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At least 19 recordsLinked to original sources
PubMed1998

Prescription changes and drug costs at the interface between primary and specialist care.

OBJECTIVE: To explore the relevance of prescription changes and related drug costs when patients are referred from primary to secondary care. PATIENTS AND METHODS: Secondary analysis of data derived from a study on the quality of referrals, which was performed in 1989-1990. New and non-acute referrals of ambulatory patients were studied for internal medicine, neurology, and dermatology. Diagnoses were coded according to the ICPC, and drug names were coded according to the ATC. Prescription data were collected from referral letters and questionnaires. Drugs were also coded as generic or brand name products. Cost of treatment was calculated on the basis of information in the 1989 edition of the Dutch Public Health Care Drug Compendium taking into account the price of the drug and the duration of the prescription. Potential savings were calculated for those brand name products for which substitution by a similar drug was possible. RESULTS: Data on 289 referrals, representing 289 patients, were available for analysis. In 126 out of the 289 patients (43.6%), specialists added to or changed prescriptions initiated by the general practitioner (GP). Specialist prescribing tended to shift to more chronic use. The costs of specialist prescribing are on average 23% higher than for GP prescriptions. Although specialists had fewer opportunities for generic substitution, the potential for savings was greater than for GPs. In many cases, the specialists changed the diagnosis. Only in neurology was the relative risk of receiving a prescription increased when the diagnosis changed. CONCLUSION: Specialists have considerable influence on prescribing to outpatients. The number of prescriptions and the related costs increased greatly when patients were referred from primary to secondary care. The opportunities for generic substitution, and therefore for possible savings, are not fully exploited by GPs or specialists.

Costs and Cost Analysis↗
PubMed1996

Antihypertensive Drug Therapy. The effect of JNC criteria on prescribing patterns and patient status through the first year.

This study was designed to evaluate the impact of the protocol-driven antihypertensive therapy on outcomes guided by the Joint National Committee (JNC) on Detection, Evaluation, and Treatment of high blood pressure. In a systematic hypertension control program for union employees conducted in New York City, untreated patients who began treatment on monotherapy guided by JNC recommendations during three representative periods: I-pre-JNC IV (1986-1987); II-post-JNC IV (1990-1991); and III (JNC V)-period of application of what were later published as JNC-V guidelines (1992) were observed during 1 year of treatment. A total of 550 presumably untreated patients were prescribed either diuretics, beta-blockers, calcium channel blockers, or angiotensin converting enzyme inhibitors. There were 231 in period I, 213 in II, and 106 in III. The patient composition over time became more predominantly female and Hispanic (I to III: 28% to 34%, and 35% to 45%, respectively). The main outcome measures were type of drug first prescribed and the outcomes at the end of 1 year-changes in blood pressure, clinical chemistry measures and therapy, and clinic attendance are dropout rate. The pattern of first drug prescription changed from 85% to 90% of patients given diuretics or beta-blockers in I to 90% begun on calcium channel blockers or angiotensin converting enzyme inhibitors in II and finally, to an even distribution of drugs in III. Blood pressure response was similar across the three periods, 135/89 mm Hg (I), 138/89 (II), and 140/89 (III). Proportion of patients remaining on their initial drug in each period was fairly similar (60%, 67%, and 69%). Scheduled clinic visits fell significantly from 7.4 visits in I, 6.9 in II, and 6.4 in III (I upsilon III P = .004). Dropouts diminished significantly from 17% in I, to 10% in II, and 9% in III (I upsilon II or III P = .045). Modest positive changes in cholesterol and fasting blood sugar level occurred over time. In this general community setting, dramatic shifts in the choice of initial drug based upon application of JNC guidelines had little discernable impact on short term patient outcomes.

Analysis of Variance↗
PubMed1997

An evaluation of community pharmacy records in the development of pharmaceutical care in The Netherlands.

