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Biomedical subjects

T I Poirier

Publications and source records attributed to T I Poirier.

At least 19 recordsLinked to original sources
PubMed1995

Clinical and ethical perspectives on rationing of high-cost drugs.

OBJECTIVE: To analyze the use of high-cost drugs from a clinical decision-making approach and ethical perspectives on rationing. CASE: The case of a 26-year-old intravenous drug user with AIDS raises issues of how to ration high-cost drugs such as foscarnet, monoclonal antibodies (MAbs) for septic shock, and granulocyte colony-stimulating factor. ASSESSMENT: Should a patient with a terminal illness receive high-cost drugs given limited healthcare resources? Necessary clinical information including treatment algorithms, risk to benefit ratios, and cost-effectiveness data are evaluated. Rationing, especially bedside rationing, by the clinician is rejected because it is contrary to the clinician's ethical obligation of beneficence and nonmaleficence. Patient autonomy and desires may also conflict with society's interest in equitably distributing resources. Treatment could be denied if costs exceed benefits for the outcomes and thus deny resources to others who have more basic healthcare needs. There is no obligation to offer medically futile care or for the patient to accept extraordinary medical care. CONCLUSIONS: An ethical argument for rationing cannot be made because of the lack of a clear clinical and societal consensus on specific criteria for rationing of healthcare dollars. The decision to use high-cost drugs in the case presented is made using a clinical decision-making approach based on available treatment guidelines. This assumes that the patient continues to consent to therapy and that there is continued benefit.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Evaluation of drug interaction microcomputer software: an updated comparison.

Nine drug interaction microcomputer software programs were evaluated and compared using clinical and general ease of use criteria. Descriptions of major changes or additions since the last review are detailed. The ability to screen for drug interactions was based on recent drug-drug and drug-food interactions. Recommended programs based on three price ranges are suggested.

CD-ROM↗
PubMed1992

Drug interaction microcomputer software evaluation: drug interaction facts on disk.

Drug Interaction Facts on Disk (DIF) was evaluated using general and specific criteria. The installation process, ease of learning and use, the user documentation, and the technical support were rated excellent. The scope of coverage, the quality of the clinical documentation, and overall clinical performance were also excellent. The frequency of updates is good. The program's clinical performance was compared to RxTriage and Drug Therapy Screening System using five recently reported drug interactions. The ability to screen for selected drug-food/nutrient interactions was also evaluated. Drug Interaction Facts is rated to be one of the better bargains in drug interaction software programs.

Drug Information Services↗
PubMed1992

Evaluation of patient counseling microcomputer software programs.

Five patient counseling drug information programs are evaluated using specific criteria definitions. This article compares the features and ratings of each program. The scope of drug coverage is found to be good to excellent. Most of the programs fared poorly in the timeliness of the database. Updates to the programs range from quarterly to undefined schedule. The ease of readability of all the programs is excellent. The inclusion of key components of information is determined to be good to excellent. The overall patient performance ratings are excellent for each of the programs. The programs are all competitively priced. All of the programs evaluated are easy to use. The only distinguishing feature among the programs is the format of the printed output.

Computer-Assisted Instruction↗
PubMed1992

Survey of clinical pharmacokinetic software for microcomputers.

Twelve distributors of pharmacokinetic software programs for microcomputers were surveyed to determine scope of drug coverage; the pharmacokinetics models, methods, and equations used; hardware requirements including use of math coprocessor, random access memory (RAM) required, storage space, printer support and mouse use; software features including availability of windows, pull-down menus, context sensitive help, graphical representation of data, ability to export data including to ASCII file and ability to store patient data; availability of support including toll-free telephone numbers, 24-hour support and clinical consultations; costs; and frequency of updates.

Clinical Pharmacy Information Systems↗
PubMed1991

Evaluation of drug interaction microcomputer software: comparative study.

Twelve drug interaction microcomputer software programs were evaluated and compared using general and specific criteria. This article summarizes and compares the features, ratings, advantages, and disadvantages of each program. Features of an ideal drug interaction program are noted. Recommended programs based on three price ranges are suggested.

Artificial Intelligence↗
PubMed1991

Survey of pharmacy computer vendors--sources of clinical databases.

Ninety-nine pharmacy computer vendors were surveyed to determine the sources of their clinical data bases for drug-drug interactions, drug-food/nutrient interactions and IV compatibilities. Sixty-five percent of the vendors cited two drug-drug interaction software programs most frequently. These are Drug Therapy Screening System from Medi-span and RxTriage from First Data Bank. First Data Bank is also the most frequently cited source for the drug-food interactions and IV compatibility databases.

Clinical Pharmacy Information Systems↗
PubMed1991

Evaluation of drug-food/nutrient interactions microcomputer software programs.

Eight drug-food/nutrient interaction microcomputer software programs were evaluated and compared using specific criteria defined for these programs. This article summarizes and compares the features, ratings, advantages, and disadvantages of each program. There are no excellent drug-food/nutrient interactions programs. Three programs performed equally well and should be considered. These are Medicom Micro, Drug Therapy Screening System and RxTriage.

