. These results suggest that the level of maximal dP/dt during morphine depression or ouabain stimulation is directly related to the extracellular concentration of Ca. The number of beats required to attain the depression or stimulation is probably a reflection of the rate at which equilibrium is established between the mobile fraction of extracellular and intracellular Ca, since transmembrane movement of Ca is believed to occur during each beat. A possible common site of morphine and ouabain effect may be the cellular membrane, where ionic flux occurs.

Animals↗

Building an integrated health management system at Honeywell.

The ideal of many a company seriously committed to managing its health care costs is to coordinate all its health-related functions. Honeywell, through a 14-person team representing 10 functions, has come closer to achieving this ideal than most. In the process, the Company saved $27.5 million in 2 years and has expanded its aims well beyond cost containment. How it conceived, staffed and developed its "hybrid" health management organization is described by the Company's Health Systems Director and the author of a recent book detailing Honeywell's many programs.

Cost Control↗

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Certification↗