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Biomedical subjects

A G Lipman

Publications and source records attributed to A G Lipman.

At least 37 records · Page 2Linked to original sources

Editors' roundtable: Current formulas for P & T Committee success (Part 1).

In this roundtable discussion, the four editors of Hospital Formulary--Arthur G. Lipman, Pharm D, Harold C. Neu, MD, Bramah N. Singh, MD, PhD, and Michael Weintraub, MD--share their views on key issues that affect hospital P & T Committees. They agree that the P & T Committee is both highly visible and functions well, and they predict that its influence in the health care system wil heighten as prospective reimbursement continues. Challenges P & T Committees are confronted with today, such as therapeutic entities from new technologies, use of approved drugs for unapproved indications, and the need for educating and re-educating the medical staff are discussed. Cost containment continues to become a more and more important consideration with maintained patient care quality. Successful strategies for coping with and benefiting from these challenges are presented.

Conflict, Psychological↗

Integrating clinical and distributive pharmaceutical services: implications for clinical pharmacy education.

For over two decades, pharmaceutical educators and practitioners have debated whether clinical and distributive pharmaceutical services should be integrated or segregated, i.e., performed by different persons. The recently defined new federal system for reimbursing hospitals for care of Medicaid patients and other beneficiaries according to a prospective reimbursement plan impacts directly on this debate. A cross section of the profession has recently reached consensus on the definition of clinical pharmacy at a national invitational workshop. Fiscal constraints also impacted on the question in schools which are no longer able to keep expanding their clinical faculties. These factors are related questions which academic clinical pharmacy must face are discussed.

Curriculum↗

Communicating.

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Communication↗

Formulary system controversies in the new environment of DRGs.

The currently rapid growth in the hospital industry is expected to continue. The massive increase in the aged population in the US, resulting in a shift from acute to chronic care, will also result in changes in reimbursement strategies. These changes, as well as structural changes in the health care system (HMOs, multihospital systems, PPOs, and so on), will have a profound impact on the way in which the P & T Committee functions. Contemporary management of drug distribution systems is essential in order to maintain financial viability within institutions. Implications for the role of P & T Committees in the future are discussed.

Diagnosis-Related Groups↗

Adjunctive antianxiety agents in the management of chronic pain.

We examined the relative clinical efficacy of three commonly used antianxiety medications and a placebo as adjuncts to analgesic treatment of chronic cancer and arthritic pain. Nine patients with chronic pain, including six with malignancy and three with rheumatic diseases, were each exposed to three treatment phases with antianxiety drugs (hydroxyzine, prochlorperazine, and chlordiazepoxide) and one placebo phase in a double-blind, counter-balanced design. Each phase lasted 2 weeks, with analgesic medication given throughout. Pre- and post-phase measures of anxiety, depression, and hostility were taken, together with daily reports by the patients on pain, mood, and medication intake. None of the antianxiety drugs were significantly more effective than the placebo in reducing pain levels, daily medication usage or hostility. Chlordiazepoxide significantly reduced anxiety and depression compared with the placebo, but also produced the most side effects (e.g., drowsiness). The preliminary findings failed to support the efficacy of the three antianxiety medications as analgesic adjuncts.

Adult↗

Costs of care.

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Cost Control↗