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Biomedical subjects

W P Munroe

Publications and source records attributed to W P Munroe.

9 recordsLinked to original sources
PubMed1994

Home diagnostic kits.

To properly advise consumers on product selection, pharmacists must be familiar with the testing procedures for each available product. Manufacturers are continually introducing new products and modifying current products to provide more user-friendly versions; to keep up to date, pharmacists should request product information from the manufacturers by calling the toll-free numbers or contacting the sales representatives.

Adult↗
PubMed1992

Impact of an electronic medication compliance aid on long-term blood pressure control.

A two-phase study was conducted to assess the effect of an electronic medication compliance aid on hypertension control and pharmaceutical compliance in ambulatory patients. In Phase I (12 weeks), 36 patients were randomly assigned to a medication vial equipped with a cap containing a digital timepiece that displays the last time the cap was removed. The control group included 34 patients randomly assigned to a standard medication vial. Subjects using the timepiece cap showed an average compliance rate of 95.1%, an average decrease in systolic pressure of 7.6 mm Hg (P = .006), and an average decrease in diastolic pressure of 8.8 mm Hg (P less than .001). Controls had an average compliance rate of 78% and decreases of 2.8 mm Hg and 0.2 mm Hg in systolic and diastolic pressures, respectively. Phase II (12 weeks) combined use of the timepiece cap with other compliance aids: a pocket-size card for recording blood pressure and a blood pressure cuff for self-monitoring. Patients using the timepiece cap and the card had an average compliance rate of 98.7% with mean decreases of 11 mm Hg in systolic pressure (P less than .01) and 7.64 Hg mm in diastolic pressure (P = .0001). The combined use of the cap, the card, and the blood pressure cuff resulted in an average 100.2% compliance rate with mean decreases of 15 mm Hg (P = .0006) and 6.60 mm Hg (P = .0006) in systolic and diastolic pressures, respectively. Results of the two-phase study showed statistically significant increases in medication compliance associated with statistically and clinically significant reductions in blood pressure for all patients using the timepiece cap.

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PubMed1991

Clinical evaluation of a finger oscillometric blood pressure device.

An oscillometric blood pressure (BP) device designed for recording systemic BP from a finger was compared with a random-zero, mercury-column sphygmomanometer in 76 subjects recruited from the patient population and staff of a primary-care center. After both devices were placed on the left arm or finger of the left hand, three BP readings were obtained with each device in alternating fashion, thereby according random assignment. The mean for all measurements was 119.2/72.4 mm Hg for the finger device and 118.6/75.3 mm Hg for the random-zero sphygmomanometer; systolic readings were not different (p = 0.53) but diastolic readings were different (p = 0.001). There were considerable differences among the readings obtained with the two devices in individual patients: the mean differences +/- tolerance limits for readings obtained with the finger device compared with the random-zero device were 0.6 +/- 33.5 mm Hg for systolic and -2.9 +/- 25.3 mm Hg for diastolic readings. There was also considerable variability in the readings obtained with the finger device; the minimum to maximum differences in 39 systolic (51 percent) and 26 diastolic readings (34 percent) were greater than 10 mm Hg with the finger device; 24 systolic (32 percent) and 11 diastolic readings (14 percent) differed by this amount with the random-zero device. The variability in measurements made with the finger device was significantly different from the random-zero device for diastolic pressure (p = 0.0048) but not for systolic pressures (p = 0.8729). Based on the experience obtained in this study, devices to measure BP from the finger cannot be recommended for routine use.

Adult↗
PubMed1988

Cost analysis of a home intravenous antibiotic program.

A cost analysis of a home intravenous antibiotic program was performed, and the feasibility of the program was evaluated. All fiscal data related to the antibiotic therapy of the 10 study patients were collected from the patients' billing records and charts. Inpatient charges for antibiotics, supplies, laboratory tests, and the hospital room were identified from the patient's bill. Personnel costs were obtained from a log maintained by the home antibiotic team members. Charges accrued were converted to costs using the cost-to-charge ratio for each cost center. Fiscal analysis was performed using a subgroup of six patients with osteomyelitis. For all the patients, the mean duration of home therapy was 26 days. Inpatient treatment averaged 15.9 days. No major catheter-related problems were identified. For the osteomyelitis patients, the total cost of therapy, both inpatient and outpatient, was $57,854. If all of the therapy for this subgroup of patients had been provided on an inpatient basis, the total cost would have been $98,314. The home intravenous antibiotic program was determined to be feasible and cost-effective.

Adult↗
PubMed1985

Systemic side effects associated with the ophthalmic administration of timolol.

Since the introduction of ophthalmic timolol solution in 1978 there have been numerous reports of systemic toxicity associated with its use. The majority of the systemic side effects reported are the same as those associated with oral timolol. Several cases of respiratory distress have been described generally in patients with underlying restrictive airway disease. Cardiovascular effects range from effects on resting pulse rate to the development of overt bradycardia and heart failure. Central nervous system effects reported include fatigue, confusion, depression, and hallucinations. A variety of other systemic effects have also been described. Caution should be used when ophthalmic timolol is administered to elderly patients or those patients with contraindications to systemic beta-blockers.

Absorption↗
PubMedDate not supplied

Economic evaluation of pharmacist involvement in disease management in a community pharmacy setting.

This study evaluated the economic impact of patient-focused pharmacist intervention in the community retail setting in patients with hypertension, diabetes, asthma, and/or hypercholesterolemia. Specially trained pharmacists intervened by providing targeted patient education, performing systematic patient monitoring, offering feedback and behavior modification, and communicating regularly with patients' physicians to enable early intervention for drug-related problems. We evaluated prescription drug costs and total medical costs by comparing claims data from 188 patients enrolled in the program at three intervention pharmacies with data from 401 control patients at five nonparticipating pharmacies from the same retail chain. For all disease states, the average cost per prescription was significantly higher in the group receiving intervention than in the control group. Differences in total monthly prescription costs were significant only for patients with asthma, with higher monthly costs in the group receiving intervention. Substantial savings were demonstrated across all cost analyses for total monthly medical costs. Savings ranged from a conservative estimate of $143.95 per patient per month to $293.39 per patient per month when accounting for the possible influence of age, comorbid conditions, and disease severity. Our data indicate that pharmacist intervention in this community pharmacy-based disease management model substantially reduced monthly health care costs in patients with hypertension, hypercholesterolemia, diabetes, and asthma.

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