RÉSUMÉ
This study evaluated the economic impact of patient-focused pharmacist intervention in the community retail setting in patients with hypertension, diabetes, asthma, and/or hypercholesterolemia. Specially trained pharmacists intervened by providing targeted patient education, performing systematic patient monitoring, offering feedback and behavior modification, and communicating regularly with patients' physicians to enable early intervention for drug-related problems. We evaluated prescription drug costs and total medical costs by comparing claims data from 188 patients enrolled in the program at three intervention pharmacies with data from 401 control patients at five nonparticipating pharmacies from the same retail chain. For all disease states, the average cost per prescription was significantly higher in the group receiving intervention than in the control group. Differences in total monthly prescription costs were significant only for patients with asthma, with higher monthly costs in the group receiving intervention. Substantial savings were demonstrated across all cost analyses for total monthly medical costs. Savings ranged from a conservative estimate of $143.95 per patient per month to $293.39 per patient per month when accounting for the possible influence of age, comorbid conditions, and disease severity. Our data indicate that pharmacist intervention in this community pharmacy-based disease management model substantially reduced monthly health care costs in patients with hypertension, hypercholesterolemia, diabetes, and asthma.
Sujet(s)
Services des pharmacies communautaires/économie , Services des pharmacies communautaires/organisation et administration , Pharmacoéconomie , Frais d'ordonnance , Sujet âgé , Femelle , Coûts des soins de santé , Humains , Mâle , Adulte d'âge moyen , Éducation du patient comme sujetRÉSUMÉ
Disorders of the central nervous system provide innumerable challenges to the clinician. Often the underlying pathophysiology is not completely understood, thus preventing the design of treatment strategies aimed at correcting the underlying process. In this decade of the brain, basic science research combined with difficult but necessary clinical trials may answer some of these seemingly over-whelming questions for these devastating illnesses.
Sujet(s)
Maladie d'Alzheimer/traitement médicamenteux , Angiopathies intracrâniennes/traitement médicamenteux , Maladie de Parkinson/traitement médicamenteux , Anticoagulants/usage thérapeutique , Apomorphine/pharmacologie , Acide acétylsalicylique/usage thérapeutique , Angiopathies intracrâniennes/prévention et contrôle , Agents cholinergiques/usage thérapeutique , Agonistes de la dopamine/pharmacologie , Humains , Inhibiteurs de la monoamine oxydase/pharmacologie , Antiagrégants plaquettaires/usage thérapeutique , Tacrine/usage thérapeutiqueRÉSUMÉ
When caring for patients with disorders of the central nervous system such as migraine headaches, epilepsy, or MS, clinicians are faced with increasingly complex pharmacotherapeutic options. Pharmacotherapeutic strategies directed toward prevention, reversal, or cure of these diseases are hampered by an incomplete understanding of the underlying pathophysiology. In this decade of the brain, basic science research combined with difficult but necessary clinical trials may answer some seemingly overwhelming questions for these devastating illnesses.
Sujet(s)
Épilepsies partielles/traitement médicamenteux , Migraines/traitement médicamenteux , Sclérose en plaques/traitement médicamenteux , Adjuvants immunologiques/usage thérapeutique , Administration par voie nasale , Administration par voie orale , Anticonvulsivants/usage thérapeutique , Dihydroergotamine/usage thérapeutique , Agonistes GABA/pharmacologie , Humains , Injections rachidiennes , Interféron bêta-1a , Interféron bêta-1b , Interféron bêta/usage thérapeutique , Vasoconstricteurs/usage thérapeutiqueRÉSUMÉ
Post-traumatic seizures are a well-recognized complication of head injury; however, the issue of seizure risk assessment remains controversial. The authors present a critical review of the literature pertaining to post-traumatic seizures, with particular emphasis on current concepts of definitions, incidence and risk factors. Different methods of risk assessment are reviewed and the possibility of utilizing functional imaging techniques for seizure risk assessment is also explored.