Clinical Pharmacy Information Systems↗
PubMed1991

Evaluation of IV compatibility microcomputer software programs.

Four microcomputer software programs that contain IV compatibility information were evaluated using specific criteria for these programs. This article compares scope of coverage, quality of clinical documentation, frequency updates, and clinical performance for these programs. There are no excellent IV compatibility programs. Of the programs tested, Micromedex performed the best. Therapeutic Software is not considered a comprehensive IV compatibility program. IV-Check PC and Medicom Micro performed equally well.

Clinical Pharmacy Information Systems↗
PubMed1990

A nationwide survey of antibiotic prescribing patterns and clinical outcomes in patients with bacterial pneumonia.

Antibiotic prescribing information was prospectively collected on 1822 hospitalized patients treated for suspected or documented bacterial pneumonia. Antibacterial therapy with a single antibiotic was employed in more than 50 percent of the patients, with cefazolin, cefuroxime, ampicillin, and ceftriaxone sodium representing the most commonly employed agents. Combination therapy using two antibiotics was employed in approximately 30 percent of patients with the aminoglycosides, particularly gentamicin, used extensively. A satisfactory outcome was achieved in approximately 80 percent of patients with a community- or institutional-acquired pneumonia; only 66 percent of nosocomial pneumonias had a satisfactory outcome. An important observation was the apparently common practice of switching patients to an oral antibiotic regimen after an average of seven days of antibiotics and subsequently discharging the patient. No difference was observed in the patterns of clinical response or duration of therapy for culture-positive versus culture-negative patients. The results of this surveillance program can serve as a basis for comparison of institution-specific drug utilization evaluation programs.

Aminoglycosides↗
PubMed1990

Evaluation of drug interaction microcomputer software: Dambro's Drug Interactions.

Dambro's Drug Interactions was evaluated using general and specific criteria. The installation process, ease of learning and use were rated excellent. The user documentation and quality of the technical support were good. The scope of coverage, clinical documentation, frequency of updates, and overall clinical performance were fair. The primary advantages of the program are the quick searching and detection of drug interactions, and the attempt to provide useful interaction data, i.e., significance and reference. The disadvantages are the lack of current drug interaction information, outdated references, lack of evaluative drug interaction information, and the inability to save or print patient profiles. The program is not a good value for the pharmacist but has limited use as a quick screening tool.

Drug Interactions↗
PubMed1990

Drug interaction micromputer software evaluation: RxTriage.

RxTriage was evaluated using general and specific criteria. The installation process, ease of learning and use, and technical support were rated excellent. The user documentation was good. The scope of coverage, frequency of updates and overall clinical performance were good. The quality of the clinical documentation, which included key drug interaction texts and primary references, was excellent. The primary advantages of the program are the quality of its data base and interaction information and the inclusion of decision support tables. The disadvantage is the relative high cost as compared to other available microcomputer programs.

Drug Information Services↗
PubMed1990

Drug interaction microcomputer software evaluation: the Medical Letter Drug Interactions Program.

The Medical Letter Drug Interactions Program was evaluated using general and specific criteria. The installation process, ease of learning, and use were rated excellent. The user documentation and technical support were good. The quality of the clinical documentation was excellent. The scope of coverage and overall clinical performance were good. The frequency of updates is fair. The primary advantages of the program are low costs and fast, reliable screening tool for drug interactions.

Artificial Intelligence↗
PubMed1990

Drug interaction microcomputer software evaluation: Drug Therapy Screening System (DTSS).

Drug Therapy Screening System (DTSS) was evaluated using general and specific criteria. The installation process, ease of learning and use, the user documentation, and the technical support were rated excellent. The scope of coverage, the quality of the clinical documentation, and overall clinical performance were also excellent. The frequency of updates is good. The program is one of the best microcomputer drug interaction software packages evaluated by the authors thus far, because of its comprehensiveness, simplicity in use, and quality of its drug interaction information. The relatively high annual cost may limit its attractiveness.

Drug Information Services↗
PubMed1990

Drug interaction microcomputer software evaluation: PDR's drug interactions and side effects diskettes.

The PDR's Drug Interactions and Side Effects System was evaluated using general and specific criteria. The installation process, ease of learning, and ease of use were rated excellent. The user documentation and technical support were good. The quality of the clinical documentation was fair. The scope of coverage and overall clinical performance were fair. The frequency of updates is good. The primary advantage of the program is its citation of drug interactions and side effects listed in the official product labeling of numerous brand name products. The major disadvantages are that it lacks evaluative interaction information, may not include current information, and only contains brand names listed in one of the PDR compendia.

Drug Information Services↗
PubMed1989

Evaluation of drug interaction microcomputer software: Part 2--Drug Interactions Advisor.

Drug Interactions Advisor was evaluated using general and specific criteria. The installation process, ease of learning and use were rated as good. The documentation and technical support were rated as fair. The program received fair ratings for scope of coverage, clinical documentation, and frequency of updates. Because of the quality and quantity of interaction information provided, overall clinical performance was rated as poor. The program has value as an initial screen for detection of potential interactions. It is not a useful source for evaluative drug interaction information.

Drug Information Services↗