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At least 19 recordsLinked to original sources

PubMed2005

Suggested guidelines for pharmacotherapy curricula in family medicine residency training: recommendations from the Society of Teachers of Family Medicine Group on Pharmacotherapy.

Rational drug use has increasingly received public policy attention in efforts to maintain quality health care at lower costs. Prescribing habits are developed during residency training, and education regarding rational drug use should be an integral part of the residency curricula. Considering that many medical errors in family medicine are related to incorrect medication management, there is need for a focused education in pharmacotherapy. This paper outlines suggested guidelines for pharmacotherapy curricula in family medicine residency training, as recommended by the Society of Teachers of Family Medicine Group on Pharmacotherapy. A pharmacotherapy curriculum should include common conditions managed in family medicine, as well as general principles of pharmacotherapy. This should allow for repeated exposure to core topics over a 3-year cycle and be delivered in various settings (didactic teaching, longitudinal active learning, point-of-care education, and rotations). The curriculum should apply and evaluate pharmacotherapy education according to the six core competencies of the Accreditation Council for Graduate Medical Education (ACGME). Although physician faculty can be responsible for pharmacotherapy education, a clinical pharmacist is uniquely qualified to provide this service. Overall, family medicine residents need comprehensive instruction in pharmacotherapy to develop rational prescribing habits. A structured pharmacotherapy curriculum may assist in achieving this goal and in meeting the ACGME core competencies for residency training.

Curriculum↗

PubMed2006

A retrospective controlled study into memory complaints reported by depressed patients after treatment with electroconvulsive therapy and pharmacotherapy or pharmacotherapy only.

Few studies have been conducted comparing complaints of memory problems using objective and subjective memory scales in depressed patients who received electroconvulsive therapy (ECT) + pharmacotherapy or treatment with pharmacotherapy only. Patients who suffer from depression according to the Diagnostic and Statistical Manual of Mental Disorder (Fourth Edition) criteria and who were admitted within the past 5 years before this study in a general psychiatric hospital were screened for inclusion. Objective retrograde amnesia was assessed using the Autobiographical Memory Interview and the Amsterdam Media Questionnaire (AMQ). Subjective retrograde amnesia was assessed using the Squire Subjective Memory Questionnaire and the ECT Retrograde Amnesia and Perception Scale (ERAPS), a newly developed scale. Twenty of the 84 patients who received ECT + pharmacotherapy and 30 of the 196 patients who received pharmacotherapy only participated in the study. Patients' ERAPS memory scores were compared with proxies' ERAPS memory scores of the patients to assess the reliability of memory complaints. The ECT + pharmacotherapy group was found to suffer more from memory problems using the AMQ 1990 test. There was also a difference for the proxy's ERAPS memory score, reflecting the conviction of proxies from the ECT + pharmacotherapy patients that these patients suffer more memory problems due to the illness, treatment with pharmacotherapy, or ECT. The differences could not be explained by the influence of determinants for retrograde amnesia. ECT + pharmacotherapy patients did not attribute their memory problems mainly to ECT but put equal "blame" on the depressive illness, treatment with pharmacotherapy, and ECT. The analyses suggest that the AMQ 1990s test is (more) sensitive in registering retrograde amnesia than the other scales used in the study.

Amnesia, Retrograde↗

PubMed1989

Comparative studies on the efficacy of psychotherapy, pharmacotherapy, and their combination in depression: was adequate pharmacotherapy provided?

Pharmacotherapy and psychotherapy, separately or in combination, have been used successfully in the treatment of depression. Recent studies have compared the two modes of treatment and their combination with respect to relative efficacy and have found psychotherapy, alone or combined with medication, to be the preferential treatment approach for depressive disorders. However, the adequacy of pharmacotherapy administered in these trials remains in question. The last decade's major comparative studies are systematically reviewed in order to evaluate the nature and specifics of pharmacotherapy. Special emphasis is placed on essential requirements of pharmacotherapy, methods of treating refractory cases, and details of treatment provision. Most of the studies used inadequate antidepressant doses, did not measure tricyclic plasma concentrations systematically, neglected the use of accepted strategies for response enhancement in refractory cases, and at times provided pharmacotherapy in nonspecialized settings or by inexperienced physicians. Findings indicate that pharmacotherapy administered in these studies does not fulfill requirements for adequacy and thereby precludes any definite conclusions regarding relative efficacy. The authors propose the term "optimization" of treatment to reflect maximized pharmacotherapy, discuss its essential requirements, and submit that such optimization be assured in future comparative trials.

Antidepressive Agents↗

PubMed2005

Choosing pharmacotherapies for the COMBINE Study--process and procedures: an investigational approach to combination pharmacotherapy for the treatment of alcohol dependence.

