Biomedical subjects

G T Woodson

Publications and source records attributed to G T Woodson.

4 recordsLinked to original sources

PubMed1997

Whither triazolam?

OBJECTIVES: The authors compare the extent and nature of triazolam use before and after its deletion from a health maintenance organization's (HMO) open and advisory-type drug formulary. METHODS: Benzodiazepine dispensings of HMO members were collected for the 3 years before (1989-1991) and for the 2 years after (1992-1993) the deletion of triazolam from the HMO's drug formulary. The number of triazolam users, their sex and ages, total annual exposure, estimated daily doses, and total days of annual exposure were calculated and compared before and after its deletion from the formulary. RESULTS: From being the most frequently dispensed short-acting benzodiazepine in the HMO in 1989, the prescribing and use of triazolam decreased tenfold by the end of 1993. The effect on who was using the drug and how it was being used was less dramatic. The elderly were frequent long-term users and had the longest exposure to the drug. CONCLUSIONS: An open and advisory-type formulary can affect providers' drug selection behavior.

Adult↗

PubMed1997

Analysis of the costs of NSAID-associated gastropathy. Experience in a US health maintenance organisation.

Clinicians recognise nonsteroidal anti-inflammatory drugs (NSAIDs) as valuable first-line agents in the treatment of rheumatic disorders and as dangerous irritants to the gastrointestinal tract. This has led to questions about the economic impact of NSAID-induced gastropathy in populations. This study estimated the 1992 costs of NSAID-associated gastropathy episodes, and calculated an iatrogenic cost factor for NSAID-associated gastropathy among elderly members of a health maintenance organisation (HMO), the Northwest Region of Kaiser Permanente. Using data retrieved from automated databases and from medical records, NSAID and antiulcer drug costs were calculated, and estimates were made of the incidence rates of inpatient and outpatient NSAID-associated gastropathies, the services provided to treat them, and the cost of those services. Kaiser Permanente Northwest spent $US0.35 for each $US1.00 spent on NSAID therapy for the elderly, an iatrogenic cost factor of 1.35. The estimated average treatment per NSAID-associated gastropathy episode was $US2172. The average outpatient pharmacy cost per elderly NSAID user was $US80 and estimated average NSAID-associated treatment cost per elderly NSAID user was $US43. Although the findings were specific to the HMO because of the databases used, the methodology employed and the drug formulary influence on NSAID selection, they show that a substantial amount of resources were used to treat NSAID-induced gastropathies in the elderly, underscoring the risk of prescribing NSAIDs and reinforcing the need for their prudent use in elderly patients.

Adolescent↗

PubMed1992

Nicotine chewing gum use in the outpatient care setting.

BACKGROUND: The purpose of this study was to assess nicotine gum use when prescribed in a nonresearch, routine outpatient setting. Special attention was given to comparing actual use patterns with established guidelines for use based on clinical research. METHODS: A randomly selected group of 612 patients who had received a prescription for nicotine gum during an 18-month period were surveyed regarding their smoking history and use of the gum. RESULTS: Most of the gum prescriptions (75%) were requested by patients rather than recommended by medical care providers. Less than one half of the users were heavy smokers. The reported amount of gum used was small, with more than one half reporting consumption of one box or less, and about one third reporting use of the gum for only 1 week or less. Larger amounts of gum use, however, were associated with abstinence from tobacco. Only one in 20 users attended a structured behavioral treatment program while using the gum. Over one half of the patients reported using nicotine gum to help them cut down on, rather than quit, smoking. CONCLUSIONS: Only a small percentage of the patients used the nicotine gum according to the established guidelines, and most of the patients used the gum in ways that have been shown to be ineffective for smoking cessation. Providers should educate their patients in the techniques that maximize the use and effectiveness of nicotine gum in smoking cessation.

Adolescent↗

PubMedDate not supplied

Patterns of nicotine gum use in a health maintenance organization.

Nicotine chewing gum is designed as an aid to smokers who intend to stop smoking. However, the efficacy of the gum in general medical practice has been questioned. This study describes the extent of nicotine chewing gum use among health maintenance organization members, the characteristics of prescribers and users, and the patterns of gum use over a two-year period. About 0.4 percent of Kaiser Permanente, Northwest Region members were exposed to the gum. Over the two-year observation period, 1970 members received at least one box (96 pieces) of the gum. Almost 70 percent of users received only one box of the gum. About 1.5 percent of users appeared to use the gum continuously at a daily dosage around the level needed to replace the nicotine addiction among most smokers, and for longer than the recommended three months. Another 2.5 percent appeared to use the gum continuously but at less than a nicotine-addiction replacement dose for longer than the recommended maximum of six months. The presence of a prepaid prescription drug benefit directly affected whether or not a person received the gum and how long he used it. The extreme variation in the patterns of use raises the questions of why the gum is used in this manner, and how effective it is when used in this manner.

Adult↗