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Biomedical subjects

B Sleath

Publications and source records attributed to B Sleath.

7 recordsLinked to original sources
PubMed1997

Physician vs patient initiation of psychotropic prescribing in primary care settings: a content analysis of audiotapes.

The primary goals of this study were to examine: (1) whether patients were involved actively in initiating the prescribing of psychotropic medications during interactions with their primary care physicians and (2) what variables influenced patient vs physician initiation of psychotropic prescribing. An analysis of 508 audiotapes of physician-patient interactions and interviews with each patient and physician from 11 different ambulatory care settings was conducted. Of 508 patients, 17% (n = 88) received prescriptions for one or more psychotropic medications. Forty-seven percent of repeat psychotropic prescriptions and 20% of new psychotropic prescriptions were initiated by patients. Logistic regression techniques showed that patients with higher incomes were more likely than their physicians to initiate psychotropic prescribing, whereas physicians were more likely to initiate psychotropic prescribing with lower income patients (P < 0.001). Patients who had more previous visits to their physician were as likely as their physicians to initiate psychotropic prescribing, whereas physicians were more likely to initiate psychotropic prescribing with patients who had been to see them fewer times in the past (P < 0.05).

Adult↗
PubMed1997

Physician responses to an educational intervention on improving their long-term prescribing of sedatives.

The current study examined response forms returned by physicians in response to a Medicaid retrospective therapeutic intervention on the long-term use of sedatives. The educational intervention was designed to notify physicians about their patients' long-term use of sedatives and suggest that they reevaluate the patient's need for sedative hypnotic medication and decrease or discontinue prescribing the medication and/or suggest non-pharmacological alternatives if deemed appropriate. Forty-seven percent of physicians responded to the educational intervention. Nineteen percent of responding physicians planned to change the patient's medication in some way. The most common planned change was to decrease the dose. Physicians also stated that they would recommend one or more non-pharmacological alternatives to 17% of patients. Thirty-eight percent of physicians planned to monitor and/or counsel the patient. Over 40% of physicians reported planning no action after receiving the intervention. Twenty-six percent of physicians planned no action because of patient demand for the sedatives. The study concludes that physicians need to be better trained on how to: (1) discuss non-pharmacological treatments with patients and (2) deal with and respond to patients who demand controlled substances.

Adult↗
PubMed1996

Medication decision-making and management: a client-centered model.

Although the traditional medical model dominates how 'provider-patient' roles are viewed, research has documented that client medication behavior strongly influences health outcomes, health care utilization, and ultimately health care costs. This paper explores the position that medication management outcomes can be improved by adopting more client-centered approaches. To examine the implications of a client-centered relationship this paper reviews research regarding client involvement in: (1) identifying treatment goals; (2) choosing from regimen options; (3) monitoring symptoms and evaluating regiments; and (4) self care with nonprescription pharmaceutical products. Based on this literature review, a collaborative client-centered model of medication consultation is examined, and implications for health care provider roles and public policy in pharmaceutical care are discussed.

Drug Therapy↗
PubMed1996

Pharmacist-patient relationships: authoritarian, participatory, or default?

The purpose of this study was to investigate the nature of pharmacist-patient relationships in New Mexico community pharmacies. A total of 344 pharmacy personnel-patient interactions were observed. Pharmacists interacted with only 57% of patients who were picking up their prescriptions. Pharmacists used an extensive participatory style with only 13% of the patients who they interacted with. Pharmacists were significantly more likely to use a participatory style with older patients and with patients who were picking up refill prescriptions. The average length of pharmacist-patient encounters was just less than 2 min (114s). Pharmacist-patient interactions were significantly longer if: (1) pharmacists used more of a participatory approach with patients and (2) pharmacists gave more drug information to patients.

Adolescent↗
PubMedDate not supplied

Response forms reflect pharmacists' participation in retrospective DUR.

This study examined pharmacists' responses to two different Medicaid retrospective therapeutic interventions (excessive use of beta 2-agonist inhalers and long-term use of sedatives) in New Mexico. It also examined the types of actions pharmacists reported taking, and the differences between actions taken by physicians and pharmacists in terms of response rate, tone of responses, and time spent responding to the intervention. The most frequent pharmacist action was to call the physician. Response rates for the drug use review (DUR) program were higher for physicians than for pharmacists; pharmacists also took twice as long as physicians to respond to both interventions. The study results indicate a need for better methods to document clinical services performed by pharmacists under the Medicaid DUR program to obtain reimbursement and justify therapeutic decisions. Pharmacists also need documentation methods that are relatively easy to use so that they can respond more quickly to interventions.

Adrenergic beta-Agonists↗