Search PubMed⌕ Search

Biomedical subjects

V Moore

Publications and source records attributed to V Moore.

59 records · Page 4Linked to original sources
PubMedDate not supplied

Cost-effectiveness of initial therapy with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors to treat hypercholesterolemia in a primary care setting of a managed-care organization.

From January 1994 through May 1995, Prudential HealthCare-North Texas prospectively studied 299 member patients diagnosed with hypercholesterolemia for whom pharmacotherapy with one of four 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, also known as statins, was prescribed. The purpose of this study was to measure the relative cost-effectiveness (CE) of these drugs in a real-world setting. This study provides information to assist decision makers in managed-care organizations (MCO) in making formulary selections. The study used a prospective, randomized, balanced cohort design, examining patients who had been prescribed initial therapy with a statin drug as monotherapy. Costs (direct medical and indirect costs) and effectiveness (percent reduction in low-density lipoprotein cholesterol levels) were based on approximately the first 6 months of initial therapy. Both the MCO and patient perspectives were considered. In the base case, mean CE ratios were significantly lower for fluvastatin compared with lovastatin, pravastatin, and simvastatin from both the managed-care perspective and the patient perspective. Sensitivity analysis did not alter the CE conclusions, even under conditions of varying cost structures. Although differences were found in the effectiveness of lovastatin, pravastatin, and simvastatin measured in this study versus efficacy measured for these drugs in controlled clinical trials, sensitivity analysis suggests that these differences alone do not determine the superior CE of fluvastatin. Finally, this study supports the idea that well-designed formularies should consider drug CE (based on safety, effectiveness, and cost) and that integration of the pharmacy benefit management with other medical management is essential. These results provide evidence that fluvastatin may represent a more cost-effective formulary choice among statin products used for initial monotherapy of hypercholesterolemia.

Adult↗
PubMedDate not supplied

The effect of centrifugation time on cellular residues in fresh plasma.

Cellular residues were present in all fresh plasma prepared by a standard technique with centrifugation times of 5, 7, or 10 minutes. The amounts of cellular residues in the plasma were inversely proportional to the time of centrifugation. Platelet contamination was statistically different in the three times tested. In contrast, the residual amounts of erythrocytes and leukocytes were significantly different only when 5- and 10-minute centrifugation times were compared.

Blood Platelets↗
PubMedDate not supplied

Development and dissemination of minimum standards of care for asthma.

Asthma is a common illness in children and adults that is often associated with suboptimal outcomes, despite the existence and distribution of carefully considered national and international guidelines for diagnosis and treatment. The need to improve asthma care in North Texas motivated a coalition of health plans, employers, hospitals, academic medical centers, providers, and benefit consultants to collaborate in developing and implementing Minimum Standards of Care for Asthma. To gain consensus, the North Central Texas HEDIS Coalition used a panel of regional asthma experts and surveyed a large number of primary-care providers to construct a one-page document that was ultimately approved by regional stakeholders in healthcare participating in this coalition and also by specialty organizations in Texas. Adopting a minimum standard guideline, developed and supported by multiple stakeholders, may represent a more realistic intermediate goal when implementing "best practice" guidelines is limited by practical barriers.

Adult↗
PubMedDate not supplied

School-based asthma management policies and practices: a regional survey.

Children with asthma may spend as much as one-third of their weekdays in the school setting. As one effort to evaluate and improve asthma care in the Dallas/Fort Worth area, the North Central Texas HEDIS Coalition surveyed 36 independent school districts (ISDs). Twenty-nine ISDs, representing 679,631 children, responded to questions on school health personnel, identification and monitoring of students with asthma, staff training in asthma care, policies for students carrying asthma medications, and campus smoking policies. Key findings were more positive than expected and included the following: (a) training in asthma management is fairly extensive, (b) students in 26 ISDs are allowed, upon physician request, to carry medihalers, and (c) smoking on school property is illegal in Texas. However, the absence of a fully developed strategy for implementing the survey findings may have hindered the continuous quality improvement efforts among schools, health plans, providers, and the community that could have evolved from this project.

Asthma↗