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Biomedical subjects

M E Pitterle

Publications and source records attributed to M E Pitterle.

At least 19 recordsLinked to original sources
PubMed1999

Health care professional staffing, hospital characteristics, and hospital mortality rates.

To evaluate associations among hospital characteristics, staffing levels of health care professionals, and mortality rates in 3763 United States hospitals, a data base was constructed from the American Hospital Association's Abridged Guide to the Health Care Field and hospital Medicare mortality rates from the Health Care Financing Administration. A multivariate regression analysis controlling for severity of illness was employed to determine the associations. Hospital characteristics associated with lower mortality were occupancy rate and private nonprofit and private for-profit ownership. Mortality rates decreased as staffing level per occupied bed increased for medical residents, registered nurses, registered pharmacists, medical technologists, and total hospital personnel. Mortality rates increased as staffing level per occupied bed increased for hospital administrators and licensed practical-vocational nurses. To our knowledge, this is the first study to show that pharmacists were associated with lower mortality rates.

Hospital Mortality↗
PubMed1999

Staffing and the cost of clinical and hospital pharmacy services in United States hospitals.

A survey was mailed to pharmacy directors at all United States acute care medical-surgical hospitals that related to staffing and cost components of hospital pharmacies and clinical services. Cost information was evaluated as both unadjusted and adjusted for severity of illness using the Health Care Financing Administration's Medicare case mix index (CMI). Unadjusted drug costs/occupied bed/year were $13,350+/-6927, a 36% increase over 1992 and a 112% increase over 1989, with statistically significant differences observed by geographic region, hospital size, hospital ownership, and drug delivery system. Annual median pharmacist salary costs/patient associated with centrally based clinical pharmacy services were drug use evaluation $111, in-service education $20, drug information $117, poison information $24, and clinical research $35. Annual median pharmacist salary costs/patient associated with patient-specific clinical services were drug therapy monitoring $5, pharmacokinetic consultation $8, patient counseling $6, medical rounds $4, admission drug histories $7, and drug therapy protocol management (prescribing) $9. Drug costs continue to increase at double-digit rates. Substantial differences exist among various regions of the country with salary and specific cost components. Registered nursing staffing is increasing at twice the rate of pharmacists staffing increases.

Hospital Costs↗
PubMed1998

Gabapentin bioavailability: effect of dose and frequency of administration in adult patients with epilepsy.

UNLABELLED: Gabapentin (GBP) is a non-metabolized antiepileptic drug that is eliminated by renal excretion and displays saturable, dose dependent absorption. The recommended dosing schedule for GBP is t.i.d. At large daily doses, oral bioavailability (F) may be improved by giving the daily dose more frequently. OBJECTIVE: To evaluate whether switching GBP dosage regimen from t.i.d. to q.i.d. results in increased oral bioavailability. METHODS: This study consisted of two parts; a computer simulated pharmacokinetic model and a clinical pharmacokinetic study in nine adult epileptic patients receiving 3600 mg/day and 11 receiving 4800 mg/day. All patients were evaluated during both t.i.d. and q.i.d. regimens. F were determined by calculation of percent of dose excreted unchanged using steady-state 24-h urine collections and were compared using a paired t-test. RESULTS: At 3600 mg/day, mean F following t.i.d. and q.i.d. dosing were 38.7+/-22.1% and 40.0+/-18.9%, respectively (P=0.738). At 4800 mg/day, mean F following t.i.d. and q.i.d. dosing were 29.2+/-16.2% and 35.6+/-17.6%, respectively (P=0.006). DISCUSSION: Good agreement was observed between values from this study and predicted values based on the pharmacokinetic model. Improved GBP F at doses of 3600 mg/day was not achieved with more frequent drug administration, and thus is not warranted. At 4800 mg/day, a 22% increase in F was observed with more frequent drug dosing. CONCLUSION: GBP F may be significantly increased by q.i.d. versus t.i.d. dosing, depending upon dose level. This increase in F however must be balanced against the inconvenience of more frequent dosing. Therapeutic drug level monitoring may aid in the evaluation of such pharmacokinetic maneuvers.

Acetates↗
PubMed1998

Gabapentin absorption: effect of mixing with foods of varying macronutrient composition.

