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Biomedical subjects

C A Jankel

Publications and source records attributed to C A Jankel.

8 recordsLinked to original sources
PubMed1994

Effect of drug interactions on outcomes of patients receiving warfarin or theophylline.

The effect of drug interactions on costs and other outcomes for hospitalized patients receiving warfarin or theophylline was studied. Data were collected from medical records during a one-year period in two community teaching hospitals in Maryland. The data included demographic information, the duration of study-drug therapy, the number of days spent in the intensive care unit, the length of stay (LOS) in the hospital, the number of prothrombin-time tests and serum theophylline assays, and the test results. A multiple-regression procedure was used to compare outcomes of patients who were prescribed specific drugs interacting with warfarin or theophylline with those of patients who were not. Among warfarin-treated patients, there was a significant difference in each outcome measure (LOS, number of laboratory tests, and test results) between those who received an interacting drug and those who did not; mean LOS was 3.14 days longer in patients given an interacting drug. No significant differences in outcome measures were observed between the two groups of theophylline-treated patients. The cost of the increased LOS attributed to the presence of a drug interacting with warfarin was estimated to range from $779 to $1005 per hospitalization. The cost of additional prothrombin-time tests was estimated at $19-$50. Patients who received warfarin and an interacting drug had an increased LOS, required more laboratory tests, and had longer prothrombin times than patients given warfarin alone; these differences probably led to higher costs.

Adult↗
PubMed1993

Epidemiology of drug-drug interactions as a cause of hospital admissions.

The purpose of this review was to focus on hospital admissions caused by a specific type of adverse drug reaction (ADR) that can be assumed to be avoidable in almost all cases: the drug-drug interaction (D-DI). To determine the epidemiology of D-DIs in hospital admissions, a review of the adverse drug reaction literature was undertaken to answer several questions: (a) what is the incidence of hospital admissions attributable to D-DIs?; (b) what percentage of drug-related hospital admissions are attributable to D-DIs?; (c) are there any patterns to the above findings, i.e. are some D-DIs or specific drugs more likely to have been associated with hospital admissions?; and (d) are there certain patient risk factors (e.g. age) that are associated with D-DIs that led to a hospital admission? Nine ADR studies were found that either included a D-DI category as a cause for hospital admissions, or provided sufficient information so that a causal relationship could be inferred. The incidence of hospital admissions due to D-DIs ranged from 0 to 2.8%. The data found in the studies we reviewed, however, were insufficient to allow meaningful quantification of specific drugs as usual causes for D-DI-related admissions, and because of the very small numbers of patients for which a D-DI was believed to be the cause it is not possible to provide a meaningful summary of risk factors specific for D-DI admissions. We cannot conclude that D-DIs are a significant problem. There is a need to view the quantification of D-DIs in relation to the number of medications prescribed by physicians, dispensed by pharmacists and taken by patients.

Drug Interactions↗
PubMed1992

Evaluation of six computerized drug interaction screening programs.

Six widely used computerized drug interaction screening programs were evaluated according to criteria developed by a panel of pharmacists. A panel of six pharmacists from various practice settings developed criteria that were used to evaluate six computerized drug interaction screening programs: Medicom Micro Plus, Medical Letter, S-O-A-P, Drug Interactions by Hansten, Drug Therapy Screening Systems (DTSS), and RxTriage. The criteria were that the programs be user friendly and efficient, provide guidance, and be relevant to the user's practice setting. Also, they should detect interactions, quickly alert the user, and guide the user to the appropriate action. The user should be able to set the level of clinical significance, screen only current drugs in a patient profile, and print out summaries. The panel selected nine known drug interactions to test the programs' knowledge bases. Only Medicom Micro Plus and DTSS detected all nine drug interactions; Medical Letter missed three. RxTriage and Drug Interactions received the highest ratings in user friendliness and efficiency, but both missed two interactions. RxTriage was rated most relevant to their practice by hospital and community pharmacists, and Drug Interactions was rated most relevant by faculty practitioners. S-O-A-P received low ratings overall. Of the six drug interaction screening programs evaluated, none was considered by the panel of pharmacists to be ideal.

Data Display↗
PubMed1990

Detecting drug interactions: a review of the literature.

This article provides a historic overview of drug interaction screening and reviews 19 studies that have sought to measure the frequency of drug interactions. Differences in study designs, methodologies, and definitions contribute to considerable variation in the reported incidence rates, which ranged from 2.2 to 70.3 percent for all potential drug interactions. The percentage of patients actually experiencing symptoms that could be attributed to a drug interaction, however, ranged from 0 to 11.1 percent. The relative importance of drug interactions as a clinical problem remains unclear. Screening programs that do more than simply identify large numbers of patients who receive potentially interacting drug combinations without indicating which subpopulations of these individuals are likely to be harmed by the drugs have not yet been developed.

Ambulatory Care↗
PubMedDate not supplied

Drug information and educational needs. A survey of rural home health care nurses.

In a study of rural home healthcare nurses' drug information and educational needs, data were collected from 40 nurses employed by a community-based public home health agency. The most serious drug-related problem identified by the nurses was patients' failure to receive prescribed drugs. The ten types of drug-related information included in the survey were viewed as very useful. The most frequently used sources of drug-related information were reference books, other nurses, and pharmacists.

Community Health Nursing↗