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Biomedical subjects

D S Sloan

Publications and source records attributed to D S Sloan.

At least 19 recordsLinked to original sources
PubMed1996

The utilisation of hepatitis A vaccine 1992-1994.

OBJECTIVES: To assess the utilisation of hepatitis A vaccine in Scotland since it was licensed and also any impact this had on the utilisation of immunoglobulin prophylaxis. DESIGN: Collation and analysis of information obtained from the Pharmacy Practice Division and the Scottish National Blood Transfusion Service (SNBTS). SETTING: Scotland. 1992 to 1994 inclusive. SUBJECTS: All supplies/persons for whom hepatitis A vaccine or Human normal immunoglobulin (commercial or via SNBTS) was prescribed or dispensed in Scotland 1992-94. RESULTS: Hepatitis A vaccine started to be utilised very shortly after it became available. Utilisation has increased progressively since April 1992 with nearly 65,000 "courses' being prescribed in 1994. There has been no obvious impact on the use of immunoglobulin which has increased during this period. New formulations of the vaccine, e.g. paediatric and one dose courses have been rapidly assimilated by practitioners into their practice. Both vaccine and immunoglobulin utilisation follow a marked seasonal pattern with a peak every June. CONCLUSION: Statistics from the Pharmacy Practice Division proved useful in monitoring utilisation of this prescribed vaccine. The increasing utilisation of hepatitis A vaccine is a significant financial outlay for the NHS in Scotland. There may be significant non-compliance with the recommendations for restricting its use. The cost effectiveness of this immunisation for travellers has been recently called in question. The changing epidemiology of endemic infection is referred to in respect of possible immunisation programmes and the likely decline in efficacy of immunoglobulin. The need for more research on the incidence of hepatitis A antibody in the Scottish population is highlighted.

Drug Utilization Review↗
PubMed1994

Phyllanthus trial.

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Carrier State↗
PubMed1993

Travel medicine and general practice: a suitable case for audit?

Travel medicine becomes more important with the continual expansion of international travel and the increased popularity of exotic holiday destinations. In the United Kingdom general practitioners provide the bulk of travel health advice and immunisation and there is growing interest in providing these services. While their armamentarium has been expanded with attractive but expensive new vaccines, the need for health service advice has never been more vital, with the risks of HIV infection and drug resistant malaria. Advantages of a general practice based travel medicine service include maintaining continuity of care for the patient, but a disadvantage might be that the general practitioner sees too few patients to acquire enough skill in the subject. Furthermore, there may be a conflict of interest between time devoted to the "vaccination ritual" and giving health advice. Overall there seems to be a case for both audit and support by the health authorities.

Communicable Disease Control↗
PubMed1989

Unsafe home births.

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Delivery, Obstetric↗