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Biomedical subjects

R Rangno

Publications and source records attributed to R Rangno.

5 recordsLinked to original sources
PubMed1999

Program design and delivery in Canadian CME drug therapy courses.

OBJECTIVE: To examine how drug therapy course directors design and deliver drug therapy courses, and whether they employ adult education principles to assure effective education. DESIGN: Analysis of a three-part questionnaire sent to directors of drug therapy courses in Canada. PARTICIPANTS: The questionnaire was sent to all seven directors of drug therapy courses at medical schools that are accredited continuing medical education providers. RESULTS: All directors completed and returned the questionnaires. To decide on course content, most use feedback from previous course attendees, peer consultations, course committee member discussions and their own perceptions of learners' needs. Courses generally use conventional teacher-dominated technology rather than methods that emphasize active learner participation. CONCLUSION: Directors of Canadian continuing medical education drug therapy courses reasonably employ adult education principles when deciding learner needs and designing teaching vehicles.

Canada↗
PubMed1998

Influences of educational interventions and adverse news about calcium-channel blockers on first-line prescribing of antihypertensive drugs to elderly people in British Columbia.

BACKGROUND: The way in which dissemination of evidence changes medical practice needs to be better understood. Controversy about calcium-channel blockers (CCB) in the past 3 years has provided a natural experiment, enabling assessment of the impact of media stories, a national warning letter, a teleconference, small group workshops, and newsletters on first-line prescribing of antihypertensive drugs. METHODS: We included all physicians (4403) in British Columbia who prescribed a thiazide diuretic, beta-blocker, inhibitor of angiotensin-converting enzyme (ACE), or CCB as the first antihypertensive agent for 36,507 residents aged 66 years and over, with no previous or concurrent sign of underlying cardiovascular disease. We used a database covering all prescriptions to elderly people to measure the change in proportion of newly treated patients who received each class of drug as first-line therapy. We used a matched cohort design for assessment of the teleconference and workshops, a randomised community design for the newsletters, and time-series analysis for the media impacts. FINDINGS: The proportion of patients who received a CCB as first-line therapy declined gradually from 22% in early 1994 to 15% in late 1996. This proportion was not affected by two waves of adverse news about CCBs in 1995, but fell by 5% for 5 months and by 3% for 1 month after two waves in 1996. The proportion of patients who received either a CCB or an ACE inhibitor as first-line therapy, contrary to guidelines, was still 42% overall in 1996. The workshops and newsletters were followed by shifts from first-line CCB to first-line thiazide prescribing. INTERPRETATION: Changes in prescribing practices occur gradually with the accumulation of small impacts from educational interventions and lay media attention.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Discrepancies between clinic and ambulatory blood pressure responses to cilazapril therapy.

OBJECTIVE: To evaluate the antihypertensive effects of cilazapril, a new angiotensin-converting enzyme inhibitor, on clinic and ambulatory blood pressure (ABP) after first and last dose administrations. DESIGN: Four weeks randomized, double-blind, controlled trial of three regimens. SETTING: Six hypertensive research clinics in Canada. PATIENTS: After a two-week placebo run-in period, 130 patients aged 22 to 77 years with mild to moderate essential hypertension were randomized and evaluated. Exclusion criteria were secondary hypertension, childbearing potential and other significant diseases. INTERVENTION: Patients were assigned to cilazapril 2.5 mg (44 patients), cilazapril 5 mg (42) or placebo (44). Fourteen patients in each group were further evaluated in a substudy by 24 h ABP monitoring. MAIN RESULTS: Cilazapril in either dosage induced significant and similar antihypertensive effects on clinic blood pressure shortly after dosing (2 to 4 h), persisting during chronic treatment; however, no relevant effect persisted at the end of dosing (24 h). After four weeks, at the end of dosing, 22, 24 and 38% of patients were clinical responders (decrease in sitting diastolic blood pressure 10 mmHg or greater) on placebo, 2.5 or 5 mg (differences not significant). Conversely, both cilazapril regimens induced similar and significant (P < 0.01) falls in mean 24 h ABP compared with placebo. Moreover, 7, 50 and 48% of patients exhibited a reduction in mean 24 h diastolic blood pressure 10 mmHg or greater on placebo, cilazapril 2.5 or 5 mg, respectively. Furthermore, both regimens induced adequate trough:peak ratios on ABP.

Adult↗