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Biomedical subjects

M Hemming

Publications and source records attributed to M Hemming.

9 recordsLinked to original sources
PubMed1999

Examining the adequacy of quantities available for subsidized antidepressant prescriptions in Australia.

In Australia the Pharmaceutical Benefits Scheme (PBS), a national drug insurance plan, aims to provide around a month's therapy for medication used in chronic conditions. However, there are marked differences among the most commonly used antidepressants in the number of days supply represented by the PBS maximum quantity after adjustment for the defined daily dose (DDD). The DDD is the assumed adult daily dose for a drug and is a WHO drug utilization standard. Whereas the selective serotonin re-uptake inhibitors (SSRIs) and moclobemide largely provide around a month's supply at the DDD, most tricyclic antidepressant (TCA) items provide considerably less than this .A patient tracking study was conducted to determine the average length of time between prescription re-supplies for a number of tricyclic antidepressants and newer antidepressants as a means of measuring the efficiency of PBS supply for the different classes of antidepressant. The number of days between dispensings was similar for patients no matter whether they were taking TCAs, SSRIs or moclobemide, although for the older antidepressants presumably at a much lower prescribed daily dose than the DDD. Care needs to be taken when adjusting usage with the DDD/1000/day unit of measurement in cases where the DDD does not reflect the prescribed daily dose (PDD).

Journal Article↗
PubMed1996

Ocular and dermal irritation studies of some quaternary ammonium compounds.

The primary ocular and dermal irritations of four quaternary ammonium compounds, namely cetylpyridinium chloride (CPC), stearylphenylethyldimethylammonium tosylate (SPDAT), dimethyldistearylammonium bisulfate (DDABS) and tri(N-butyl)benzylammonium 4-hydroxynapththalene-1-sulfonate (TBAHNS), were studied. Both CPC and SPDAT were extremely or severely irritating to the eyes of the test animals, whereas DDABS and TBAHNS were mildly or minimally irritating. Both CPC and SPDAT were also severely or extremely irritating to the skin of the test animals, while DDABS and TBAHNS were non-irritating. These quaternary ammonium compounds have little similarity in chemical structure and possess different solubilities. CPC is very soluble in both lipid and water; SPDAT is very soluble in lipid but only slightly soluble in water; and DDABS and TBAHNS are poorly soluble in either lipid or water. The irritancy of these compounds is likely to be related to their solubility, in addition to the cationic characteristics. It appears that not all quaternary ammonium compounds in this study are irritants. Those that are not soluble are not expected to be absorbed in eye/skin tissues and thus irritation reactions will not take place. The use of in vitro alternatives should be considered when assessing the ocular and dermal irritancy potential of water- and lipid-soluble quaternary ammonium compounds.

Animals↗
PubMed1986

Educational antibiotic advertising.

Antibiotic audits that were conducted within our hospital between 1978 and 1982 showed persisting patterns of inappropriate antibiotic use. A commercial advertising agency was commissioned to plan a campaign to change entrenched prescribing habits. Amoxycillin was chosen as the test drug because previous audits consistently had shown that its intravenous administration was prescribed more frequently than was that of benzylpenicillin in the treatment of primary pneumonia. In addition, amoxycillin given by mouth was prescribed six-hourly rather than eight-hourly in one-third of the patients who were surveyed. A three-month remedial campaign used direct mail (pads and pens), display stands and posters, all of which focused on the booklet Antibiotic guidelines. Educational material was placed wherever staff members congregated. At the end of the campaign, intravenously administered amoxycillin was used in only 8% of 50 patients with primary pneumonia and amoxycillin given by mouth was prescribed six-hourly in only 10% of 99 patients. These changed habits were sustained six months after the campaign but showed some fall-off 18 months after the campaign. The campaign costs of $10,000 were recouped within 12 months by savings on drug costs. It is concluded that educational advertising is an effective means of changing prescribing behaviour in a hospital.

Administration, Oral↗
PubMed1983

Use of antibiotic agents in a large teaching hospital. The impact of Antibiotic Guidelines.

Three surveys of antibiotic use have been conducted at The Royal Melbourne Hospital. The first was conducted in 1978, before the introduction of the booklet, Antibiotic Guidelines; the second was conducted eight months after, and the most recent, four years after, its distribution. In 1978, 30% of 563 patients surveyed were receiving antibiotic therapy; this proportion declined to 28% of 967 patients studied in 1982. At the beginning of 1978, 52% of all treatments audited were judged appropriate when compared with those recommended in the Guidelines; this proportion rose to 72% in the second survey and was maintained at 70% in 1982. Certain inappropriate prescribing patterns persisted, such as the use of amoxycillin for the treatment of primary pneumonia, surgical antibiotic prophylaxis which was started too late, and the failure to simplify therapy when the results of microbiological investigations became available. Antibiotic guidelines facilitate the auditing of antibiotic usage and aid rational prescribing. Nevertheless, additional measures appear necessary if specific patterns of misuse of antibiotic agents are to be corrected.

Amoxicillin↗
PubMedDate not supplied

Changing antibiotic prescribing by educational marketing.

A controlled cross-over study in 12 Victorian public hospitals was performed to examine the power of marketing techniques in influencing prescribing. The targeted prescribing behaviour was the use of antibiotic prophylaxis in surgery, and the criteria for judging the appropriateness of therapy were its duration and timing, as are detailed in the fourth edition of the booklet Antibiotic guidelines. The first intervention was mounted in 1985 in six hospitals (two metropolitan teaching hospitals, one suburban general hospital and three rural hospitals), and six matched hospitals acted as control hospitals. One year later, the intervention was mounted in the six hospitals that previously had been the control hospitals. The interventional campaign consisted of material that was similar to that which is used by the pharmaceutical industry, including an "academic" representative. Its effect was assessed by audits that were performed before and after the first interventional campaign and again, one year later, after the second interventional campaign. The proportion of antibiotic courses that were assessed as satisfactory in terms of duration increased significantly after the first campaign in the hospitals where the intervention was mounted. No significant changes in prescribing occurred in the control hospitals. In the hospitals which were control hospitals in 1985, and in which the intervention occurred in 1986, the proportion of antibiotic courses that were assessed as satisfactory also increased significantly after the interventional campaign. A fall-off in performance occurred during the 12 months after the campaign in the 1985-interventional hospitals. Calculated cost savings more than outweighed the costs of the campaign. We conclude that inappropriate prescribing behaviour in hospitals can be modified successfully by educational marketing techniques.

Anti-Bacterial Agents↗