An electronic patient database linking prescribes with a Dutch community pharmacy consortium was evaluated in a subset of the population of Noordwijk (11,760 patients out of a total of 25,600). The pharmacy database (a file of 41 disease contra-indications representing a subset of the prescribers' medical diagnosis) was studied in order to assess its value for the accurate discrimination of target patient groups within the community and for support to the pharmaceutical care of individual patients. The aim was to examine the application of the pharmacy records to pharmaceutical care, tested by measuring the accuracy of the pharmacy database to predict the community public health profile; and, more specifically, the accuracy to identify three potential target groups for pharmaceutical care. The records of patients with angina, chronic respiratory disease and diabetes (n = 1116), representing 65% of the total pharmacy morbidity records, were studied in detail and verified by the files and texts of the prescriber's individual patient records. From samples of patients (n = 273) from the three patient groups, the extent and nature of co-morbidity, polypharmacy (drug entities prescribed annually) and drug therapy instability (prescription changes to dose or dose form annually) were characterised. Angina patients showed the most comorbidity, 46% having three or more additional diseases; chronic respiratory disease patients showed most drug therapy instability; and insulin-dependent diabetic patients received most polypharmacy per disease. The pharmacy database predicted the prevalence of 10 of 23 relevant disease categories (representing 51% of the total morbidity on the medical records). However, the prevalences of eight categories were underestimated and of five categories overestimated. Of the three patient groups, 73% of patients appeared on both the pharmacy and the medical database. Of the total co-morbidity recorded for these patients, 68% of records were common to both databases. The database discrepancies (32%) were due to morbidity omitted (12%) and morbidity unverified (10%) on the pharmacy database, together with morbidity omitted from the medical database (10%). The current pharmacy database provides a limited view of morbidity. A strategic approach to pharmaceutical care requires pharmacists and prescribers to verify and share patient information if patient groups and individuals within a group are to be usefully targeted.

Cardiovascular Diseases↗
PubMed1998

Community pharmacist interventions in a capitated pharmacy benefit contract.

Documented interventions associated with processing prescriptions in a managed care environment were analyzed, and a bench-mark for interventions was proposed. A retrospective analysis of documented interventions by 31 pharmacies contracted by a managed care organization to serve 22,000 Medi-Cal patients was undertaken. An intervention consisted of identifying any problem related to a prescription, taking action, and recording the problem, action, and outcome on a form. Problems were categorized as drug selection issues, clinical issues, errors in prescription writing, and patient education issues. A similar process was followed for describing actions and outcomes. The data were used as an indicator of prescription-related problems in contemporary pharmacies in a managed care environment; data from another study were used as an indicator of "ideal" pharmacist performance in detecting and resolving problems. The estimated intervention rate when pharmacists meeting ideal performance expectations worked in a managed care environment was set as a benchmark. The economic impact of drug selection interventions was determined as well. Data were retrieved and compiled from 595 (93.4%) of 637 interventions performed in 1995, when 93,483 contract-related prescriptions were processed by the 31 pharmacies. Fifty percent of problems related to drug selection issues. The most frequent action was contacting the presciber (56.1%). The overall intervention rate was 0.7% (range, 0-4.1%). It was estimated that 4% of prescriptions would require an intervention; two pharmacies met this level. Interventions resulting in prescription change realized an average decrease in cost of 65.8%. Community pharmacies under contract with a managed care organization intervened on 0.7% of prescriptions, but the rate of intervention across pharmacies was inconsistent, ranging from 0% to 4.1%; a benchmark of 4% would be reasonable.

California↗
PubMed1997

Management of patient-controlled analgesia: a comparison of primary surgeons and a dedicated pain service.

Although Patient-Controlled Analgesia (PCA) is routinely available in most hospitals in the United States, there appears to be little standardization regarding who provides this valuable service to postoperative patients. This study evaluates the differences in PCA management practices and patient outcomes between primary service (PS) physicians and acute pain service (APS) physicians. Over a 3-mo period, 40 patients prescribed PCA by PS physicians were prospectively studied without the knowledge of the physicians or nurses involved in PCA management. After collecting PS data, a proportionate stratified random sampling procedure was used to select 40 APS patients matched for gender, age, and type of surgery. Data regarding patient demographics, PCA prescription, changes in PCA orders, opioid consumption, reason for discontinuation of PCA, verbal analog scale pain scores, side effects, and post-PCA pain management were analyzed. Although pain scores were not different between groups, APS patients had fewer side effects, were more likely to receive a loading dose, had their PCA settings adjusted more often (P < 0.05), and used more opioid. PS patients were more likely to receive intramuscular medications after PCA discontinuation (P < 0.05). This study demonstrates potentially important PCA management differences between APS and PS physicians.

Analgesia, Patient-Controlled↗
PubMed1997

Determining the effectiveness of a clinical-practice intervention in improving the control of pain in outpatients with cancer.

