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Biomedical subjects

W F McGhan

Publications and source records attributed to W F McGhan.

At least 55 records · Page 3Linked to original sources
PubMed1990

Improving antiulcer agent prescribing in a health maintenance organization.

A study was made of the effect of one-to-one educational meetings between prescribers and a pharmacist on the prescribing of antiulcer agents for outpatients in a health maintenance organization (HMO). Ten-minute presentations were developed that communicated the same basic facts through the use of case studies (vivid interventions) or statistical data (nonvivid interventions). After a control group (n = 8) was selected, prescribers (n = 16) were randomly assigned to receive vivid interventions or nonvivid interventions. Data on the prescribing of cimetidine, ranitidine, and sucralfate were collected for one month before the interventions and for two months afterward. Three clinical pharmacy professors independently evaluated prescriptions for appropriateness of indication, dosage, and duration. No differences in appropriateness were found between the two intervention groups, but in the first postintervention month the mean rate of inappropriate prescribing per control practitioner was 80%, versus less than 32% for the intervention groups (p less than 0.01). Each prescription in the first postintervention month entailed a mean cost of $31 per control practitioner for inappropriate prescribing, compared with less than $12 for the intervention groups (p less than 0.01). Mean costs of inappropriate prescriptions per practitioner per patient visit were $0.88 and less than or equal to $0.41 for the control and intervention groups, respectively (p less than 0.05). During postvisit month 2, inappropriate prescribing for both intervention groups increased slightly and was no longer significantly less than that in the control group. One-to-one educational meetings improved the prescribing of antiulcer agents for outpatients in an HMO.

Anti-Ulcer Agents↗
PubMed1989

Self-care practices of college students.

The literature indicates that the majority of symptoms of minor illness or injury experienced by individuals are handled routinely through some form of self-care. Less well described are the sources of information relied on in the self-care decision-making process. The purpose of this study was to assess the use of self-care measures by college students prior to visiting a student health service and, if self-care was undertaken, to determine the source(s) of self-care information. Results indicated that almost two thirds of the subjects had engaged in self-care for the symptoms that led to their visits. The most popular sources of self-care information included family members or friends, prior interaction with a health care provider, and nonprescription medication advertisements. This study did not address the appropriateness of the self-care information obtained; therefore, the quality of the information was not analyzed. Due to the prevalence of self-care among college students, attempts should be made to provide them with objective, high quality, and readily accessible self-care information. This information should be provided as part of an overall effort that encourages students to view health as a personal responsibility.

Adolescent↗
PubMed1989

The effect of self-care information on health-related attitudes and beliefs of college students.

We conducted a study to determine whether an intervention using self-care information would change college students' attitudes and beliefs concerning personal responsibility and involvement in their own health care. Individuals entering a student health service were randomly assigned to a treatment or control group. Members of the treatment group (n = 187) received the intervention and completed the survey instrument. Members of the control group (n = 204) completed the survey instrument only. The intervention consisted of one page of general information about the benefits to individuals of taking responsibility for their own health and a booklet containing excerpts from a consumer-oriented health care book. The survey instrument was composed of a measure of attitudes toward information and behavioral involvement in health care and a measure of beliefs regarding control over one's health. Results indicated that the intervention was able to change the treatment group's attitudes regarding active participation in health care. The treatment group's responses also reflected less belief that health was outside of the individual's control. The study showed that a positive change in health-related attitudes and beliefs can result from a relatively uncomplicated informational intervention.

Adolescent↗
PubMed1989

Pharmacoeconomic research and clinical trials: concepts and issues.

The purpose of this article is to provide an overview of the emerging discipline of pharmacoeconomics. Specific methodologies and terms are defined. Pharmacoeconomic research is described, related to, and contrasted with clinical drug trials. Additionally, we present a brief overview of the general steps taken designing a pharmacoeconomic study. Finally, several issues centering around pharmacoeconomic analysis are presented for discussion and debate. The need for high-quality pharmacoeconomic research is stressed along with the need for appropriate education of individuals trained in the health sciences.

Clinical Trials as Topic↗
PubMed1988

Establishment and evaluation of a serum cholesterol monitoring service in a community pharmacy.

A clinical pharmacy service providing blood cholesterol testing and consultation was implemented in a community pharmacy. In this pilot study, 27 patients each paid $10 to have a serum cholesterol determination. All subjects completed a questionnaire to determine attitude toward such a service, intention to use it in the future, and willingness to pay for its use. A posttest patient satisfaction questionnaire was completed after blood-level results were reported and discussed with the patient. All subjects stated that they were strongly in favor of such a service, that they would use it, and that they would pay an average of $11.60 for the test. On the posttest questionnaire, patients expressed strong satisfaction with various aspects of the service, and the amount that they were willing to pay increased significantly to $14.35. It is recommended that community pharmacies implement such patient-oriented services.

Adult↗
PubMed1988

Use of histamine2-receptor blocking agents and sucralfate in a health maintenance organization following continued clinical pharmacist intervention.

