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Biomedical subjects

A B Amerson

Publications and source records attributed to A B Amerson.

At least 19 recordsLinked to original sources
PubMed1995

Implementation of a criteria-based antimicrobial formulary system.

The development of a criteria-based antimicrobial formulary system for use in a 432-bed university-based tertiary-care hospital is described. A subcommittee of the hospital's pharmacy and therapeutics committee developed prescribing criteria for antimicrobials thought to have a specific place in the treatment of various infections. The criteria were based primarily on patient needs, but when two therapies were thought to have similar effectiveness and similar toxicity profiles, cost became the deciding factor in drug selection. Educational packets were designed to assist physicians in prescribing criteria-based antimicrobials. An antimicrobial order form was also developed. The program was implemented after an extensive orientation and education period; data on antimicrobial use were collected for the first year of the program. Hospitalwide compliance with the criteria was 89%, although compliance in certain departments was poorer. The database was formulated to be both service- and physician-specific for the purposes of reporting and education.

Anti-Infective Agents↗
PubMed1991

Multidisciplinary education ensures successful formulary conversion.

Anticipating and preparing for objections to formulary changes is essential to the success of policies set by Pharmacy & Therapeutics Committees. At the University of Kentucky Medical Center, a 461-bed teaching hospital, an intensive educational plan was under way well before the hospital converted from ranitidine to cimetidine as the preferred formulary H2-receptor antagonist.

Cimetidine↗
PubMed1986

Drug information centers: an overview.

Drug information centers have existed for more than 20 years. Well over 100 centers function across the country, primarily affiliated with hospitals and/or colleges of pharmacy. The centers serve an audience of primarily health professionals but in some settings meet consumer needs. Three general areas of responsibility exist: service, education and research. In the area of service, specific functions such as answering questions, supporting the Pharmacy and Therapeutics Committee, and preparing newsletters are frequent. Educational responsibilities often include teaching pharmacy students drug information skills. Evaluation of the services has focused mostly on answering questions and Pharmacy and Therapeutics (P&T) Committee functions. Commercial information systems used by Drug Information Centers (DICs) are increasingly sophisticated and offer the opportunity to improve efficiency. Funding generally is provided by the institution with which the center is affiliated. Attempts to charge for services have provided only modest revenue. Drug information centers continue to mature and offer a useful service.

Data Collection↗
PubMed1986

Effectiveness of drug information centers.

Drug information centers (DICs) have existed for more than 20 years in the U.S., with the number growing over this period to approximately 120 centers. Although future growth in the number of centers will be limited, the present activities will become more refined and productive. The present activities of drug information centers can be classified into three general areas: service, education, and research. The scope of the services provided often depends on location and affiliations. Likewise, these same factors may influence involvement in education and research activities. The effectiveness of centers is measured most often in terms of service productivity and perceived value by users. The methods and results of such evaluations are reviewed with discussion of the need to develop more definitive standards of practice.

Drug Information Services↗
PubMed1986

Pharmacy initiatives to reduce clindamycin use.

The effectiveness of clinical pharmacists and attending physicians in altering the prescribing of metronidazole and clindamycin by resident physicians was evaluated, and the effect of these changes on antibiotic costs was determined. In July 1983, clinical pharmacists and attending physicians educated resident physicians about the efficacy and cost-effectiveness of substituting metronidazole for clindamycin in the treatment of intraabdominal and pelvic infections. A three-month educational program was implemented, which included distribution of a newsletter and involvement of clinical pharmacists in patient rounds. The use patterns of these drugs were then monitored for a 12-month period. A total of 425 treatment periods for 414 patients were reviewed, representing 91% of all therapy with metronidazole and clindamycin. Metronidazole use increased from 18.2% one month after implementation of the educational program to a plateau of 50% by November. Clindamycin expenditures decreased by more than 50% from the previous fiscal year, resulting in a savings of $33,469 to the pharmacy. The prescribing patterns of resident physicians were altered and cost savings were realized as a result of a comprehensive educational program that focused on substituting metronidazole for clindamycin. The program's success was enhanced because an equally efficacious agent was available and because of the participation of clinical pharmacists in patient rounds.

Anti-Bacterial Agents↗
PubMed1986

Evaluation of drug reviews.

