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PubMed1990

[The study on Chinese herbal medicinal prescription with enzyme inhibitory activity. II. The study of kanbaku-taiso-to with adenosine 3',5'-cyclic monophosphate phosphodiesterase].

A Chinese herbal medicinal prescription, Kanbaku-taiso-to, was studied for the inhibitory activity of adenosine 3',5'-cyclic monophosphate (cAMP) phosphodiesterase. The effect for the inhibitory activity of cAMP phosphodiesterase in combination with constituent crude drugs and difference in kind of crude drugs of the prescription were studied. The inhibitory activity of the prescriptions which were combined with low protein content wheat were higher than that with high protein content wheat.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1991

[The study of Chinese herbal medicinal prescription with enzyme inhibitory activity. V. The study of hange-shashin-to, kanzo-shashin-to, shokyo-shashin-to with adenosine 3',5'-cyclic monophosphate phosphodiesterase].

Fifty-nine species of extracts of Chinese herbal medicinal prescription were tested for inhibitory activity of adenosine 3',5'-cyclic monophosphate (cAMP) phosphodiesterase (PDE). Kanzo-shashin-to showed the highest activity in these prescriptions. Kanzo-shashin-to, Hange-shashin-to and Shokyo-shashin-to, whose contracting crude drugs were very similar, were especially studied among these prescriptions. Pinellia tuber acted as an ascent component for Scutellaria root and a mitigatory component for Giycyrrhiza. Jujube acted as a mitigatory component for Glycyrrhiza. Ginger acted as an additional component for Scutellaria root in cAMP PDE test. This additional effect of 6-gingerol, 6-shogaol from Ginger and baicalin from Scutellaria root were investigated.

Catechols↗
PubMed1990

Cross-modal exercise prescription at absolute and relative oxygen uptake using perceived exertion.

Cross-modal exercise prescription at absolute and relative oxygen uptake using perceived exertion. Med. Sci. Sports Exerc., Vol. 22, No. 5, pp. 653-659, 1990. The validity of cross-modal prescription of exercise intensity based on rated perceived exertion (RPE) was determined for eight men (26 +/- SE 1.9 yr) at absolute and relative VO2. Exercise modes were treadmill (TM), cycle ergometer (C), and bench stepping while pumping 0.91 kg handweights (HB). Relative (Rel) constant load sessions were performed for each mode at 70% of mode-specific VO2 peak. Absolute (Absol) constant load sessions were performed for C and HB at the VO2 equivalent to 70% of TM VO2 peak. The five 12 min sessions were presented on separate days in random order. RPE-Overall during TM-Rel (11.1) was a) lower (P less than 0.05) than C-Absol (12.6) and HB-Absol (12.5) and b) the same as C-Rel (11.3) and HB-Rel (10.7). RPE-Legs during TM-Rel was a) lower (P less than 0.05) than C-Absol and HB-Absol and b) the same as C-Rel and HB-Rel. RPE-Chest a) did not differ between TM-Rel and C-Absol or HB-Absol and b) was lower (P less than 0.05) for C-Rel and HB-Rel than TM-Rel. RPE-Arms was higher (P less than 0.05) for C-Absol, HB-Absol, and HB-Rel than TM-Rel but did not differ between TM-Rel and C-Rel. Oxygen uptake, heart rate, and ventilation during TM-Rel were a) the same as C-Absol and HB-Absol and b) higher (P less than 0.05) than C-Rel and HB-Rel. Perceptually based cross-modal prescription of exercise intensity using a psychophysical estimation method is valid provided that the physiological reference is the relative, not the absolute, VO2.

Adult↗
PubMed2004

Fundamentals of resistance training: progression and exercise prescription.

Progression in resistance training is a dynamic process that requires an exercise prescription process, evaluation of training progress, and careful development of target goals. The process starts with the determination of individual needs and training goals. This involves decisions regarding questions as to what muscles must be trained, injury prevention sites, metabolic demands of target training goals, etc. The single workout must then be designed reflecting these targeted program goals including the choice of exercises, order of exercise, amount of rest used between sets and exercises, number of repetitions and sets used for each exercise, and the intensity of each exercise. For progression, these variables must then be varied over time and the exercise prescription altered to maintain or advance specific training goals and to avoid overtraining. A careful system of goal targeting, exercise testing, proper exercise technique, supervision, and optimal exercise prescription all contribute to the successful implementation of a resistance training program.