OBJECTIVE: To compare the oral absorption profile of gabapentin following administration of the contents of opened capsules that were mixed with food vehicles of varied macronutrient (protein) composition. DESIGN: An unblinded, randomized, single-dose, four-way crossover pharmacokinetic study in nine healthy adult men and women volunteers. METHODS: Following an overnight fast, a single 600-mg dose of gabapentin (2 x 300-mg Neurontin capsules) was given either as an intact capsule swallowed with 120 mL of tap water (control, phase I), or after capsule contents were opened and mixed with; 4 oz. of applesauce (phase II), 120 mL of orange juice (phase III), or 4 oz. of fat-free chocolate pudding (phase IV). Subjects fasted for 4 hours following drug ingestion. Serial venous blood samples were obtained over 24 hours to determine gabapentin serum concentrations. Pharmacokinetic variables including AUC, maximum serum concentration (Cmax), and time to maximum serum concentration (tmax) were calculated by using standard noncompartmental methods. Subjects served as their own controls, and were randomly crossed over following a minimum 7-day washout period. Statistical analysis was performed by using ANOVA and Student's t-test where appropriate. RESULTS: No statistically significant differences in any kinetic variable were found between any study arm. A trend was noted for a modest increase in both Cmax and AUC in phase IV (chocolate pudding) compared with control (+18.6% and +13.2%, respectively). In a comparison of protein (phase IV) versus nonprotein phases (phases I-III), gabapentin AUC was 26% greater (47.28+/-14.65 vs. 37.43+/-9.78 microg/mL x h; p = 0.03), and Cmax was 32% higher (4.72+/-1.04 vs. 3.56+/-0.92 microg/mL; p = 0.003). CONCLUSIONS: Opening and mixing the contents of gabapentin capsules does not significantly impair drug absorption. This may be a viable administration option for patients who are unable to swallow intact capsules. Dietary macronutrient composition (i.e., protein) may favorably influence gabapentin oral absorption.

Acetates↗
PubMed1997

Diet- and valproate-induced transient hyperammonemia: effect of L-carnitine.

Hyperammonemia is an adverse effect of valproate (VPA) treatment. In particular, transient hyperammonemia has been reported to occur in VPA-treated patients after protein-rich meals. This phenomenon may occur secondary to a VPA-mediated carnitine insufficiency. We sought to confirm that protein ingestion would result in transient hyperammonemia and to determine whether supplementation with L-carnitine would prevent this effect. We studied the effect of consumption of a standardized protein-rich meal (45 g protein) before (phase I) and after (phase II) administration of L-carnitine 50 mg/kg/day for 7 days in 11 epileptic children (13.3 +/- 2.3 years of age) receiving VPA. Venous blood was obtained during fasting (baseline) and at 2 and 4 hours after the protein-rich meal for analysis of ammonia (NH3), and VPA concentrations. Mean VPA trough concentrations did not differ significantly at any time. After protein ingestion, 2-hour NH3 concentration increased by 86% (P < .05) from baseline in phase I as compared with a 38% increase in phase II. In both phases I and II, 4-hour NH3 concentrations decreased toward baseline values. We conclude that (1) modest protein ingestion can result in significant transient increases in NH3 in VPA-treated children, (2) significant increases may occur in patients with normal fasting NH3 concentrations, (3) these increases can be significantly attenuated by L-carnitine supplementation, and (4) these changes do not appear to be related to changes in VPA concentration.

Administration, Oral↗
PubMed1997

Effect of lamotrigine on carbamazepine epoxide/carbamazepine serum concentration ratios in adult patients with epilepsy.

Although lamotrigine (LTG) appears to have a low propensity to cause pharmacokinetic interactions with other medications, it has been suggested that LTG may interfere with the elimination of carbamazepine 10,11-epoxide (CBZE), the active metabolite of carbamazepine (CBZ). Evidence for this pharmacokinetic interaction is inconclusive and conflicting, however. We evaluated CBZ apparent oral clearance and the steady-state CBZE/CBZ serum concentration ratios in nine patients (30.8 +/- 7.7 years) with epilepsy prior to and following the initiation of adjunctive treatment with LTG. Overall, CBZ oral clearance was unchanged following the introduction of LTG (5.58 +/- 1.60 vs. 5.81 +/- 1.74 1/h, P = 0.630). Likewise, CBZE to CBZ serum concentration ratios were not significantly different (0.241 +/- 0.082 vs. 0.232 +/- 0.082, P = 0.782). These observations suggest that the addition of LTG did not result in a significant pharmacokinetic interaction involving either CBZ or CBZE.