Drug reviews appearing in Clinical Pharmacy, Drug Intelligence and Clinical Pharmacy (DICP), Drugs, and Pharmacotherapy from January 1982 through December 1984 were evaluated for number, duplication among journals, timeliness, scope, and format. The design of this study was primarily quantitative rather than qualitative. Pharmacotherapy published the most reviews (49), followed by Drugs (43), Clinical Pharmacy (37), and DICP (29). Drugs and Pharmacotherapy published the largest number of unique reviews (agents not reviewed by the other journals during the study period), while Pharmacotherapy and Clinical Pharmacy published the most reviews on newly marketed drugs. Reviews of four drugs (acyclovir, moxalactam, ranitidine, and trazodone) were compared in terms of major sections, terminology and format, bibliography, use of tables and figures, scope of evaluative comments, and review process. Reviews in Drugs consistently contained the most references and tables and provided the most detail. Information was most accessible in Drugs, followed by Pharmacotherapy. Drugs used the largest panel of reviewers. All of the journals provided evaluative comments, although the scope varied. Continuing-education credit is available for review articles in Clinical Pharmacy and DICP. In selecting one or more of these journals, individuals or institutions should compare their needs with regard to the timeliness, scope, and format of the review articles in each journal.

Evaluation Studies as Topic↗
PubMed1983

Twenty years' experience with drug information centers.

The origin, growth, and development of drug information centers (DICs) are reviewed. The first center was established in 1962 to assist in a more selective and rational approach to drug therapy. Initial expectations and the development of other centers are described. Regional programs were initiated in the late 1960s and early 1970s. Currently there are more than 100 centers in the U.S.; a recent survey revealed that 81% are affiliated with a hospital or medical center and 37.5% with a poison-control operation. Affiliations of DICs with pharmaceutical-education programs are increasing. The influence on pharmacy and therapeutics committees of DIC reports is discussed, as is the role of community-oriented DICs in promoting appropriate drug use. No generally accepted criteria for measuring the usefulness and quality of DICs have been established. Centers have been evaluated on the basis of number and type of questions received, but the growth of clinical pharmacy practice may affect these statistics. A peer-review committee has been reported, and physicians' attitudes about DICs have been surveyed. In the future, attention will be concentrated on funding sources and applications of computerized drug information and retrieval systems. Decrease in numerical growth of DICs and expansion of service to consumers are expected. As a link between pharmacy and therapeutics committees, physicians, and clinical pharmacy practitioners, DICs will assume a more active role in influencing drug-use policy.

Drug Information Services↗
PubMed1982

Factors potentially influencing aminoglycoside use and expenditure.

Factors that may have influenced aminoglycoside use and expenditure in one hospital were examined. Factors that were evaluated as to their influence on aminoglycoside-use patterns were: (1) formulary status; (2) bacterial susceptibility patterns; (3) identified or perceived differences in toxicity; (4) changes in patient population; (5) price paid by the hospital for aminoglycosides; (6) distribution of newsletters or memoranda; (7) advertising and detailing; and (8) pharmacy policies. For FY 1976-77 to 1979-80, the largest proportion of aminoglycoside expense was for gentamicin. During FY 1980-81, the expenditure for gentamicin decreased and tobramycin accounted for the largest proportion of total expenditure. Monthly gentamicin use decreased 20% during FY 1980-81 from the previous year. Tobramycin use increased from January 1979 to November 1980 and decreased from December 1980 to June 1981. Kanamycin use and amikacin use were fairly constant during the study period. Based on temporal relationships, the following factors appeared to influence aminoglycoside use and expenditure: (1) a study conducted at the institution from June 1977 to June 1979 comparing gentamicin and tobramycin nephrotoxicity; (2) a comparative nephrotoxicity study published in a widely circulated medical journal in May 1980; and (3) an intramural newsletter and memorandum distributed in March 1981 encouraging selective aminoglycoside use. The identification of factors that potentially influenced aminoglycoside use can be used to anticipate the future impact of similar events and to devise strategies to influence antimicrobial use.

Aminoglycosides↗
PubMed1980

Evaluation of patient medication counseling sources.

Seven sources of information on patient medication counseling were evaluated. Each source was reviewed for inclusion of five types of information on 20 drugs selected randomly from the top 200 prescription drugs. The ASHP's Medication Teaching Manual was the most complete source in terms of including the largest number of sample drugs. Apelgren and Rowles's Handbook for Counseling Patients on Their Medications, Griffith's Drug Information for patients, Maudlin and Young's Drug Consultation Guide, and Smith's Medication Guide for Patient Counseling were nearly as complete in this regard. In terms of including information in each of the five categories for the sample drugs, the U.S. Pharmacopeia Dispensing Information and the Medication Teaching Manual ranked highest. Cost, size, format, and indexing of the sources are compared, and special features and limitations of the source are presented. All the publications are at least adequate patient counseling sources, although some are more complete and thorough than others.

Counseling↗