Exercise↗
PubMed2006

Profile of antihypertensive prescription in a developing country.

Data from pharmocoepidemiologic studies examining the patterns of antihypertensives prescription within a population are important for identifying any discordance between published recommendations and clinical practice. The aims of this article are to investigate the antihypertensive drug prescription pattern and utilization in the management of systemic hypertension among Nigerians, and to relate these to established guidelines. Within the population, the prescription pattern of antihypertensive drugs is still at variance with established guidelines.

Adult↗
PubMed1988

"Of no use without health": late nineteenth century medical prescriptions for female exercise through the life span.

In the rapidly changing society of the late nineteenth century, American medical theory and practice functioned as a social force to shape and limit the ways in which females viewed their physical potential. This paper analyzes the social and physical expectations which were elaborated for and experienced by middle-class urban females throughout their life span, identifies the kinds of exercise prescriptions which were promoted by doctors to assist women in fulfilling these expectations at different life stages and points out the underlying significance of these prescriptions in defining and perpetuating notions of females' limited physical capabilities. For late nineteenth century women, two significant influences upon their body behavior were: the physical realities of sickness and early death which modified, or curtailed female energy and physical capacity; and the discursive practices of medical experts and scientists concerning the identification and etiology of female ill-health and disease and their agreed upon therapies for assisting women to maintain, or regain their health. An understanding of the disease model which informed medical prescriptions for exercise explains, in part, why physicians concentrated their efforts upon women's reproductive capacity and lifestyle habits-rather than upon the widespread and devastating diseases that took such a toll upon women before the turn of the twentieth century.

Adolescent↗
PubMed1999

Prescription-type drug misuse and workplace access among nurses.

Access to prescription-type substances in the workplace is a unique feature of the practice of health professionals. Empirical data on the relation between workplace access to substances and prescription-type drug misuse among nurses are limited. Using an anonymous mailed survey, data were collected on three dimensions of access: perceived availability, frequency of administration, and degree of workplace control over storage and dispensing of substances. Each dimension was independently associated with increased use. When these dimensions were combined into an index, nurses with very easy access were most likely to have misused prescription-type drugs (adjusted Odds Ratio = 4.18; 95% Confidence Interval: 1.70-10.30). Level of knowledge of controlled substances was also associated with use, but did not explain the relation between access and use.

Adult↗
PubMedDate not supplied

Purchasing Medicare prescription drug benefits: a new proposal.

Medicare policymakers are considering using private-sector firms to offer and manage a prescription drug benefit. In such arrangements Medicare and its potential contractors will need to consider four major areas of risk: selection risk, cost management risk, risks of government as a business partner, and risks that new Medicare benefits will change competitive advantages. This paper considers these risk factors and suggests a model for Medicare prescription drug coverage. By adapting private-sector purchasing practices and using competitive markets, Medicare could offer prescription drug benefits--at affordable premiums for beneficiaries--without resorting to national price controls for pharmaceutical products.

Cost-Benefit Analysis↗
PubMedDate not supplied

Prescription drug spending trends for the privately insured in Maryland, 2000-2001.

Out-of-pocket drug spending per patient rose 25 percent in 2001 for the privately insured nonelderly in Maryland, outpacing the 10 percent increase in total drug spending per patient. Prescription drug use patterns changed little in response to a 30 percent rise in copayments, with the number of prescriptions per patient decreasing by 3 percent, and the proportion of generic drugs remaining steady. About 23 percent of patients spent less than 50 dollars on drugs in 2001, while 21 percent spent more than 700 dollars. Findings suggest that a greater proportion of the economic burden of prescription drugs in coming years will be borne by those who use them.

Adolescent↗
PubMedDate not supplied

Prescription drugs and the changing patterns of treatment for mental disorders, 1996-2001.

