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A survey of drug usage among patients admitted to a psychiatric hospital.

A six-month survey of the urinary concentrations of drugs and alcohol of 176 patients within one hour of their admission to the acute psychiatric wards of the Macquarie Hospital, Sydney, is reported. Non-prescribed drugs were detected in the urine specimens of 29.5% of patients and alcohol in the urine specimens of 13.6% of patients. The survey demonstrated inconsistencies between patients' reports of their recent drug or alcohol intake and the laboratory findings, and inadequacies in the information recorded and relayed to the laboratory at the time of patients' admission to the hospital.

Adolescent↗

Alcohol and drug usage in parents soon after stillbirth, neonatal death or SIDS.

The behaviour of bereaved parents with respect to their drug and alcohol ingestion was examined 2 months following the loss of an infant from stillbirth (SB) neonatal death (NND) or sudden infant death syndrome (SIDS). Responses from bereaved families (99 SB, 109 NND, 52 SIDS) were compared with 252 control families (who had a liveborn infant). There was no difference in self-medication using aspirin as the example. The use of sedative drugs was significantly higher in all bereaved mothers (but especially the SIDS group). Use of sedatives by fathers was significantly higher only in the SIDS group. There was also a greater frequency of heavy drinking of mothers in all the bereaved groups and fathers in the SIDS group. These results have implications for the understanding and care of families following infant loss.

Alcohol Drinking↗

Drug usage by patients attending chiropractic clinics.

While chiropractors themselves offer a "natural" form of health care, their patients are drawn from a drug-ingesting population. This survey, conducted on patients attending chiropractic teaching clinics, found that more than 92% of respondents used drugs. Drugs assessed included nutritional supplements, social and prescription drugs. This paper considers the clinical manifestations of drugs frequently encountered in this study and comments on their impact for chiropractic practitioner's clinical practice.

Adult↗

Drug-usage evaluation: traditional versus outcome-based approaches.

The use of outcome assessment with DUE can provide more detailed information on the impact of drug therapy on the overall health status of the patient, rather than just the narrow view of the drug-prescribing process within the institution. These studies may justify additional pharmacists to help in the selection of drugs and their potential to affect overall quality patient care. In addition, the Joint Commission is recommending that measurement of health outcomes is important in QA. The Joint Commission has stated in their Agenda for Change program "that patient outcomes are influenced by all activities of a health care program." The Joint Commission plans to develop standards that "describe in functional terms what the key jobs are that need to be done to produce good patient outcomes." The major problem with adding outcome measures in the assessment of DUE programs is the evolutionary nature of the available technology to measure these patient outcomes. Incorporation of outcome measures into DUE programs can provide measures of the impact of drug therapy on the patients' HQOL. This HQOL is potentially a better reflection of patient outcomes and the assessment of quality of care.

Drug Utilization↗

DUE (drug usage evaluation) of ticarcillin and clavulanate potassium: determining appropriate and cost-effective therapeutic options.

The initial 46 patients who were prescribed the combination drug ticarcillin disodium and clavulanate potassium in a 640-bed teaching hospital were evaluated to determine the potential usefulness of the drug in the institution. The review revealed frequent use of the drug for inappropriate indications and in situations for which less expensive antimicrobials were appropriate. The results demonstrate that an increase in costs can occur when an agent that is being considered for formulary addition--because of its cost-saving potential--is not used as expected. In order to optimally utilize the clinical or cost advantages of newer antimicrobials, a program of prescriber education, drug use controls or guidelines, and a concurrent monitoring program may be required and should be implemented at the time of initial drug use within an institution.

Anti-Bacterial Agents↗