Biomedical subjects

Ronald E Aubert

Publications and source records attributed to Ronald E Aubert.

4 recordsLinked to original sources

PubMed2005

Dispensing error rate in a highly automated mail-service pharmacy practice.

STUDY OBJECTIVE: To measure the rate of dispensing errors and to identify the types and sources of dispensing errors in a highly automated mail-service pharmacy practice. DESIGN: Descriptive analysis of a random sample of completed prescriptions. SETTING: A high-volume mail-service pharmacy practice comprising a network of prescription processing and dispensing pharmacies in the United States. MEASUREMENTS AND MAIN RESULTS: During September and October 2003, new and refill prescriptions were retrieved before shipping and evaluated for dispensing accuracy. Container contents were compared against the container label, and the label record was compared against the original prescription order. The overall dispensing error rate was 0.075% (16 dispensing errors among 21,252 prescriptions, 95% confidence interval 0.043-0.122). Fourteen errors involved incomplete or incorrect directions on the final label. All dispensing errors were associated with the initial stages of prescription processing (including order entry); no errors were associated with the mechanical stages of product dispensing. CONCLUSION: A highly automated mail-service pharmacy can achieve a dispensing error rate of less than 1 error/1000 prescriptions, which is substantially lower than the rates reported for retail pharmacies. A high degree of automation in the mechanical aspects of dispensing appears to be a key factor in achieving this high dispensing accuracy.

Humans↗

PubMed2005

Estimating medication persistency using administrative claims data.

OBJECTIVES: To review the definitions and methods for measuring medication persistency, and to propose a uniform definition of and calculation for persistency using pharmacy claims data. STUDY DESIGN: Literature review. METHODS: A MEDLINE search (1966 to present) was performed to identify articles detailing a definition or method of persistency measurement based on automated pharmacy data. Articles were screened for relevance by title and abstract. References from identified articles were used to expand the search results. RESULTS: The concept behind medication persistency measurement is to capture the amount of time that an individual remains on chronic drug therapy. The methods to calculate medication persistency can be classified into 1 of 3 categories: (1) Persistency as a function of the medication possession ratio; (2) persistency as a function of medication availability at a fixed point in time; and (3) persistency as a function of the gaps between refills. CONCLUSIONS: The common goal of all persistency measures should be to reflect the continuity of medication usage and to capture the timeliness and the frequency of refilling. The measurement of persistency as a function of the gaps between refills provides the best assessment of refill compliance across a variety of medication and disease states and lends itself to the well-established measurements of survival analysis.

Drug Prescriptions↗

PubMed2003

Evaluation of a depression health management program to improve outcomes in first or recurrent episode depression.

OBJECTIVES: To evaluate the impact of telephone counseling and educational materials on medication adherence and persistency among members with newly diagnosed depression enrolled in a pharmacy benefit management-sponsored disease management program. STUDY DESIGN: Longitudinal cohort observation. METHODS: The study population comprised 505 members with a new or recurrent episode of depression who consented and enrolled in a depression disease management program. After written consent was obtained, program participants received up to 4 telephone-counseling calls and 5 educational mailings focused on the importance of medication compliance, barriers to medication compliance, quality of life, symptoms, and satisfaction with the program. A control group of 3744 members was selected from client companies that opted not to offer the depression program. Measures of medication adherence, persistency with prescription drug therapy, and patient refill timeliness were computed for both groups and compared. RESULTS: Patients enrolled in the depression disease management program were significantly more likely to adhere to their medication regimen during acute (89.0% vs 67.7%, P < .001) and continuation treatment phases (81.1% vs 57.6%, P < .001). In addition, members enrolled in the program were significantly more likely to continue their therapy after 7 months (77.8% vs 49.5%, P < .001) and refilled their prescriptions on a more timely basis (0 vs 18 days, P < .001). CONCLUSIONS: A pharmacy benefit management-sponsored health management depression program succeeded in encouraging patients with new or recurrent depression to stay on antidepressant medication and to reach treatment goals outlined by best practice guidelines.

Antidepressive Agents↗

PubMedDate not supplied

Comparative analysis of two quality-of-life instruments for patients with chronic obstructive pulmonary disease.

OBJECTIVE: The St. George's Respiratory Questionnaire (SGRQ) has been validated and widely used in assessing quality of life among patients with chronic obstructive pulmonary disease (COPD), but it is time-consuming and complicated to score. A more concise instrument, the Airways Questionnaire (AQ), was developed to measure quality of life (QoL) among patients with asthma and COPD. The shorter version of this instrument has 20 items (AQ20) and the longer version has 30 items (AQ30). The purpose of this study was to determine the relationship between QoL scores measured by the AQ20/30 or the SGRQ scale and utilization of health-care services by COPD patients and to evaluate the comparative advantage of any one of these instruments in measuring the QoL of COPD patients. METHODS: Results from a survey of 1000 patients participating in a pilot COPD health management program were used for this analysis. A total of 303 patients completed both the AQ20/30 and the SGRQ questionnaires. Logistic regression models were used to analyze the relationship between utilization of health care services and QoL scores while controlling for a set of covariates. Spearman's rank correlation was used to determine whether the AQ30 and the SGRQ scores for symptoms, activity, and impact, and the overall scores were correlated. RESULTS: The regression results demonstrate that there is a strong relationship between quality-of-life scores and health-care utilization variables. Moreover, the degree of association between the AQ20/30 scores and utilization variables and the SGRQ and utilization variables are comparable. Both the AQ20 and the AQ30 were highly correlated with the overall SGRQ score and with symptoms, activity, and impact component scores. CONCLUSION: The AQ20/30 and the SGRQ scores are comparable in terms of measuring QoL in COPD patients and are equally useful in determining the association between utilization of health-care services and QoL.

Aged↗