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PubMedDate not supplied

Pelvic inflammatory disease in the United States. Incidence and trends in private practice.

The National Ambulatory Care Survey, conducted by the National Center for Health Statistics (Rockville, Md.), provides national estimates for conditions diagnosed by office-based private practitioners in the United States. The Venereal Disease Control Division of the Centers for Disease Control (Atlanta, Ga.) obtained data from the National Ambulatory Care Survey for the years 1973-1976 and analyzed the epidemiology of pelvic inflammatory disease in women who sought care from private physicians. More that 7.5 million office visits for pelvic inflammatory disease were made over the four-year period (average, 1.89 million visits pe year). All races other than white bear a disproportionate burden of pelvic inflammatory disease. Since the advent of the National Gonorrhea Screening Program in 1972, the number of visits to private physicians for pelvic inflammatory disease has apparently declined.

Adolescent↗
PubMed1999

Hypertension management of medical aid patients attending private practices.

OBJECTIVES: The study aimed to describe the treatment status of hypertensive patients and the prescribing patterns of private medical practitioners treating medical aid scheme patients with hypertension. METHOD: Data on hypertensive patients belonging to medical aid schemes were provided to the drug utilisation review consultancy, Quality Health Services (QHS), by private medical practitioners. The data were computerised and included the age and gender of the patient, the diastolic and systolic blood pressure (BP), the medication prescribed for the condition and the qualifications of the reporting doctor. All the prescribed drugs were categorised into 12 drug classes and combination preparations had each constituent categorised. The level of BP allowed the degree of BP control to be described as controlled (< 140/90 mmHg), borderline (140/90-< 160/95 mmHg) and uncontrolled (> or = 160/95 mmHg). RESULTS: Included in the study were 11,696 hypertensive patients (46.3% male and 53.7% female) and the 3,503 doctors who cared for them. The systolic BP showed an age-related increase, but the diastolic BP did not. The level of BP control was high, with less than a quarter of patients having uncontrolled hypertension. The most frequently prescribed drug class was angiotensin-converting enzyme (ACE) inhibitors (32.2%). Beta-blockers accounted for 20.8% and calcium antagonists for 14% of all prescriptions. Thiazide and thiazide-like diuretics on their own accounted for only 7.8% of prescriptions. However, a further 13.8% of prescriptions contained this class of diuretics in combination with other drug classes. Diuretics of all classes taken on their own or in combination were used by 33.9% of patients. CONCLUSIONS: Good levels of hypertension control were reported for hypertensive patients by their private practitioners. Almost half of all prescriptions were for the newer and more costly antihypertensive drugs (ACE inhibitors and calcium antagonists), although their effectiveness in reducing long-term complications of hypertension is still unproven. Furthermore, these prescribing patterns do not conform to those recommended by the Southern African Hypertension Society's hypertension management guidelines.

Cross-Sectional Studies↗
PubMedDate not supplied

Treatment of infertility patients with hMG-IUI in a private practice.

Between December 1988 and September 1990, 132 patients were treated with 432 cycles of superovulation with hMG and timed IUI for various infertility subgroups in a private office setting. All patients had a complete infertility evaluation, including semen analysis, postcoital testing, hysterosalpingogram, endometrial biopsy and laparoscopy, and immunological testing in most cases. Abnormal factors were treated by conventional surgical and/or medical means. Most patients had at least a 6-month trial at achieving normal conception prior to hMG-IUI therapy. Patients received up to six cycles of treatment. Forty-five patients (34%) are still under treatment; thus far, the overall pregnancy rate is 58 of 132 or 44%. Of the 58 pregnancies, there were 13 abortions (22.5%) and two ectopic pregnancies (3.5%). The pregnancy rate per cycles has been 58/432, or 13.5%. The on-going pregnancy rate is 43/132, or 32.6%, or 32/432 (10%) per cycle. Treatment with hMG-IUI seems to approach that for IVF for most conventionally treated infertility subgroups. It can be done at a much lower cost per cycle, thus allowing a greater number of couples the availability of treatment. The authors suggest that most infertility patients be offered hMG-IUI therapy prior to IVF referral.

Adult↗
PubMedDate not supplied

Actors play patients. Using surrogate patients to look into private practice.

The authors describe a prospective research design in which actors serve as surrogate patients; this approach can be used to study health care delivery in providers' private offices. A previously published study -- in which an actor with actual dental pathology played the roles of a heterosexual, a homosexual, and an intravenous drug user to learn how dentists would respond to a new patient who appeared to belong to a group at hgh risk for AIDS -- offers an example of the design methodology. The authors discuss the benefits and limitations of the design and note that the behavior of other health care practitioners can be examined using simulated patients. Using carefully selected and trained professional actors rather than untrained patients or students can increase the reliability of findings and protect the rigor of the research.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Prescribing patterns of antimicrobial agents in private practice in Umtata, Eastern Cape, South Africa.

OBJECTIVE: To describe the prescription patterns of antimicrobial drugs in the private sector in Umtata. DESIGN: Descriptive, retrospective study. SETTING: Umtata Pharmacy, Umtata (a town in the Eastern Cape). MAIN OUTCOME MEASURES: Prescription patterns and quality of prescription indicators. METHODS: Retrospective analysis of all prescriptions for antimicrobial drugs between 1 January and 31 December 2000, noting the method of payment, number of drugs, use of generic or brand name, and also whether or not the following were stated: diagnosis, dose, dosage form, dosing interval and duration of treatment. RESULTS: There were 2352 prescriptions, of which 57.7% were paid through medical aid; 41.7% by cash, while 0.6% of the prescriptions had no form of payment stated. Only 10.4% of prescriptions used generic names exclusively; 83.2% used brand names alone and 6.4% had both generic and brand names. The form of payment apparently influenced the number of items per prescription, with the average number for medical aid prescriptions higher than for those paid for in cash (2.71 vs. 2.11; p < 0.001). Of the prescriptions 12.5% had five or more drugs. The diagnosis was not stated in 94.3% of prescriptions, the dose and duration of treatment were not properly stated in 53.3% and 59.6% of prescriptions respectively. The dosage forms and dosing intervals were stated in 99% and 85% of prescriptions, respectively. The most commonly prescribed antimicrobials were amoxycillin, metronidazole and ketoconazole. CONCLUSION: The low rate of generic prescribing and the incomplete nature of many prescriptions are a cause for concern. Their cost implications and possible effect on the effective use of antimicrobial agents are discussed.

Anti-Bacterial Agents↗