This paper uses detailed data on prescription drug and other services from the Medical Expenditure Panel Survey (MEPS) to examine recent trends in mental health and substance abuse (MH/SA) treatment between 1996 and 2001. While use of ambulatory services remained constant, prescription drug use increased rapidly, with the result that 5.5 million more Americans received treatment in 2001. Prescription drug spending increased at a real rate of almost 20 percent a year. About one-third of this increase came from more MH/SA medication users and two-thirds from higher costs per user.

Adolescent↗
PubMedDate not supplied

The role of PBMs in implementing the Medicare prescription drug benefit.

In creating the Medicare prescription drug benefit and stipulating that it be managed by private-sector prescription drug insurance plans, Congress opened a huge business opportunity for pharmacy benefit managers (PBMs). Although hardly noticed by the general public, PBMs already administer prescription drug benefits for nearly everyone with employer coverage and for many Medicaid recipients. The new law contains requirements for Medicare drug plan sponsors that could challenge some PBMs--most notably, the requirement to assume insurance risk. This paper explores challenges to PBMs' business practices and provisions of the Medicare benefit that will require them to adapt their mode of operation.

Administrative Personnel↗
PubMedDate not supplied

Prescription drug coverage and seniors: findings from a 2003 national survey.

Beginning in 2006 the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) will offer pharmacy benefits to forty-two million Medicare beneficiaries nationwide. In a 2003 national survey of Medicare beneficiaries age sixty-five and older, more than one-quarter reported no prescription coverage, and nearly half of low-income seniors in some states lacked coverage. Wide coverage differences among states highlight implementation challenges and the need for tailored enrollment strategies. Evidence of Medicaid's highly effective coverage delineates the importance of assuring this group's continued protection under Part D plans. Reports of complex drug regimens, multiple prescribing physicians and pharmacies, nonadherence, and reimportation demonstrate the challenges of integrating seniors' prescription care. We discuss MMA's potential to improve quality and the need to monitor performance.

Aged↗
PubMed1994

The effects of exercise testing on the prescription of oxygen therapy.

This study reviews the effects of using oxygen saturation measurements during exercise and the effects of the method of exercise testing on the prescription of oxygen therapy. Using cutaneous oximetry (designated A and B models) and co-oximetry, 25 of 41 patients (model A), 30 of 39 patients (model B), and 28 of 42 patients (co-oximetry) had an oxygen saturation measurement greater than 85 percent at maximal incremental exercise despite an arterial oxygen tension less than 55 mm Hg. Also, in a group of patients who underwent incremental followed by constant work rate testing, 9 of 28 exhibited a fall in arterial oxygen tension to 55 mm Hg or below only during the constant work rate testing. Oxygen saturation measurements cannot reliably be used as a substitute for arterial oxygen tension measurements for the prescription of oxygen therapy. The type of exercise study performed may influence the outcome of such oxygen prescription.

Aged↗
PubMedDate not supplied

Bariatric surgery: shedding the monetary weight of prescription costs in the managed care arena.

BACKGROUND: Prescription costs for treatment of comorbidities associated with morbid obesity is a considerable annual health-care expenditure. This study addressed the effect of Roux-en-Y gastric bypass (RYGBP) on diabetic and anti-hypertensive pharmaceutical utilization and cost savings at our institution. METHODS: Retrospective data from the electronic database of 51 consecutive patients, who underwent RYGBP from March 2001 to May 2002 were studied. Patients had BMI >40 associated with obesity-related diabetes and hypertension. Prescription medications utilized by this cohort were reviewed preoperatively and at 3- and 9-month intervals postoperatively. Significance was analyzed by paired t-test. RESULTS: Prevalence of diabetes and hypertension was 55.7% (29/53) and 44.3% (24/53) respectively, and 34% (18/53) patients had both co-morbidities. Preoperatively, patients were on an average of 2.44 +/- 1.86 medications at a cost of 187.24 USD +/- 237.41 USD per month. Postoperatively, the mean number of medications was reduced to 0.56 +/- 0.81 agents (P<0.001) at a monthly cost of 42.53 USD +/- 116.60 (P<0.001). CONCLUSIONS: RYGBP can decrease the prescription medication requirements, resulting in significant cost-savings in the treatment of obesity-related hypertension and diabetes. This study found a 77.3% reduction in total cost of diabetic and anti-hypertensive medications.