PURPOSE: To determine the effectiveness of a clinical-practice intervention in improving the control of pain in outpatients with cancer. METHOD: Between July 5 and September 30, 1995, a randomized, controlled trial of 510 cancer outpatients and 13 oncologists was conducted at 23 clinics in Indiana. All the patients completed assessments of their pain, their pain regimens, and the degrees of relief received; they were surveyed again by mail four weeks after their clinic visits. The intervention group's clinical charts contained a summary of the completed pain scales; the oncologists who treated these patients were instructed to review the summary sheet prior to an evaluation. This summary was not available for the oncologists treating the patients in the control group. Each patient's pain management index (PMI) was calculated: the patient's pain medication level was rated on a scale of 0 to 3; the patients's pain level was rated on a scale of 0 to 3 and then subtracted from the first rating. A negative PMI was interpreted as representing insufficient treatment. Data were analyzed with several statistical tests. RESULTS: In all, only 320 patients who reported cancer-related pain were used in the analysis: 160 to 260 in the control group and 160 of 250 in the intervention group. The groups were similar with respect to demographics, cancer sites, and performance status. A significant difference (p = .0162) in the physicians' prescription patterns was found. In the control group, prescriptions for 86% of the patients did not change, with no decrease in analgesic prescriptions; for 14% of the patients analgesic prescriptions increased. In the intervention group, analgesic prescriptions changed for 25% of the patients, decreasing for 5% and increasing for 20%. A decrease in the incidence of pain described as more than life's usual aches and pains was found for the intervention group (p = .05). No significant difference was found between the groups for the patients undertreated for pain, as measured by PMIs. CONCLUSION: Although analgesic regimens were altered significantly when the physicians understood more about the patient's pain, cancer pain management remains a complex problem. Future studies should focus on the long-term systematic incorporation of simple pain-assessment tools into daily outpatient oncology practices as well as on innovative ways to address other aspects of managing cancer pain.

Adolescent↗
PubMed1996

Comparison in prescribing patterns of antibacterial drugs in salmonid farming in Norway during the periods 1980-1988 and 1989-1994.

The choice of antibacterial drugs for the treatment of bacterial diseases in farmed salmonids changed dramatically during the period 1980-1994. In terms of treatment doses, oxytetracycline chloride was the most frequently prescribed antibacterial drug during the periods 1980-1983 and 1985-1986. In 1984, prescriptions changed in favour of furazolidone and trimethoprim/ sulphadiazine (1:5). Oxolinic acid was introduced for use in farmed fish in Norway in 1987, and immediately became the drug of choice, comprising 36% and 50% of the prescribed treatment doses in 1987 and 1988, respectively. In 1989, flumequine was temporarily approved for use in farmed salmonids, and during the period 1989-1994 antibacterial drug therapy in farmed salmonids acquired the character of "mono-therapy' with the quinolones flumequine and oxolinic acid. This rapid change-over in the choice of drug may partly be explained by the development of bacterial drug resistance in farmed salmonids, both to oxytetracycline and trimethoprim/sulphadiazine. The prescribing of furazolidone declined to zero during the study period. The morbidity caused by bacterial infections was defined as the number of treatment doses of antibacterial drugs per kg biomass of farmed salmonids per year. It was estimated that during the period 1988-1995, an average of 39% (mean value) of farmed salmon received, in theory, an antibacterial cure once each year. In comparison, the corresponding figure for the period 1981-1988 was 60%. However, in 1993 this figure fell to 13%, and declined even further in 1994 to 2.3%. The practice of on-farm mixing of medicated feed, using prescribed raw materials (pure drug substances) or premix formulations, declined significantly during the period 1992-1994. This was due to the introduction, in 1992, of new regulations on the prescribing of drugs to farmed fish.

Animals↗
PubMed1979

Simulated discharge system of prescription and long-term drug treatment in a psychiatric hospital.

The drug sheets of patients resident in a psychiatric hospital for more than 1 year were reviewed. The simulated discharge system involving the re-writing of drug sheets every 12 weeks was in operation, but there was only a slight increase in prescription changes at the time of renewal; 35.4% of prescriptions had been unchanged for 1 year and 4.3% for 5 years. A high proportion of long-term prescriptions were for purgatives, hypnotics and neuroleptics.

Antidepressive Agents↗
PubMedDate not supplied

Magnification in dentistry.

