[Social and other factors influencing drug usage: who used anti-depressive drugs?].
Explore the source record for details and available documents.
Age Factors↗
SEARCH · Search PubMed
Results for “Drug Usage”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Strengthening the formulary system by implementing a drug usage guidelines program.
The development and implementation of a Drug Usage Guidelines (DUG) program in a 1,200-bed, federal teaching hospital are described. The program was designed to promote effective formulary control through established procedures for the review and evaluation of drugs submitted to the Pharmacy and Therapeutics (P & T) Committee for addition to the formulary. The procedures required the submission of the DUG and an oral presentation to the Committee prior to any final vote on the request. Anticipated potential benefits of the DUG program are to: (1) stimulate rational drug therapy, (2) provide reliable drug information to the professional staff in a usable format, (3) promote a thorough evaluation of therapeutic agents before approving for formulary inclusion, and (4) provide physician-generated guidelines for use as criteria in drug utilization review audits.
Drug Utilization↗
Drug usage review of cefamandole at a teaching hospital.
A drug usage audit of cefamandole was conducted at a 900-bed teaching hospital. Health records of all in-patients receiving cefamandole during a three-month period (November 1, 1985 to January 31, 1986) were retrospectively reviewed. Treatment of lower respiratory tract infections accounted for 35 (44%) of the 79 treatment courses examined. Surgical antimicrobial prophylaxis for cardiovascular procedures involved 26 (33%) courses of therapy and 15 (19%) courses were associated with biliary tract procedures. The three remaining treatment courses (4%) included therapy for septicemia, orthopedic surgery prophylaxis, and a leg ulcer. Twenty-eight percent of all treatment courses were deemed to be appropriate. Thirty-two percent were considered controversial, and 40 percent inappropriate. The majority of the suboptimal use identified involved prescribing cefamandole for cardiovascular surgery prophylaxis. The role of cefamandole in the acute hospital setting is reviewed with reference to other available first, second and third-generation cephalosporins. General recommendations for its use are outlined.
Anti-Bacterial Agents↗
How to develop a successful DUE (drug usage evaluation) program: experience of a teaching medical center.
A drug usage evaluation (DUE) program was successfully implemented in a busy teaching medical center within 12 months of adding a full-time coordinator. The success of this program was due largely to its approval by hospital administration, the recruitment of a pharmacist with the necessary background, and the creation of a structure and process that encouraged participation by leaders of the medical staff. Although the primary objective of hiring the coordinator was to meet Joint Commission on Accreditation of Healthcare Organizations requirements for accreditation, another achievement was confirmed cost savings. Techniques used in selecting DUE subjects and the steps taken in implementing and managing the program are presented.
California↗
Drug usage review and inventory analysis in promoting rational parenteral cephalosporin therapy.
Drug usage review and inventory analysis data on the cephalosporin antibotics were presented by the pharmacy to a hospital pharmacy and therapeutics committee in an effort to promote rational use of these drugs and decrease drug costs. The committee recommended that cefazolin be the parenteral cephalosporin of choice. Cephalothin was placed on a limited formulary status for ophthamology patients and patients with renal impairment. Efforts by the committee to promote physician compliance with its recommendations are discussed.
Bacterial Infections↗
Drug usage guidelines, Part 3: assessment of acceptance of the program.
The Drug Usage Guidelines (DUG) program, as perceived by the members of the P & T Committee and by physicians who had prepared and submitted DUGs, was demonstrated to be an effective method for evaluating drugs for formulary inclusion. The majority of P & T members felt that the DUG program had strengthened the drug review process without being too tedious or preventing the addition of valuable drugs to the formulary. Sixty-eight percent of physicians who had submitted a DUG expressed the opinion that it served as a vehicle for providing educational information on rational therapeutics. A majority of respondents stated that they would recommend the DUG program to other hospitals.
Drug Utilization↗
Patterns of rheumatic diseases and antirheumatic drug usage in 11931 Indian patients.
Patterns of rheumatic diseases and antirheumatic drug usage in different regions of India were analysed. The data was collected from a post-marketing surveillance of diclofenac sodium (Voveran) in 11931 patients. The common conditions were-rheumatoid arthritis (RA) 28.1%, osteoarthrosis (OA) 24.8%, soft-tissue rheumatism 12.4%, cervical spondylosis 6%, ankylosing spondylitis (AS) 3.5%, gout 2%. East zone had a significantly lower proportion of osteoarthritis (20.9%). The age distribution and sex ratios of RA, OA and AS were in line with literature reports. The severity of illness was moderate in 62% and duration was more than 6 months in 50.2%. Data on NSAID usage showed a preponderance of combinations and ibuprofen. There were no significant differences in NSAID usage across diseases or regions.
Adolescent↗
An adverse drug reaction reporting system as an integral part of a drug-usage evaluation program.
The Adverse Drug Reaction program at CSMC identifies patients whose charts have been encoded with an ICD-9 code of E930 through E949, inclusively. Incidences per drug or drug category have permitted the Department of Pharmacy, acting through the Pharmacy and Therapeutics Committee, to review patient charts, identify trends and risk factors, and subsequently develop usage criteria for DUE studies. It is hoped that these activities will result in an improvement in usage of these drugs and a reduction in adverse drug reactions to them.
