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Legal and medical issues in therapeutic interchange: implications for pharmacists, physicians, and P & T committees. 治疗交换中的法律和医学问题:对药剂师、医生和药检委员会的影响。
Hospital formulary Pub Date : 1992-10-01
P A Plumeri, V S Crane
{"title":"Legal and medical issues in therapeutic interchange: implications for pharmacists, physicians, and P & T committees.","authors":"P A Plumeri,&nbsp;V S Crane","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In today's health care environment, pharmacists, physicians, P & T Committees, hospital administrators and other clinicians involved in therapeutic interchange issues should be knowledgeable about the legal and medical issues associated with this practice. In this paper, a general discussion of liability under tort law is provided, followed by a specific discussion of the legal aspects of therapeutic interchange. In addition, steps that hospitals, P & T Committees, physicians, and pharmacists can take to establish sound therapeutic interchange policies--and thus reduce liability risks--are presented. Armed with this knowledge, clinicians and administrators can continue to provide cost-effective, patient-oriented care that uphold their professional responsibilities.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 10","pages":"1040-2, 1047-8"},"PeriodicalIF":0.0,"publicationDate":"1992-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20994081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Issues in formulary management: therapeutic interchange. The value, cost, and quality of therapeutic interchange. 处方管理中的问题:治疗互换。治疗交换的价值、成本和质量。
Hospital formulary Pub Date : 1992-10-01
C D Mahoney
{"title":"Issues in formulary management: therapeutic interchange. The value, cost, and quality of therapeutic interchange.","authors":"C D Mahoney","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Therapeutic interchange is a process of substituting a prescribed medication with one that offers therapeutic and cost benefits. The practice not only provides short-term savings but also is associated with decreases in lengths of stay in hospitals and total hospital drug expenses. There may be medicolegal implications when FDA-approved indications differ for interchanged drugs. The potential for liability is decreased when a standard of care is met, but since standards can change, guidelines should be reviewed regularly. High-tech, high-cost drugs are sometimes appropriate for therapeutic interchange. Pharmacy and therapeutics committees should assure best value by considering indirect expenses, quality, and therapeutic outcome, as well as product cost. Therapeutic interchange programs enable pharmacy managers to neutralize or at least slow the rate of drug cost increases, ensuring appropriate utilization of resources and more favorable patient outcomes.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 Suppl 2 ","pages":"2-3"},"PeriodicalIF":0.0,"publicationDate":"1992-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20993707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of the use of i.v. ciprofloxacin. 静脉注射环丙沙星的评价。
Hospital formulary Pub Date : 1992-10-01
G P Sesin, L Stefanski
{"title":"Evaluation of the use of i.v. ciprofloxacin.","authors":"G P Sesin,&nbsp;L Stefanski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A drug usage evaluation was conducted at our institution, a 344-bed teaching hospital, in order to determine whether intravenous ciprofloxacin was being used appropriately based on preestablished hospital criteria.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 10","pages":"1053-4"},"PeriodicalIF":0.0,"publicationDate":"1992-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20994082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Issues in formulary management: therapeutic interchange. Communicating a policy: roundtable discussion, Part 2. 处方管理中的问题:治疗互换。沟通策略:圆桌讨论，第2部分。
Hospital formulary Pub Date : 1992-10-01
M Cichon, C Mahoney, B Renshaw, M Cromer, F A Rodriguez, H DeGiulio, D Wert
{"title":"Issues in formulary management: therapeutic interchange. Communicating a policy: roundtable discussion, Part 2.","authors":"M Cichon,&nbsp;C Mahoney,&nbsp;B Renshaw,&nbsp;M Cromer,&nbsp;F A Rodriguez,&nbsp;H DeGiulio,&nbsp;D Wert","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 Suppl 2 ","pages":"9-12"},"PeriodicalIF":0.0,"publicationDate":"1992-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20993709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Drug usage evaluation of epoetin in chronic renal failure. 促生成素在慢性肾功能衰竭中的用药评价。
Hospital formulary Pub Date : 1992-09-01
N A Mason, D P Iacobellis
{"title":"Drug usage evaluation of epoetin in chronic renal failure.","authors":"N A Mason,&nbsp;D P Iacobellis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>All patients (48) followed by the chronic dialysis program on either peritoneal dialysis or incenter hemodialysis who received epoetin were included in this 1 year retrospective study. Variables evaluated included appropriateness of patient selection, drug dosage, monitoring of epoetin therapy as well as treatment outcome, incidence of side effects, cost versus reimbursement of epoetin, and need for iron supplementation. The target hematocrit of 30 to 36% was reached by 84.6% of patients. The difference between the baseline and treatment hematocrits was statistically significant (p less than 0.01). The average number of transfusions dropped significantly from 0.66 to 0.11 per patient per month (p less than 0.01) and the mean percentage of cytotoxic panel reactivity antibody was also significantly reduced (p less than 0.01) during treatment with epoetin. Serious side effects of epoetin therapy were rare, but four hemodialysis patients experienced five episodes of clotted accesses. The incidence of hypertension requiring addition or change of antihypertensive medication was 17.1%. No seizures were observed during the study period. The results of this study also revealed that more careful attention to iron status was needed during the period of data collection. A nomogram for prediction of iron need based on initial hemoglobin and ferritin levels was also studied and found to be accurate in 87.5% of patients.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 9","pages":"928-32, 937-8"},"PeriodicalIF":0.0,"publicationDate":"1992-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20993714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Drug use evaluation of acetaminophen-containing products at a community hospital. 某社区医院含对乙酰氨基酚产品的用药评价
