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Biomedical subjects

J T Cirn

Publications and source records attributed to J T Cirn.

6 recordsLinked to original sources
PubMed1982

Inadequately written prescriptions: prescriber rationales for "take as needed" and "take as directed.".

An audit of a large sample of prescriptions written by 39 physicians revealed considerable variation in the rate at which they specified adequate dosage instructions. When asked for their rationales for saying "Take as needed" or "Take as directed" on prescriptions, the physicians cited several circumstances where these instructions may be indicated. "Take as directed;; is defended 1) when the patient has a history of compliance with the regimen being prescribed; 2) when the prescription is accompanied by verbal or auxiliary written instructions; 3) when oral contraceptives are ordered; and 4) when the prescribers may need to make frequent changes in a regimen and wish to communicate these changes orally. "Take as needed" is defended when the drug is to be taken only when the patient determines that sufficient symptoms have appeared. Prescribers are cautioned to consider whether the assumed advantages of nonspecific dosage instructions are outweighed by the possible risks of patient confusion.

Drug Labeling↗
PubMed1980

Pharmacists' views of an experience in capitation reimbursement under the Iowa Medicaid drug program.

The Iowa Medicaid Drug Program recently performed a 2-year experiment in capitation reimbursement of pharmacies in two counties. The aim was to reduce costs and improve the quality of services by creating new economic incentives for pharmacists to expand their role in drug use control. This study is part of an evaluation of this experiment. It summarizes the responses to personal interviews held with the owners or managers of the 11 participating pharmacies and with four employee pharmacists. Almost all pharmacists considered capitation a big improvement over the traditional fee-for-service system of Medicaid payment. The benefit most commonly cites was the advance payment system that some respondents said reduced paperwork and improved their cash flow. Value was also seen in requiring Medicaid patients to designate and obtain services from a single pharmacy, but the pharmacists complained about lack of accurate lists of eligible patients and described wide variations in enforcement of the lock-in. Diversity also appeared in their discussion of problems encountered in making product substitutions. Deficiencies in comprehension and motivation were found to be especially prevalent among the salaried employees.

Attitude of Health Personnel↗