OBJECTIVE: This article describes the process by whichthe COMBINE investigators evaluated and chose the two pharmacotherapies to be studied in COMBINE. METHOD: The pharmacotherapies were chosen through a consensus process that involved the evaluation of neuropharmacological agents known to modify alcohol consumption or other alcohol-related behaviors in animals and humans. Medications were classified according to the published evidence, with the highest ranking given to those with evidence of efficacy in human clinical trials. The investigators also considered evidence for safety, potential drug-drug interactions, management of side effects, optimal dose, treatment duration, availability of the medication and integration with the psychosocial therapies. The full evaluation required conducting two pilot studies and the development of an instrument to monitor safety, the COMBINE Systematic Assessment for Treatment Emergent Events. RESULTS: Naltrexone, at a dose of 100 mg per day, and acamprosate, at a dose of 3,000 mg per day, were chosen for the study. The medications were administered for a period of 4 months, concurrent with the COMBINE psychosocial therapies CONCLUSIONS: The results of the decision making with respect to medications and safety monitoring resulted in a well-planned and well-executed study that minimized risks to the participants.

Acamprosate↗

PubMedDate not supplied

Pharmacotherapy specialty certification examination. IV. 1992 results and process modifications, including recertification. The 1992 Specialty Council on Pharmacotherapy, Board of Pharmaceutical Specialties.

Certification of pharmacotherapy specialists is proceeding smoothly. Modifications to the examination process, which include reapportioning domains, offering the examination at several sites, and establishing the recertification process, have occurred. The guidelines for petitioners and structure of specialization continue to receive the attention and interest of prospective candidates, pharmacy organizations, and the BPS. To date, 674 specialists have been certified in the approved specialties: 175 nuclear pharmacists, 236 nutrition pharmacists, and 263 pharmacotherapy specialists.

Certification↗

PubMed1988

Cognitive training adjunctive to pharmacotherapy in schizophrenia and depression: a pilot study on the lateralization hypothesis of schizophrenia and depression and on cognitive therapy as adjunctive to pharmacotherapy.

Although controversial, evidence from various experimental sources suggests a dysfunction/overactivity of the hemisphere dominant for speech - usually the left - in schizophrenia and of the other one in depression. Based on these lateralization hypotheses and on the dependency of regional cerebral blood flow on regional neuronal activity, the concept of pharmacopsychotherapy was proposed. The present double-blind pilot study tried to test this concept by cognitive training procedures tentatively relevant to the mechanisms of information processing of the left (analytical) and right (holistic) hemisphere, respectively. It was hypothesized that the outcome of patients putatively trained in mechanisms of the right hemisphere might be superior to that of those trained left in depression and the converse in schizophrenia. This hypothesis could not be verified. Apparent differences in the outcome of depressives were attributable to differences of independent variables (age, seriousness of illness).

Adolescent↗

PubMed2006

The Salmeterol Multicenter Asthma Research Trial: a comparison of usual pharmacotherapy for asthma or usual pharmacotherapy plus salmeterol.

STUDY OBJECTIVE: To compare the safety of salmeterol xinafoate or placebo added to usual asthma care. DESIGN: A 28-week, randomized, double-blind, placebo-controlled, observational study. SETTING: Study subjects were seen once in the study physician's office for screening and were provided all blinded study medication for the entire study period. Follow-up by telephone was scheduled every 4 weeks. PARTICIPANTS: Subjects (> 12 years old) with asthma as judged by the study physician were eligible. Individuals with a history of long-acting beta2-agonist use were excluded. INTERVENTIONS: Salmeterol, 42 mug bid via metered-dose inhaler (MDI), and placebo bid via MDI. MEASUREMENTS AND RESULTS: Following an interim analysis in 26,355 subjects, the study was terminated due to findings in African Americans and difficulties in enrollment. The occurrence of the primary outcome, respiratory-related deaths, or life-threatening experiences was low and not significantly different for salmeterol vs placebo (50 vs 36; relative risk [RR] = 1.40; 95% confidence interval [CI], 0.91 to 2.14). There was a small, significant increase in respiratory-related deaths (24 vs 11; RR, 2.16; 95% CI, 1.06 to 4.41) and asthma-related deaths (13 vs 3; RR, 4.37; 95% CI, 1.25 to 15.34), and in combined asthma-related deaths or life-threatening experiences (37 vs 22; RR, 1.71; 95% CI, 1.01 to 2.89) in subjects receiving salmeterol vs placebo. The imbalance occurred largely in the African-American subpopulation: respiratory-related deaths or life-threatening experiences (20 vs 5; RR, 4.10; 95% CI, 1.54 to 10.90) and combined asthma-related deaths or life-threatening experiences (19 vs 4; RR, 4.92; 95% CI, 1.68 to 14.45) in subjects receiving salmeterol vs placebo. CONCLUSIONS: For the primary end point in the total population, there were no significant differences between treatments. There were small, but statistically significant increases in respiratory-related and asthma-related deaths and combined asthma-related deaths or life-threatening experiences in the total population receiving salmeterol. Subgroup analyses suggest the risk may be greater in African Americans compared with Caucasian subjects. Whether this risk is due to factors including but not limited to a physiologic treatment effect, genetic factors, or patient behaviors leading to poor outcomes remains unknown.

Administration, Inhalation↗

PubMed2001