Biomedical subjects

J Kotzan

Publications and source records attributed to J Kotzan.

3 recordsLinked to original sources

PubMed2001

Assessing NSAID prescription use as a predisposing factor for gastroesophageal reflux disease in a Medicaid population.

PURPOSE: The purpose of the study was to determine the incidence of GERD associated with prescription NSAID consumption. METHODS: All Georgia Medicaid patients > 25 years of age and continuously eligible for 1996, 1997, and 1998 were included in the study. Patients were excluded if they received a GERD diagnoses during 1996 and 1997. Patients were observed in 1998 and classified into GERD and control cohorts. Comorbidities, demographics, and NSAID prescription consumption were retained and modeled with logistic regression. RESULTS: The absolute risk of developing GERD without previous NSAID consumption was 0.38. The absolute risk of developing GERD for those patients who consumed one or more NSAID prescriptions during 1996 and 1997 was 0.80. Thus, the relative risk of GERD for NSAID patients was 2.11. GERD was significantly associated with one or more NSAID prescriptions (OR = 1.82), age (OR = 1.05 for 5 year range), gender (OR = 1.31 for females), asthma (OR = 3.24), obesity (OR = 2.77), hiatal hernia (OR = 4.17), tobacco use (OR = 2.56), and alcohol (OR = 1.83). The initial NSAID prescription was responsible for the greatest marginal increase in GERD. CONCLUSIONS: Our study suggests that NSAIDs are associated with GERD especially for females, alcohol and tobacco users, and patients with asthma, hiatal hernia, or obesity.

Adult↗

PubMed1995

OBRA '90: the impact on pharmacists and patients.

Two separate studies were conducted in Georgia for this investigation. The first study measured by observation, pharmacists' compliance with the mandates of the Omnibus Budget Reconciliation Act of 1990 (OBRA '90) before (December 1992) and after (June 1993) the law took effect in January 1993. The second assessed patient awareness, experience, and degree of cooperation with pharmacists in complying with OBRA '90. Eight chain and four independent pharmacies were recruited for the first study. For the second, a representative sampling of patients answered questions by telephone. Findings from the pharmacy study indicated more streamlined information gathering, more time devoted to prospective drug utilization review, and a 29% increase in counseling frequency in the post-OBRA '90 period. Some changes may be due to increased computer sophistication. The patient survey indicated a lower frequency of counseling than was reported in the pharmacy study. Patients appeared willing to supply information to pharmacists when patients viewed it as a way to improve the care they receive.

Georgia↗

PubMed1978

Correlation of aspirin excretion with parameters from different dissolution methods.

The cumulative urinary excretion of four different aspirin products (two tablets, a capsule, and a timed-release tablet) was determined in a crossover study using five subjects. Comparison of in vivo results showed a significant difference in cumulative urinary excretion levels at only 1 hr. The excretion from the two regular tablets was significantly different from the timed-release tablet, but the capsule showed no significant difference from the other three products. Each product was tested in the USP, Levy beaker, and the regular and large magnetic basket dissolution apparatus. Analysis of variance of the in vitro results showed a significant difference between the aspirin products and the dissolution methods at selected times. In vitro comparison with in vivo results for the four products showed that a regression analysis can be used to determined which dissolution methods produce a significant correlation with urinary excretion.

Adult↗