The Annals of pharmacotherapy
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To estimate the prevalence of inappropriate medications prescribed by office-based physicians for patients 65 years or older. ⋯ The prescribing of inappropriate medications by office-based physicians raises concerns regarding the quality of care for the elderly in ambulatory settings. The crux of improving patient care in ambulatory settings rests with collaborative efforts between physicians and pharmacists.
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To describe the therapeutic management of Medicaid patients with urinary tract infections (UTIs) in urban long-term-care facilities (LTCFs) and to link individual therapies to patient outcomes. ⋯ There were no differences in cure rates when comparing LTCF UTI patients receiving various regimens. With outcomes being the same, the clinician should closely consider costs of drug therapy in selecting a treatment preference.
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A number of studies evaluated the pharmacologic management of patients with coronary artery stents. Four studies demonstrated a low subacute thrombosis rate with antiplatelet therapy without implementation of anticoagulant therapy. However, in three of these trials conflicting results were reported regarding the relative efficacy of various antiplatelet therapies. ⋯ In addition, the potential benefits of combination therapy with ticlopidine and aspirin apply only to patients at low risk as defined by the ACCP and ACC expert panels. Until further data become available, high-risk patients should be managed with conventional anticoagulation regimens. Studies are needed to determine whether antiplatelet therapy is effective in high-risk patients and the optimal antiplatelet therapy (ticlopidine, aspirin, or ticlopidine/aspirin) for the management of patients with coronary artery stents.
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Comparative Study
The effect of ICU sedation guidelines and pharmacist interventions on clinical outcomes and drug cost.
To measure the effect of evidence-based intensive care unit (ICU) sedation guidelines and interventions by a pharmacist to promote these guidelines on the weaning time from mechanical ventilation and sedation drug cost. ⋯ High compliance with ICU sedation guidelines promoting lorazepam rather than midazolam or propofol in mechanically ventilated patients led to a 75% decrease in sedation drug costs and did not adversely affect the clinicians' ability to wean patients from mechanical ventilation.