Digoxin↗
Paediatric inpatient morbidity patterns and drug usage in a teaching hospital serving an underdeveloped area.
Morbidity patterns and drug usage in hospitalized children in a developing area were prospectively studied. The study group consisted of 347 children (age 0-12 yrs) representing all admissions to a paediatric unit over a six month period. Respiratory tract diseases (30.5%) and infectious diseases (26.1%) were the most common reasons for hospitalization. Tuberculosis was the most common infectious disease seen among the hospitalized children. Antimicrobials (60.8%), iron preparations (45.5%), vitamins (43.2%) and antipyretics (29.9%) were the most frequently prescribed groups of drugs. Ampicillin was the most commonly used antimicrobial. Adverse drug reactions were seen in 1.7% of the children. The overall mortality was 9.2%. The mean length of stay was 7.9 days and the mean number of drugs used was 3.4 per patient. More than 4 drugs were prescribed in 54.4% of children. Approximately two thirds received parenteral therapy.
Child↗
Drug usage as a treat to the stability of treatment outcome: a one-year follow-up study of adolescent psychiatric patients.
OBJECTIVE: To examine the stability of treatment outcome one year after discharge from an inpatient treatment programme for adolescents with severe behavioural problems combined with psychiatric disorders. METHOD: Symptom Check List-90 Revised (SCL-90 R) ratings were obtained at admission, discharge and one-year follow-up for 75 patients. Treatment outcome was determined by calculating clinically significant change on the SCL-90 R Global Severity Index (GSI) between admission and discharge. Stability of treatment outcome was determined by comparing the clinically significant changes on the GSI between admission and discharge, and between admission and follow-up. RESULTS: Compared to baseline, 46.7% of the patients recovered (reliable change was found and their GSI at discharge was below the cutoff point for the functional population), 20% improved (reliable change was found, but the GSI was still above the cutoff point). For the other patients no reliable change was found (12.0%) or they deteriorated (21.3%). At follow-up, compared to the base score, 52.0% recovered, 13.3% improved, 12.0% showed no reliable change, and 22.7% deteriorated. Although for the whole sample no significant change was found between discharge and follow-up, some individual patients continued to improve after discharge, while others deteriorated. Analyses show that drug usage during the follow-up period is a strong predictor for these changes. CONCLUSION: The results indicated that the majority of the patients recovered or improved during treatment and this treatment outcome was relatively stable at one-year follow-up. However, in a minority of patients the treatment results deteriorated during the one-year follow-up period. Drug usage turned out to be an important predictor for this deterioration.
Adolescent↗
Drug usage guidelines, Part 2: Analysis of program outcome.
The effect of integrating a Drug Usage Guidelines (DUG) program with a hospital formulary system was analyzed. Significant changes were observed in both the number of requests submitted to the P & T Committee and the number of drugs added to the formulary after implementation of the DUG program. Failure to follow the DUG submission protocol, particularly with respect to the requirement for supportive clinical data from the primary literature, led to delayed consideration and eventual withdrawal of several highly promoted drug products. The initial involvement of physicians in the planning and implementation of the DUG program has been an important factor in the continued success of the program.
Drug Utilization↗
Fluconazole dosing in renal impairment: a drug usage evaluation.
Fluconazole is an antifungal agent available for oral and parenteral use. Drug dosage is based on the type and severity of infection, identity of the causative organism, the patient's renal function as determined by creatinine clearance, and response to therapy. To determine whether or not IV fluconazole was being dosed appropriately based on the above parameters, the pharmacy department at St. Joseph Hospital in Flint, Michigan, decided to perform a 3-month drug usage evaluation. As had been speculated, many fluconazole-treated patients were receiving inappropriate dosages. Specifically, renal function was not being taken into consideration in 30% of the cases. Additionally, 33% of patients received higher than necessary doses based on site and severity of infection. With the help of the P & T Committee, an educational program was implemented to assist physicians in the appropriate dosing of fluconazole.
Drug Utilization↗
Drug-usage evaluation by disease state: developing protocols.
The Joint Commission definition of drug-usage evaluation (DUE) also applies to DUE by disease state. The criteria for disease process selection, key processes being evaluated, methods to develop initial DUE protocols, and DUE validation and approval processes are reviewed. The treatment of community-acquired pneumonia is a disease state DUE performed at Saint Joseph Health Center in Kansas City, Missouri. The preliminary protocol was developed by a collaborative network of clinical pharmacists in the metropolitan area. Outcome measures were included in the evaluation. The results were used as baseline data in the development of a pneumonia clinical pathway.
Community-Acquired Infections↗
[Drug usage of men and women with coronary heart disease. Results of the German Federal Health Survey 1998].
