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Richard F Adair

Publications and source records attributed to Richard F Adair.

2 recordsLinked to original sources

Do drug samples influence resident prescribing behavior? A randomized trial.

PURPOSE: The purpose of the study was to determine whether access to drug samples influences resident prescribing decisions. SUBJECTS AND METHODS: The authors observed 390 decisions to initiate drug therapy by 29 internal medicine residents over a 6-month period in an inner-city primary care clinic. By random selection, half of the residents agreed not to use available free drug samples. Five drug class pairs were chosen for study prospectively. Highly advertised drugs were matched with drugs commonly used for the same indication that were less expensive, available over-the-counter, or available in generic formulation. RESULTS: Resident physicians with access to drug samples were less likely to choose unadvertised drugs (131/202 decisions) than residents who did not have access to samples (138/188 decisions; P = .04) and less likely to choose over-the-counter drugs (51/202, 73/188; P = .003). There was a trend toward less use of inexpensive drugs. CONCLUSION: Access to drug samples in clinic influences resident prescribing decisions. This could affect resident education and increase drug costs for patients.

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Diabetes control improved when inner-city patients received graphic feedback about glycosylated hemoglobin levels.

OBJECTIVE: To develop and test an inexpensive visual tool to help patients with diabetes improve glycemic control. METHODS: A multidisciplinary team developed a 1-page form, the "Take-home Diabetes Record" (THDR), providing feedback to patients by displaying per cent glycosylated hemoglobin (GHb) values graphically over time, with target levels highlighted. Patients with type 2 diabetes in an inner-city clinic were randomized to THDR use (n = 57) or not (n = 70) over 15 months. Self-care activities were discussed, linked with GHb results, and charted at each clinic visit. Initial and final GHb were compared. RESULTS: Mean GHb fell significantly in THDR patients (-0.94, P =.003), but not in control patients (-0.18, P =.36). Mean GHb decrease was greater in THDR patients (P =.047). A greater proportion of THDR patients (51%) than control patients (18%) achieved a decrease in GHb >/=0.9 (P =.001). CONCLUSIONS: A graph linking GHb and self-care activities shows promise for improving glycemic control.

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