The use of today's highly sophisticated dental materials has required a corresponding increase in the technical skills of the operator. Surgical telescopes with high resolution and contrast are replacing plastic lenses of somewhat lesser quality. Moreover, depending on their frame mounting, these ground glass magnifiers are also offering the operator additional comfort and safety. The problem for the dentist, however, is to assess properly the products currently being presented by manufacturers. A detailed description of each device offered by four major suppliers is given relative to true field width and depth, working distance or range, "down time" during prescription changes, usefulness with correction, operator positioning, light admittance, degrees of magnification available, and expense. Photographs of the operator practicing without magnification and then using each of three devices is shown and analyzed. With some exceptions, those instruments providing the most flexibility as regards the above factors are most worthy of the dentist's consideration.

Dental Instruments↗
PubMed1999

Guidance to users of Nycomed Amersham and North American Scientific, Inc., I-125 interstitial sources: dosimetry and calibration changes: recommendations of the American Association of Physicists in Medicine Radiation Therapy Committee Ad Hoc Subcommittee on Low-Energy Seed Dosimetry.

Dose calculations to patients undergoing implantation of 125I interstitial brachytherapy sources are affected by two recent changes in low-energy seed dosimetry: (a) implantation of a new primary air-kerma strength standard at the National Institute of Standards and Technology (NIST) on 1 January 1999 and (b) publication of revised dose-rate distributions in AAPM's Task Group 43 Report. The guidance herein represents AAPM's recommendations for users of 125I interstitial seed products marketed prior to 1 January 1999 (Nycomed Amersham models 6711 and 6702 and North American Scientific, Inc. models 3631 A/S and 3631 A/M. Implementation of Task Group 43 (TG43) 125I dose calculations involves revising data stored in files of radiation treatment planning software and lowering the prescribed dose to be delivered to patients by as much as 15% to avoid modifying the dose actually delivered to patients. The magnitude of the dose prescription change depends on the dosimetry data used prior to TG43 and the implant geometry. Adapting to the revised NIST calibration standard requires the user to increase the dose-rate constant (or its equivalent by 11.5%) but does not require modification of the prescribed dose. Failure to correctly implement these modifications can result in 20% or even 30% errors.

Brachytherapy↗
PubMed1998

Rapid growth in the use of automated peritoneal dialysis (APD) in adult patients on peritoneal dialysis.

Inadequate dialysis dose is associated with poor patient-survival in peritoneal dialysis (PD). Most patients would require more than four exchanges a day after losing residual renal function. The use of automated peritoneal dialysis (APD) seems to be a practical way to provide extra dialysis for these patients. In our Dialysis Centre in Northern Alberta, we started to use APD for our adult patients only from 1993. When we evaluated our practice recently, we found that we are progressively increasing the use of APD (including cyclers and night exchange devices) from 3% to 21% for our total adult PD patients in the last 3 years. This increase in the use of APD is mostly to accommodate PD prescription changes and not changes in lifestyle. Increase in the use of APD was associated with decrease in the rate of our PD dropout to hemodialysis. We conclude that to maintain adequate dialysis, rapid growth of APD will become common in North American PD centers in the future and will reduce transfer to hemodialysis.

Adult↗
PubMedDate not supplied

[The study of the impact of the consensus conference "Strategies for long-term therapy of patients with schizophrenia"].