Adult↗
PubMed2005

Using the internet to provide information prescriptions.

INTRODUCTION: An information prescription is the provision of specific information to a patient on how to help manage a health problem. The Internet is being used increasingly as a source for information prescriptions, with clinicians directing patients to specific Web sites. As with any health care intervention, patients' lack of compliance is a barrier to the effectiveness of Web-based information prescriptions (WebIPs). WebIPs cannot be helpful if patients do not review the information prescribed for them. OBJECTIVE: The main objective of this study was to quantify the percentage of families who visit a Web site that was specifically prescribed by their physician. In addition, the use of an e-mail reminder was used to determine if it increases the likelihood that families will visit the prescribed Web site. Finally, barriers to accessing the prescribed Web site were identified. METHODS: Children were eligible if they presented to the pediatric gastroenterology clinic with chronic constipation and/or encopresis and their family had an active e-mail account and access to the Internet in their home. During their clinic visit, physicians instructed families to visit a Web site that provided educational information pertinent to their child's problem. Families were given a form with the Web-site address and a log-in identification number. Two days after their clinic visit, half of the families received an e-mail reminding them to visit the Web site. Families were contacted 1 week after their clinic visit to identify barriers to accessing the Web site. RESULTS: Eighty-three families participated in the study. Of the 83 families, 54 (65%) visited the prescribed Web site within 1 week of their clinic visit. Families who received e-mail reminders were significantly more likely to visit the Web site than families who did not receive an e-mail reminder (77% vs 53%). This difference could not be explained by the type or speed of Internet connection or how frequently they accessed the Internet or e-mail. The most common reasons that families cited for not accessing the Web site were "I forgot" and "I didn't have time." Few families cited technical reasons for not accessing the Web site. CONCLUSIONS: Almost two thirds of the families given a WebIP logged on to the prescribed Web site. The probability that families would access the site was increased by 45% with an e-mail reminder. Clearly, e-mail prompts improve compliance to WebIPs. As content and treatment programs continue to proliferate on the Web, it is important to identify barriers and solutions to them to improve overall compliance.

Adolescent↗
PubMed2001

Prescription and adherence to statins of patients with coronary artery disease and hypercholesterolemia.

OBJECTIVE: Statins have proved to be safe and effective in the secondary prevention of coronary artery disease, but the level of prescription and the reasons for nonadherence to treatment in many coronary diseases treatment centers has not been determined. The purpose of this study was to identify reasons for nonadherence to statin therapy. METHODS: We analyzed 207 consecutive patients with coronary artery disease and hypercholesterolemia (total cholesterol > or = 200 mg/dL or LDL-cholesterol > or = 130 mg/dL). Patients' average age was 61.7 +/- 10 year; 111 (53.6 %) male were and 94 (46.6 %) were female. We analyzed the level of prescription and adherence to treatment with statins. RESULTS: Statins were prescribed for 139 (67 %) patients, but only 85 (41 %) used the drug. In spite of being indicated, statins were not prescribed in 68 (33 %) patients. Of 54 (26 %) patients, nonadherent to statins, 67 % did not use the drug due to its high cost, 31 % due to the lack of instruction, and only 2 % due to side effects. Total cholesterol (260.3 +/- 42.2 vs 226.4 +/- 51.9; p < 0.0001) and LDL cholesterol (174.6 +/- 38.1 vs 149.6 +/- 36.1; p < 0.0001) were lower in patients on medication. HDL-cholesterol increased from 37.6 +/- 9.6 to 41.5 +/- 12.9 mg/dL (p = 0.02), and triglycerides were not modified in patients using statins. CONCLUSION: The prescription of statins in patients with coronary artery disease and dyslipidemia is high; however, its adherence is far from satisfactory, due to the high cost of the medication. Reduction in total cholesterol and LDL cholesterol levels did not reach the targets recommended by the Brazilian Consensus on Dyslipidemia.

