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Gregory P Schepers

Publications and source records attributed to Gregory P Schepers.

3 recordsLinked to original sources
PubMed2006

Practitioners' views on computerized drug-drug interaction alerts in the VA system.

OBJECTIVES: To assess Veterans Affairs (VA) prescribers' and pharmacists' opinions about computer-generated drug-drug interaction (DDI) alerts and obtain suggestions for improving DDI alerts. DESIGN: A mail survey of 725 prescribers and 142 pharmacists from seven VA medical centers across the United States. MEASUREMENTS: A questionnaire asked respondents about their sources of drug and DDI information, satisfaction with the combined inpatient and outpatient computerized prescriber order entry (CPOE) system, attitude toward DDI alerts, and suggestions for improving DDI alerts. RESULTS: The overall response rate was 40% (prescribers: 36%; pharmacists: 59%). Both prescribers and pharmacists indicated that the CPOE system had a neutral to positive impact on their jobs. DDI alerts were not viewed as a waste of time and the majority (61%) of prescribers felt that DDI alerts had increased their potential to prescribe safely. However, only 30% of prescribers felt DDI alerts provided them with what they needed most of the time. Both prescribers and pharmacists agreed that DDI alerts should be accompanied by management alternatives (73% and 82%, respectively) and more detailed information (65% and 89%, respectively). When asked about suggestions for improving DDI alerts, prescribers most preferred including management options whereas pharmacists most preferred making it more difficult to override lethal interactions. Prescribers and pharmacists reported primarily relying on electronic references for general drug information (62% and 55%, respectively) and DDI information (51% and 79%, respectively). CONCLUSION: Respondents reported neutral to positive views regarding the effect of CPOE on their jobs. Their opinions suggest DDI alerts are useful but still require additional work to increase their clinical utility.

Attitude of Health Personnel↗
PubMed2002

Antihypertensive medication compliance in a Veterans Affairs Healthcare System.

OBJECTIVE: To compare compliance rates associated with categories of antihypertensive medications in a Veteran's Affairs (VA) Healthcare System by use of readily available data and standard software. METHODS: Prescriptions from the Veteran's Health Information System Technology Architecture (VISTA) database for angiotension-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, calcium-channel blockers (CCBs), diuretics, and a miscellaneous group of antihypertensives filled or refilled during a 12-month period were included in the analysis. Claims data for each prescription were exported from the VISTA database to Microsoft Excel, and compliance rates were calculated by use of a methodology reported elsewhere. Mean compliance rates for each antihypertensive category were compared. RESULTS: A total of 26 201 prescription records accounting for 51 927 separate prescription fills or refills were included. The majority of prescriptions (77%) were associated with calculated compliance rates >80%. The CCB category was associated with a significantly higher compliance rate (p < 0.001) than the beta-blockers (95% CI 1.3% to 3.7%), diuretics (95% CI 1.4% to 3.8%), and miscellaneous agents (95% CI 1.7% to 7.5%). The ACE inhibitor category was associated with a significantly higher rate (p < 0.001) than the beta-blockers (95% CI 0.7% to 3.0%), diuretics (95% CI 0.7% to 3.0%), and miscellaneous agents (95% CI 1.1% to 6.8%). The ARB category had a higher compliance rate (p < 0.001) than the miscellaneous category (95% CI 1.2% to 11.9%). There were no significant differences in compliance rates among ACE inhibitors, CCBs, or ARBs. CONCLUSIONS: VA outpatients are relatively compliant when taking their antihypertensive medications as measured by prescription refill rates. Compliance rates for CCBs and ACE inhibitors are higher than those for beta-blockers, diuretics, and agents such as clonidine, methyldopa, hydralazine, and reserpine. Compliance for ARBs compared favorably with those of CCBs and ACE inhibitors. The methods used in this evaluation can be easily implemented at other institutions as part of ongoing medication compliance improvement efforts.

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