Administration, Oral↗
PubMed1996

Effect of a high-protein meal on gabapentin pharmacokinetics.

The anticonvulsant gabapentin is transported across biological membranes via the L-amino acid transport system (System-L). Absorption of gabapentin is saturable, and in-vitro data have previously demonstrated that both L-leucine and L-phenylalanine may compete with the intestinal transport of gabapentin. The purpose of this study therefore was to determine whether a high-protein meal would interfere with gabapentin absorption. Ten healthy volunteers received in a randomized, cross-over design, a single 600-mg dose of gabapentin in the fasting state and after a high-protein meal consisting of 80 gm total protein (4.1 g phenylalanine, 8.2 g leucine and 4.2 g isoleucine), 52 g carbohydrate, and 9 g fat. Plasma gabapentin concentrations were measured by HPLC at baseline, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 12, 24, 30 h. Calculated pharmacokinetic parameters included Cmax' Tmax' AUC and T1/2. In addition, a pharmacodynamic assessment (using visual analog scales) of gabapentin-related adverse effects was performed at 2 h post drug ingestion and was compared between study phases. Statistical analysis included Student's t-test for paired data, with significance assigned at P < 0.05. Cmax was significantly increased by 36% (3.87 +/- 1.15 vs 5.28 +/- .97 micrograms/ml, P = 0.002), and Tmax tended to be shorter (3.9 +/- 1.8 vs 2.8 +/- .35 h, P = 0.10), after the high-protein meal. Although AUC was increased by 11%, this did not achieve statistical significance. Despite significantly higher plasma concentrations at 2 h, subjects reported significantly fewer adverse effects after the high-protein meal. Potential mechanisms to explain these unexpected findings may be that the large amino acid load delivered with the high-protein meal enhanced gabapentin absorption via trans-stimulation, the process by which acutely increased intestinal luminal amino acid concentrations result in an acute up regulation in System-L activity. Conversely, the decrease in perceived adverse CNS effects of gabapentin following the high-protein meal may reflect CNS competition for System-L transport.

Acetates↗
PubMed1996

Evaluation of carbamazepine and carbamazepine-epoxide protein binding in patients undergoing epilepsy surgery.

Carbamazepine (CBZ) serum concentrations increase after epilepsy surgery. A possible mechanism may be acute changes in protein binding, specifically those involving the acute phase reactant alpha(1)-acid glycoprotein (AAG). We prospectively evaluated 16 adults (11 receiving CBZ) with epilepsy (mean age 30 +/- 9.9 years, 8 women and 8 men) undergoing temporal lobe resections and characterized AAG, albumin, CBZ, and CBZ-epoxide (CBZ-E) free fractions over time. AAG, ALB, CBZ, and CBZ-E free fractions were determined before surgery (baseline) and on postoperative days 1-5, 14, and 30. AAG was measured with a radial immunodiffusion assay method, CBZ and CBZ-E serum concentrations were determined by high-performance liquid chromatography (HPLC). Free fractions of CBZ and CBZ-E were calculated as the ratio of unbound (determined after ultracentrifugation) to total serum drug concentrations. Statistical analysis included analysis of variance (ANOVA) and Student's t test for paired data when appropriate, with significance assigned at p<0.05. All data are mean +/- SD. AAG concentrations increased significantly from baseline 61.9 +/- 21.3 mg/dl), peaking at postoperative day 3 (116.8 +/- 20.6 mg/gl) and decreasing to baseline levels between days 14 and 30. CBZ serum concentrations were significantly increased in the immediate postoperative period (day 3), but albumin concentrations and CBZ and CBZ-E free fractions did not differ significantly between baseline and the postoperative time points. Temporal lobe resection results in an acute phase reaction which is manifested in part by significant changes in AAG. Although CBZ and CBZ-E total serum concentrations increased significantly in the immediate postoperative period, epilepsy surgery did not appear to result in significant overall changes in drug binding to plasma proteins.

Adult↗
PubMed1995

Cost of pharmaceutical services in U.S. hospitals in 1992.