UNLABELLED: The case management, treatment and psychosocial rehabilitation of schizophrenic patients is an important part of the activity of the psychiatric sector and takes up many human, scientific, organizational and financial resources. The best way to reach satisfactory results for the individual patient is still uncertain and current practice in France shows noticeable variations that have been rarely investigated in terms of outcome. A consensus conference (CC) on "Strategies for long-term therapy of patients with schizophrenia" was therefore held in Paris in 1994 to produce accurate guidelines designed to help both clinicians and patients and to improve practice. It was organized by the French Federation of Psychiatry, the National Union of Friends and Relatives of Mental Patients, and the National Agency for the Development of Health Evaluation. The conclusions of the CC were mailed, in the form of a booklet, to members of these associations (psychiatrists and relatives) and were reported in the medical and general press. METHODS: The impact of the CC was judged by (a) the psychiatrists'awareness of the existence of the CC, (b) their knowledge of its conclusions, and (c) changes in practice. The following were analyzed: press coverage; requests for the booklet; the results of a survey of a representative sample of 396 psychiatrists two years after the CC; prescription changes in the public sector in a cohort of 2,407 schizophrenic patients under treatment at the time of the CC; prescriptions to psychotic patients by a representative sample of psychiatrists in private practice. RESULTS: Awareness: Articles on the CC were published in 27 journals and newspapers, 30,000 booklets were distributed and 8,348 were mailed in response to 1,121 spontaneous requests; 78% of the psychiatrists interviewed said they were aware of the existence of the CC and 70% said they were aware of the conclusions. Knowledge: The psychiatrists' declared practice conformed with CC conclusions 41%-85% of the time depending on the recommendation. No difference in practice was noted between the psychiatrists who said they knew of the recommendations and those who said they did not. Changes in practice: A significant but small improvement in prescription habits was noted for a principal recommendation ("just one neuroleptic is enough"). One-neuroleptic prescriptions increased from 51.1% the year before the CC to 56.4% two years after the CC. The increase mainly concerned the most recently treated patients. However, during the same time-span, prescriptions of anti-cholinergics plus neuroleptics rose from 48.2% to 54.3%. CONCLUSION: It is difficult to attribute changes in practice to a CC. However, the impact of the CC seemed real even if inconstant and not great enough. Clearly, to enhance impact an action plan is needed. It should include corrective measures and focus on additional dissemination efforts, teaching and training programs, and updating of guidelines if necessary.

Adult↗
PubMedDate not supplied

Incremental initiation of dialysis: one center's experience over a two-year period.

OBJECTIVE: This pilot study describes our center's experience with peritoneal dialysis (PD) over the past 2 years using a "healthy start" dialysis protocol with an incremental approach to prescription management. DESIGN: Nonrandomized, prospective pilot study. SETTING: Single PD unit of a university teaching hospital. PATIENTS: Thirteen PD patients who initiated dialysis at our center from April 1997 to June 1999. METHODS: Patients initiating PD with residual renal Kt/V of 1.0 - 2.0/week were invited to participate. They were given an initial dialysis prescription so that total (residual renal + dialysis) weekly Kt/V exceeded 2.0. The dialysis prescription was "incrementally" increased as residual renal function (RRF) declined. Data collected for all patients included monthly serum chemistries, residual renal weekly Kt/V and creatinine clearance (CCr) at 1- to 2-month intervals, and peritoneal weekly Kt/V and CCr at 3-month intervals and 1 month after each prescription change. RESULTS: To date, we have followed 13 patients on our incremental PD protocol for a total of 159.3 patient-months. Mean serum albumin concentration and mean normalized protein equivalent of nitrogen appearance (nPNA) were stable throughout the study. Mean total Kt/V and CCr remained above the recommended targets of 2.0/wk and 60 L/wk, respectively. Residual renal function declined rather slowly in our PD patients. One patient died from complications of aortic valve surgery and a second died from pneumonia. A third patient died from peritonitis. One patient required a new Tenckhoff catheter after catheter migration. Three patients were temporarily switched to hemodialysis after a hernia repair, a pleural leak, and elective native/transplant nephrectomies, respectively. Two patients were permanently switched to hemodialysis: one after an episode of peritonitis, the second after accidentally damaging his PD catheter. CONCLUSIONS: Providing incremental dialysis to maintain adequate total small solute clearance has been technically feasible in our patient population. However, a larger than expected number of complications was seen in our study. Fortunately, complications were easier to manage due to the presence of RRF. Because this study was not designed to compare outcome with that observed after traditional initiation of dialysis, further large-scale studies are needed.

Adult↗
PubMed1991

Evaluation of CAPD prescription.

Adequacy of CAPD has not been established. The recommendation is a Kt/V (K, total urea clearance in ml/min; t. time in minutes on dialysis; and V, total body water which is the volume of distribution of urea) greater than 1.5/week and/or a creatinine clearance (residual + dialysis) greater than 40 l/week/1.73 m2. We followed 20 CAPD patients for 38.6 +/- 28 mo. We measured blood urea nitrogen, serum creatinine, body weight, residual renal function (Kr), normalized protein catabolic rate (NPCR), Kt/V/week and creatinine clearance (CC) l/w/1.73 m2. We obtained the following values: B Wt 72 +/- 16 kg, BUN 56 +/- 13 mg/dl, s. Cr. 12.6 +/- 5 mg/dl, Kr 0.6 +/- 1 ml/min, NPCR 0.84 +/- 0.3 g/kg/day, Kt/V/week 1.8 +/- 0.3 and CC 50.4 +/- 10 l/w/1.73 m2. Patients dialyzed with a wide range of prescription. There was a good correlation between Kt/V and CC. There was no correlation between the dialysis prescription changes in weight and biochemical determinations. There was a direct correlation between Kt/V and NPCR: patients who were dialyzed more eat more. Of the 20 patients, 10 had 24 hospitalizations, and of these were 12 due to peritonitis. Dialysis prescription and biochemical findings of these patients did not differ significantly from nonhospitalized patients. Larger prospective studies are necessary to determine the adequate range of CAPD prescription and its relationship to morbidity and mortality.