When managing the risk factors of coronary heart diseases, therapies using drugs play an important role. This present study analyses self-reported data on current drug usage of men and women with coronary heart disease. The data were collected as a part of a wider drug utilisation survey which in turn is a module of the German National Health Interview and Examination Survey 1998 (Bundes-Gesundheitssurvey 1998). This survey was compiled by conducting a standardised computer-assisted medical interview with a representative sample of the German population between the ages of 18 and 79 years. Of the 7099 participants, 209 of the women and 252 of the men affirmed having had a medically diagnosed coronary heart disease (CHD) such as angina pectoris and/ or myocardial infarction. Slightly more men (87.3%) were using drugs to treat CHDs than the women (86.1%). They (the men) also used more drugs on average (men 3.3, women 3.0). These differences however were not statistically significant. Clear and statistically significant differences were present in the usage of salicylic acid (men 54.4%, women 45.6%), HMG CoA reductase inhibitors (men 26%, women 15.3%) and cardiac glycosides (men 14%, women 25.8%). The higher usage prevalence rate of salicylic acid found in the men still remained after taking their age, social status and the region (east vs west) into account. The differences in the usage of specific drugs in the treatment of CHDs in men and women indicate a difference in prescription behaviour in the ambulatory medical care. Whether and to which extent gender-specific differences still remain today has to be decided by using current epidemiological data representative of the population.
Adolescent↗
Relationship between antimicrobial drug usage and antimicrobial susceptibility of gram-positive mastitis pathogens.
The objective of this study was to analyze relationships between usage of antimicrobial drugs on dairy farms and results of antimicrobial susceptibility testing of mastitis pathogens. Exposure to selected antimicrobial drugs (n = 10) was standardized by calculation of the number of defined daily doses used per cow. Farms (n = 40) were categorized based on amount of antimicrobial exposure: organic (no usage); conventional-low usage (conventional farms not using or using less than or equal to the first quartile of use of each compound); and conventional-high usage (conventional farms using more than the first quartile of a particular compound). The minimum inhibitory concentration (MIC) of selected antimicrobial drugs was determined using a commercial microbroth dilution system for isolates of Staphylococcus aureus (n = 137), coagulase-negative staphylococci (CNS, n = 294), and Streptococcus spp. (n = 95) obtained from subclinical mastitis infections. Most isolates were inhibited at the lowest dilution tested of most antimicrobial drugs. Survival curves for Staph. aureus and CNS demonstrated heterogeneity in MIC based on the amount of exposure to penicillin and pirlimycin. For CNS, farm type was associated with the MIC of ampicillin and tetracycline. For Streptococcus spp., farm type was associated with MIC of pirlimycin and tetracycline. For all mastitis pathogens studied, the MIC of pirlimycin increased with increasing exposure to defined daily doses of pirlimycin. The level of exposure to most other antimicrobial drugs was not associated with MIC of mastitis pathogens. A dose-response effect between antimicrobial exposure and susceptibility was observed for some pathogen-antimicrobial combinations, but exposure to other antimicrobial drugs commonly used for prevention and treatment of mastitis was not associated with resistance.
Animals↗
Designing drug-usage evaluation to meet Joint Commission requirements.
Strategies for influencing prescribing practices utilizing the drug-usage evaluation (DUE) process are described. Our DUE program has evolved into a collaborative program that provides significant pharmacy involvement while maintaining medical staff responsibility, as outlined by the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission). A multidisciplinary approach is utilized to identify prescribing problems, develop prescribing criteria, and provide educational initiatives. Pharmacists provide drug therapy monitoring, engage in clinical interventions, and document the outcomes of these interventions. DUE pharmacists report results of these initiatives to the medical staff and quality assessment program. Physician performance compliance is incorporated into the credentialing process. Corrective measures are determined by the Pharmacy and Therapeutics Subcommittee, with subsequent actions carried out by peer physicians. The net result is a positive influence on prescribing practices that improves the appropriate and effective use of drugs, while meeting Joint Commission standards.
Cost-Benefit Analysis↗
Drug usage in newborn intensive care units.
A national survey of neonatal intensive care units (NICUs) was undertaken to obtain information concerning drug usage, dosages, methods of administration, incidence of drug-induced phlebitis, and drug reference sources. Antimicrobial agents are the most frequently used drugs in NICUs. Dosages reported by NICUs generally agreed with dosage recommendations by the manufacturer and literature citations. A 10% estimate of phlebitis was the consensus report by NICUs. Calcium gluconate was implicated most often as causing phlebitis, and most NICUs reported that drugs are not mixed with hyperalimentation solutions. The Pharmacy and Therapeutic Committee should review drug dosages in neonates and establish policies for intravenous drug administration methods and rates to ensure uniform initial doses and to provide a consensus among clinicians using these medications.
Data Collection↗
Dimensionality and the structure of student drug usage.
The purpose of this study is to explore the relationship between political alienation and drug behavior using nonmetric techniques. A survey of undergraduate students was used to explore the dimensionality of drug attitudes and behavior. Through the use of smallest space analysis a dimensional structure of two dimension was derived from the data. Two space diagrams were constructed and examined as to the rank order of distances between alienation and drug behavior. The finding of the analysis indicates the validity of a nonmetric approach which focuses upon the rank order of alienation and drug usage.
Humans↗