The results of a 1992 national survey of hospital-based pharmaceutical services are reported and compared with data collected during a similar survey in 1989. A questionnaire was mailed to pharmacy directors at all 3756 medical-surgical hospitals in the United States that had 50 or more licensed beds. Cost results were evaluated both as unadjusted data and as data adjusted for severity of illness with the case mix index. The response rate was 43% (1597 usable responses). Mean +/- S.D. unadjusted medication costs per occupied bed were $9850 +/- 4744 (a 46% increase over 1989 costs); significant differences were observed for geographic region, hospital ownership, drug delivery system, and pharmacy director's education. Mean +/- S.D. unadjusted total pharmacy costs per occupied bed were $16,550 +/- 6,249 (a 40% increase over 1989 costs); significant differences were observed for geographic region, hospital ownership, drug delivery system, and pharmacy director's education. Other mean +/- S.D. unadjusted pharmacy cost components were as follows: injectable solution costs, $2627 +/- 2191 (a 38% increase over 1989 costs); inventory costs, $2029 +/- 2593 (70% increase); pharmacist salary costs per occupied bed, $2997 +/- 1267 (33% increase); pharmacy technician costs per occupied bed, $995 +/- 876 (24% increase); pharmacist salary costs per full-time equivalent (FTE), $43,791 +/- 12,206 (14% increase); pharmacy technician salary costs per FTE, $18,953 +/- 6,154 (15% increase); and pharmacy staff development costs per occupied bed, $45 +/- 41 (29% increase). Pharmacist salary costs associated with centrally based clinical pharmacy services ranged from a high of $361 per occupied bed per year for drug-use evaluation to a low of $15 per occupied bed per year for inservice education. Pharmacist salary costs for patient-specific pharmaceutical services ranged from $3 per patient for medical rounds to $8 per patient for cardiopulmonary resuscitation team participation and drug protocol management. A 1992 survey provided comprehensive data on the cost structure of hospital-based pharmaceutical services and a basis for comparison with 1989 cost data.

Geography↗
PubMed1995

Relationship between valproic acid dosage, plasma concentration and clearance in adult monotherapy patients with epilepsy.

Significant variability has been reported in the plasma concentration-dose relationship for the anticonvulsant compound valproic acid (VPA). Several factors may contribute to this observed variability, including heterogeneous patient populations of children and adults, polytherapy, and timing of plasma concentration sampling. To optimally determine the relationship between trough VPA plasma concentration and dose, we evaluated a homogeneous group of adult ambulatory patients with epilepsy receiving VPA monotherapy. Furthermore, we sought to evaluate whether a relationship existed between VPA dosage and plasma clearance for both total and unbound or free drug. Steady-state trough plasma concentrations were determined in thirty-two patients. Mean VPA dose was 22.8 +/- 10.3 mg/kg/day. Mean total and unbound VPA plasma concentrations were 97.9 +/- 34.9 and 13.2 +/- 10.6 micrograms/ml, respectively. Significant correlations between VPA dose and total and unbound plasma concentrations were found (r = 0.82 and r = 0.85, P < or = 0.001, respectively). Significant relationships were also observed between VPA dose and clearance. A positive correlation was noted for dose and total plasma clearance (r = 0.61, P < or = 0.001), while an inverse correlation existed between dose and unbound VPA plasma clearance (r = -0.51, P < 0.01). Although a statistically significant correlation does exist between VPA dosage and both total and unbound plasma concentrations, significant interpatient variability still remains even under 'optimal' therapeutic drug monitoring conditions.

Administration, Oral↗
PubMed1994

Evaluation of recent pharmacy graduates' practice patterns, professional lifelong learning, pharmacy organization memberships, and salary.