Adult↗
PubMedDate not supplied

Recombinant human erythropoietin correction of anemia. Dialysis efficiency, waste retention, and chronic dose variables.

A clinical review of patients who were treated with recombinant human erythropoietin was undertaken to evaluate the effect of partial correction of anemia upon dialysis function and waste retention. Assessment of possible variables that might influence the dosage response was also undertaken, both in a retrospective and prospective manner. Finally, a chart review of patients' symptoms while on dialysis was done to evaluate the effect of correction of anemia. Hematologic improvement was noted in all patients placed on hormone therapy with the correction of hemoglobin and hematocrit. There was no effect on white cell count, although a slight change in the differential was noted at target and one year; platelets rose to a new steady state. Dialysis efficiency was decreased slightly for urea and markedly for creatinine, probable reflecting the distribution characteristics of the latter. Retention of urate, phosphorus, and potassium was noted at target, with a drop toward usual serum levels with minimal dialysis prescription change. Variables such as age, gender, race, and dialysis prescription were compared in an effort to establish dosage variation, but no statistically significant changes were seen. There was an inverse trend in dosage, however, with increasing dialysis efficiency. Patients also seemed to be more tolerant of their dialysis treatments when nonanemic, compared to when anemic. While there is retention of some substances with improvement of anemia, the levels were easily corrected with adjustment of the dialysis prescription. No definite relationship could be seen in any of the variables studied and hormone dose requirements. Attention must be paid to adequate dialysis prescription in the erythropoietin treated patient.

Anemia↗
PubMed1995

[Does the consumption of drugs change among nursing home residents after an intervention by systematic visits of "family physicians"?].

The aim of the study was to investigate whether an intervention by the patient's general practitioner (GP) changes the consumption of medicine in nursing homes. It was designed as an intervention study including 111 inhabitants in nursing homes in a municipality (Odder). All the general practitioners in this local authority visited and evaluated their own patients. It was found that there were great variations in the consumption of medicine between nursing homes. Sixty-six percent of the inhabitants had their prescriptions changed after the intervention. Thirty-six percent had their prescriptions stopped and 30% received a new prescription. It is concluded that a single visit with a special focus on medicine consumption by the GP caused a large number of changes in the residents' consumption of medicine in nursing homes.

Aged↗
PubMed1998

Original research: the relationship between dialysis adequacy and quality of life: a report of a pilot study.

Adequacy of dialysis, as measured by urea kinetic modelling (UKM), is considered an extremely important clinical outcome for all dialysis programs. While improving adequacy has been clearly linked to decreased mortality among hemodialysis patients, the relationship between adequacy and patients' quality of life remains less clear. Patients with higher Kt/Vs live longer, but do they live better? This paper describes the results of a pilot study designed to examine the relationship between adequacy of hemodialysis and the patient's perceived quality of life. This time series study employed a convenience sampling technique consisting of all willing new patients to join an in-centre hemodialysis program in a six-month period. The adequacy of each new patient's dialysis prescription was determined by analyzing urea kinetics at one and three months following the commencement of therapy. Dialysis prescription changes were made by the interdisciplinary team, as necessary and where possible, to achieve a minimum Kt/V of 1.2. Each new patient's quality of life was measured at the same time intervals, that is, one and three months using two instruments. The first, the SF36 is a generic 36-item instrument designed to measure a range of functioning and well-being. The second, the Kidney Disease Questionnaire (KDQ) is a disease-specific quality of life instrument designed for use with chronic hemodialysis patients. Results showed that both adequacy and quality of life scores improved from one to three months. There are, however, too many competing explanations to assume a relationship between the two variables. Future analysis with a larger sample will employ an analysis of covariance to look for relationships.

Adult↗