The effect of continued clinical pharmacist intervention on the proper use of histamine2-receptor blocking agents and sucralfate in a health maintenance organization was studied. New prescriptions written for cimetidine, famotidine, ranitidine, and sucralfate in January 1986 (preintervention), October 1986 (postintervention), and February 1987 (follow-up), and the medical record of each patient were analyzed for appropriateness using approved criteria. Clinical pharmacist intervention occurred throughout the study. There was a significant decrease (p less than 0.005) in the rate of inappropriate prescribing in the postintervention (42.4 percent) and follow-up (48.7 percent) periods versus the preintervention period (81.5 percent), and in the average number of refills authorized per patient in the postintervention (1.2 +/- 1.54) and follow-up (1.3 +/- 1.00) periods versus the preintervention period (3.0 +/- 3.67). There were no significant differences in these areas between the postintervention and follow-up periods (p greater than 0.05). A benefit-to-cost ratio of 4.3:1 was generated from this study which demonstrated that continued clinical pharmacy interventions can have a positive, cost-effective impact on the proper use of these commonly prescribed medications.

Adolescent↗
PubMed1988

Association of length of stay and total hospital charges with antimicrobial regimen changes.

The association of changes in antimicrobial therapy with length of stay and total hospital charges in a 600-bed general medical hospital was studied. Changes in antimicrobial regimens were examined in three diagnosis-related groups (DRGs): DRG 79 (respiratory infections and inflammations, age greater than 69 years, and/or secondary diagnosis), DRG 89 (simple pneumonia and pleurisy, age greater than 69 years, and/or secondary diagnosis), and DRG 416 (septicemia, age greater than 17 years). These changes were defined as follows: (1) switching from one drug or drug combination to another, (2) adding one or more drugs to a regimen, or (3) discontinuing one drug of a multiple-drug regimen. Variables examined for association with these changes were length of hospital stay and pharmacy, antimicrobial, intravenous therapy, and hospital charges. In DRGs 79 and 89, changes in antimicrobial regimens were associated with significantly longer hospital stay and significantly higher pharmacy, antimicrobial, intravenous therapy, and total hospital charges. In DRG 416, changes in antimicrobial regimens were not associated with higher charges or longer stay. Significant differences among DRGs were found with respect to the types of changes, with more changes from broad- to narrow-spectrum coverage occurring in DRGs 89 and 416 than in DRG 79. At this institution, patients whose antimicrobial regimens were changed had significantly longer hospital stays and higher charges in two of three DRGs.

Anti-Bacterial Agents↗
PubMed1987

An equity model of staff pharmacists' job satisfaction.

Secondary analysis of data obtained during the 1982 Socioeconomic Survey of California pharmacists examined staff pharmacists' satisfaction with their job and with their employers' compensation practices. A systematic sample of licensed pharmacists residing in California was surveyed. Usable data from 208 staff pharmacists was analyzed. School of pharmacy, gender, practice setting and academic degree did not have a statistically significant effect upon pharmacists' overall job satisfaction when examined individually. When examined all together, only academic degree made a statistically significant difference in the level of job satisfaction. Pharmacists making less than the 25th wage percentile were less satisfied with their employers' compensation practices. For the entire sample of pharmacists, the factors having the greatest impact on general job satisfaction were: (1) satisfaction with compensation practices; (2) percent of time spent in patient care functions; and, (3) percent of time spent in purchasing and receiving. Academic degree did not contribute significantly to the prediction of job satisfaction.

California↗
PubMed1987

Prescribing intention and the relative importance of drug attributes: a comparative study of HMO and fee-for-service physicians.

This study utilized the Fishbein Behavioral Intention Model as a conceptual framework to compare health maintenance organization (HMO) and fee-for-service (FFS) physicians. A mail questionnaire was used to obtain data and information from random samples of HMO (n = 73; 50% response) and FFS (n = 49; 33% response) physicians in the Phoenix and Tucson metropolitan areas. No differences were found between the two groups of physicians regarding the Fishbein variables: prescribing intention, importance of attributes, attribute beliefs, and subjective norms. The Fishbein Model was found to explain a significant portion of the variance in prescribing intentions of the HMO and FFS physicians.

Analysis of Variance↗
PubMed1986

PharmD or BS: does the degree really make a difference in pharmacists' job satisfaction?

Secondary analysis of data obtained during the 1982 Socioeconomic Survey of California Pharmacists compared practice patterns and job satisfaction of BS and PharmD level practitioners. Questionnaires were mailed to 2,864 pharmacists in April 1982. Questionnaires were returned by 1,463 pharmacists yielding a response rate of 51 percent. Of those responding, 1,030 were currently practicing with either a BS or PharmD as their highest degree. Results indicate that BS level practitioners are more likely to be in hospital management or staff positions. The percent of time spent educating the public, pharmacy students and other health care professionals was the only job activity in which BS and PharmD practitioners differed to a statistically significant degree. Time spent processing the prescription and management activities had the most influence on job satisfaction. Academic degree did not have a statistically significant effect upon job satisfaction. These results suggest that when PharmD and BS pharmacists spend an equivalent amount of time doing the same job related activities, PharmD pharmacists are no more dissatisfied with their positions than are BS pharmacists.

Attitude of Health Personnel↗