OBJECTIVES: To document information on recent bachelor of science (B.S.) pharmacy graduates' practice patterns, professional lifelong learning (PLL) methods, pharmacy organization memberships, and salary. The association between advanced training and education on PLL methods, pharmacy organization membership, and salary are explored. DATA SOURCES: Pertinent literature was identified by MEDLINE searches (1966-1992). STUDY DESIGN: The results of a Fall 1991 survey of recent B.S. pharmacy graduates (n = 371) of the University of Wisconsin School of Pharmacy are reported (55 percent response rate). RESULTS: Hospital pharmacists devoted more time to PLL outside of work (18.00 +/- 17.89 h/mo) than community pharmacists (9.93 +/- 8.76 h/mo), t = 5.02, degrees of freedom (df) = 289, p < 0.001. Graduates who had completed an advanced degree program, residency, or fellowship (advanced degree/training [ADT]) spent more time in PLL (17.76 +/- 10.63 h/mo) compared with graduates who had only obtained a B.S. degree (10.63 +/- 8.56 h/mo), t = 3.80, df = 311, p < 0.001. Graduates who had ADT were more likely to belong to multiple pharmacy organizations (2.14 +/- 1.38 organizations) than hospital pharmacists (1.61 +/- 1.27 organizations) and community pharmacists (1.11 +/- 1.06 organizations). Of the pharmacists who graduated in 1989 and 1990 (one to two years postgraduation), 55 percent belonged to the American Pharmaceutical Association. This declined to 19 percent of the graduates from 1984 and 1985 (six to seven years postgraduation), a 62 percent decline in membership. Membership in the American Society of Hospital Pharmacists (ASHP) was held by 19 percent of graduates one to two years after graduation; and 34 percent of graduates belonged to ASHP six to seven years after graduation, an 81 percent increase. Graduates with ADT (compared with graduates with the B.S. degree only) showed the strongest correlation of membership affiliation, which was about equal with ASHP (phi = 0.32) and ACCP (phi = 0.33). Although pharmacists changed their individual pharmacy organization memberships during the first seven years after graduation, there was no evidence of a decline in overall interest in pharmacy organization membership. Pharmacists who had completed ADT had an annual mean salary of $51,112 +/- $10,012; those pharmacists who did not complete an ADT program had an annual mean salary of $46,440 +/- $7802, a difference of $4672 per year. Hospital pharmacists who had obtained ADT had an annual mean salary of $51,840 +/- $9765; B.S. pharmacists without ADT in hospital practice had an annual mean salary of $43,603 +/- $8192, a difference of $8237 per year. CONCLUSIONS: Pharmacists' PLL methods, organization memberships, and salaries varied significantly by their practice site and the completion of an ADT program.

Education, Pharmacy, Continuing↗
PubMed1993

Potential interaction between carbamazepine and loxapine: case report and retrospective review.

OBJECTIVE: To report a potential interaction between carbamazepine (CBZ), an anticonvulsant medication, and loxapine, an antipsychotic. CBZ is being increasingly used to treat a variety of psychiatric disorders. Because of this, the potential for multiple-drug therapy and subsequent drug interactions is increased. METHODS: We prospectively monitored plasma CBZ and carbamazepine epoxide (CBZE) concentrations in a single patient during and after withdrawal of loxapine comedication. Additionally, we retrospectively evaluated four patients who had received concomitant therapy with CBZ and loxapine. RESULTS: Plasma CBZE/CBZ ratios decreased from 0.76 to 0.18 following discontinuation of loxapine. Absolute CBZE plasma concentrations also decreased from 1.7 to 0.6 micrograms/mL after loxapine therapy was stopped. Retrospectively screened patients who were receiving concomitant loxapine-CBZ therapy all had unusually elevated CBZE/CBZ plasma concentration ratios (0.75-1.91). CONCLUSIONS: These cases suggest that an interaction occurs between loxapine and CBZ. Possible mechanisms include either induction of CBZ metabolism to its epoxide metabolite, or inhibition of the enzymatic metabolism of CBZE (epoxide hydrolase).

Adult↗
PubMed1992

Computer-based patient simulations: hospital pharmacists' performance and opinions.

The performance of pharmacists in using an interactive computer-based patient simulation program and their attitudes toward the simulations are reported. The Institutional Patient Medication Simulation program is designed to enhance and evaluate the medication problem-solving skills of pharmacists. Each simulation consists of patient data-gathering, case question, and therapy decision modules with initial assessment and monitoring nodes. Five simulations were tested: gout, urinary-tract infection, congestive heart failure, antimicrobial prophylaxis in surgery, and hypertension. Pharmacists from nine hospitals were recruited for the study. Participants were asked to perform the simulations within a specified period and to complete attitudinal questionnaires. Of the 91 pharmacists who volunteered, 72 (79%) completed the simulations and the questionnaires. The practitioners indicated that the simulations adequately tested their knowledge and that they would recommend them to colleagues. Performance scores for data gathering were less than 70%, with no significant differences among the simulations. Case question scores exceeded 80% and again were consistent among simulations, whereas therapy decision scores were more variable, with the lowest scores being recorded for antimicrobial-related simulations. Pharmacists with more hospital experience tended to perform better. Pharmacists completing a patient simulation program found the simulations to be worthwhile. Performance scores indicated some difficulty in gathering patient data and showed that correct therapeutic decisions may not always occur even if adequate information is obtained.

Adult↗
PubMed1992

Legal status and functions of hospital-based pharmacy technicians and their relationship to clinical pharmacy services.