Aged↗
PubMed2006

Relationships between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence among Filipino Americans.

OBJECTIVES: We examined associations between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence. METHODS: We used data from the Filipino American Community Epidemiological Survey, a cross-sectional investigation involving 2217 Filipino Americans interviewed in 1998-1999. Multinomial logistic and negative binomial regression analyses were used in assessing associations between unfair treatment and the substance use categories. RESULTS: Reports of unfair treatment were associated with prescription drug use, illicit drug use, and alcohol dependence after control for age, gender, location of residence, employment status, educational level, ethnic identity level, nativity, language spoken, marital status, and several health conditions. CONCLUSIONS: Unfair treatment may contribute to illness and subsequent use of prescription medications. Furthermore, some individuals may use illicit drugs and alcohol to cope with the stress associated with such treatment. Addressing the antecedents of unfair treatment may be a potential intervention route.

Adaptation, Psychological↗
PubMed2006

Comparison of the risk of drowsiness and sedation between levocetirizine and desloratadine: a prescription-event monitoring study in England.

BACKGROUND AND OBJECTIVES: Desloratadine and levocetirizine are histamine H(1) receptor antagonists (antihistamines) that were launched in the UK in 2001. Our objective was to compare the frequency with which drowsiness and sedation were reported for desloratadine and levocetirizine within the first 30 days of observation, as monitored using the observational cohort technique of prescription-event monitoring (PEM). METHODS: Exposure data were derived from dispensed prescriptions written by primary care physicians and outcome data were derived from questionnaires that were posted to prescribers at least 6 months after the date of the first prescription for each patient. The odds ratio (OR) was calculated using unconditional logistic regression modelling. The effect of age, sex, reported prescribing indication (allergic rhinitis with asthma/wheezing, allergic rhinitis without asthma/wheezing, 'other'), pattern of use and reported previous antihistamine use on the OR was examined. A time-to-event analysis was performed. RESULTS: The cohorts comprised >24,000 patients in total. Cohort demographics were similar (both cohorts: median age 37 years; 60% women); the most frequently reported prescribing indication for both drugs was allergic rhinitis without asthma/wheezing (54%). The incidence of first reports of drowsiness/sedation for levocetirizine or desloratadine was low (46 [0.37%] and 9 [0.08%], respectively) and statistically different (p < 0.0001). These events tended to occur earlier for desloratadine than levocetirizine (50% at 7 or 14 days of observation, respectively; p = 0.6487), but the cumulative time to event differed, with more events observed for levocetirizine than expected (p < 0.0001; 46 vs 28.09). The final estimates of risk were the sex-adjusted ORs for each prescribing indication category: allergic rhinitis with asthma/wheezing (3.51; 95% CI 0.71, 17.43; n = 3357), allergic rhinitis without asthma/wheezing (6.75; 95% CI 2.37, 19.22; n = 12,627) and 'other' (3.11; 95% CI 0.86, 11.31; n = 6725). DISCUSSION: Although the reporting rates of drowsiness and sedation are low for both drugs, patients prescribed levocetirizine are more likely to experience drowsiness and sedation in the first month of observation (after starting treatment) than patients prescribed desloratadine. For patients with allergic rhinitis without asthma/wheezing, the sex-adjusted odds of drowsiness/sedation were over six times greater in patients using levocetirizine than desloratadine in the first month of observation, with the OR being statistically significant. For the other two indication categories, allergic rhinitis with asthma/wheezing and 'other', the OR was not statistically significant. CONCLUSIONS: Although the risk of drowsiness/sedation is low, conditions such as allergic rhinitis are common, which makes any impact on patient cognitive function important. Doctors should be aware of this when prescribing these products to patients where daytime sedation is undesirable. However, essential components of the comparative benefit-risk evaluation of these two products include assessment of efficacy and patient preference (neither of which forms part of this study).

Adult↗