The relationships among (1) laws and regulations governing hospital-based pharmacy technicians, (2) functions pharmacy technicians perform, and (3) pharmacists' provision of clinical pharmacy services were studied. A state-level technician-restriction score was developed, based on state rules and regulations in effect in 1989. Scoring included (1) type of supervision required for hospital-based pharmacy technicians, (2) ratio of technicians to pharmacists, (3) pharmacist-only reconstitution of injectable products, and (4) pharmacist-only counting and pouring. Actual use of hospital pharmacy technicians was measured with the technician-use index, and overall provision of clinical pharmacy services was measured with the pharmaceutical-care index. Based on the technician-restriction scores, 25 states and the District of Columbia were categorized as having less restrictive laws and 25 states as having more restrictive laws. Technician use varied with hospital size, teaching affiliation, owner-ship, type of drug delivery system, and education level of the director of pharmacy. Use of pharmacy technicians increased with the severity of hospital-patient illness treated. A fair correlation was found between the pharmaceutical-care index and the technician-use index. A positive association was found between pharmacy technician use and pharmacists' provision of clinical pharmacy services.

Certification↗
PubMed1992

Pharmaceutical services in U.S. hospitals in 1989.

The results of a spring 1989 national survey of hospital-based pharmacy services are reported. The study group (n = 2112) comprised half of U.S. acute-care general surgical or medical hospitals with 50 or more licensed beds. Pharmacy directors were asked about their hospital's provision of 14 clinical pharmacy services. The survey had a response rate of 56% (1174 usable responses). Provision levels varied significantly with the pharmacy drug delivery system for 14 services, pharmacy director's education for 12 services, hospital teaching affiliation for 12 services, hospital ownership for 9 services, hospital size for 9 services, and geographic region for 5 services. The following percentages of respondents offered specific services: drug-use evaluation, 90%; inservice education, 66%; adverse drug reaction (ADR) management, 46%; drug therapy monitoring, 41%; pharmacokinetic consultations, 40%; parenteral-enteral nutrition team participation, 28%; patient medication counseling, 26%; drug therapy protocol management, 25%; cardiopulmonary resuscitation (CPR) team participation, 25%; clinical research, 22%; drug information, 16%; participation in medical rounds, 13%; poison information, 9%; and medication histories, 2%. Pharmacist staffing requirements for clinical services usually centralized within the department were highest for drug information and poison information. Within hospitals offering the services, four of nine patient-specific services were potentially available to more than half the patients: ADR management, CPR team participation, drug therapy monitoring, and nutrition team participation. Drug therapy protocol management required the most pharmacist staff time. Only one service, pharmacokinetic consultations, was justified by more than half of the providers of that service. Respondents expected all the services to undergo net growth during 1989-90. The 1989 National Clinical Pharmacy Services Survey showed that provision of clinical pharmacy services varied with the pharmacy drug delivery system, pharmacy director's education, hospital teaching affiliation, hospital ownership, hospital size, and geographic region.

Adverse Drug Reaction Reporting Systems↗
PubMed1992

Cost of inpatient pharmaceutical services in U.S. hospitals in 1989.

The results of a spring 1989 national survey of hospital-based pharmacy services are reported; this article focuses on the cost structure of services. A questionnaire was sent to 2112 hospitals, comprising half of U.S. acute-care general medical or surgical hospitals with 50 or more licensed beds. Cost results were evaluated both as unadjusted data and as data adjusted with the case mix index (CMI). The survey had a response rate of 56% (1174 usable responses). Both pharmacy cost information and the CMI were obtained for 1000 hospitals. Mean +/- S.D. unadjusted medication costs per occupied bed were $6744 +/- $3048 and varied significantly with geographic region. Mean +/- S.D. pharmacist salary costs per full-time equivalent (FTE) were $38,432 +/- $8,550 and differed with geographic region, hospital ownership, the pharmacy drug delivery system, and the pharmacy director's education. Pharmacist salary costs associated with centrally based clinical pharmacy services ranged from a high of $60 per occupied bed per year for drug information services to a low of $15 for inservice education. The state with the highest mean +/- S.D. pharmacist annual salary per FTE was California ($45,900 +/- $11,037); the state with the lowest annual salary was Indiana ($29,637 +/- $7,110). A 1989 survey of clinical pharmacy services provided comprehensive data on complex cost structures.

Allied Health Personnel↗