Hospital formulary Pub Date : 1992-09-01
T S Ward, H I Jablonski, J Vanantwerp
{"title":"Drug use evaluation of acetaminophen-containing products at a community hospital.","authors":"T S Ward,&nbsp;H I Jablonski,&nbsp;J Vanantwerp","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Humana Hospital, a 356-bed facility, set up a drug use evaluation (DUE) program to monitor the administration of products containing acetaminophen (APAP), to observe the extent of overdosing of APAP products, and to educate and resolve the problems. The DUE originated in the OB/GYN unit and then was expanded to all hospital units. The study methods and the process used to resolve noncompliance with recommended dosing guidelines are presented below.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 9","pages":"947-8, 950"},"PeriodicalIF":0.0,"publicationDate":"1992-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20993715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementing an automatic fluoroquinolone therapeutic interchange program in a community hospital. 在某社区医院实施氟喹诺酮类药物自动交换方案。
Hospital formulary Pub Date : 1992-09-01
H J Mioduch
{"title":"Implementing an automatic fluoroquinolone therapeutic interchange program in a community hospital.","authors":"H J Mioduch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A community hospital developed an automatic therapeutic interchange program for fluoroquinolone antibiotics. After considering efficacy, available formulations, and cost, this P&T Committee selected ciprofloxacin (Cipro) as the class representative for formulary use. The steps taken to implement this automatic therapeutic interchange policy are presented.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 9","pages":"943-4, 947"},"PeriodicalIF":0.0,"publicationDate":"1992-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20999068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing a pharmaceutical purchasing strategy. 制定药品采购策略。
Hospital formulary Pub Date : 1992-09-01
C E Hynniman
{"title":"Developing a pharmaceutical purchasing strategy.","authors":"C E Hynniman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The process commonly used by group purchasing organizations to contract for multisource pharmaceuticals and a strategic approach for the director of pharmacy in working with the purchasing group and the P & T Committee is described. The pharmacist should be knowledgeable concerning the group's contract commitment requirements, product specifications, terms and conditions and procedures for vendor selection, product award, contract implementation, and performance monitoring. To ensure results that meet the needs of the medical staff, it is important that the P & T Committee actively participate. The P & T Committee should understand the reasons for selecting a particular purchasing group, understand the necessary steps in obtaining the most favorable economic advantage, review products with potential brand interchange concerns, recommend product specifications, and reaffirm formulary procedures regarding the principle of current consent.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 9","pages":"918-20, 925-7"},"PeriodicalIF":0.0,"publicationDate":"1992-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21043101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surfactant replacement therapy: development of criteria for appropriate use. Ohio State University Hospitals. 表面活性剂替代疗法:制定适当使用的标准。俄亥俄州立大学医院。
Hospital formulary Pub Date : 1992-08-01
D K Gardner
{"title":"Surfactant replacement therapy: development of criteria for appropriate use. Ohio State University Hospitals.","authors":"D K Gardner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>At The Ohio State University (OSU) Hospitals, DUE criteria were established when colfosceril palmitate, a synthetic surfactant, was added to the formulary in January 1991. The DUE criteria were designed to assure appropriate drug use, educate physicians, and establish an effective way to monitor drug use and patient outcome (ie, response rate and complications). The criteria include a mechanism for evaluation and modification of the guidelines, as necessary. In addition, a review process will be used to determine the therapy's cost effectiveness and to serve as a guideline for making recommendations on other surfactant formulations as they become available.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 8","pages":"821-2, 825-6, 828-30 passim"},"PeriodicalIF":0.0,"publicationDate":"1992-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20992317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Establishing a more formal adverse drug reaction reporting system. 建立更正式的药品不良反应报告制度。
Hospital formulary Pub Date : 1992-08-01
C S Tse, A J Madura
{"title":"Establishing a more formal adverse drug reaction reporting system.","authors":"C S Tse,&nbsp;A J Madura","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 8","pages":"845-8"},"PeriodicalIF":0.0,"publicationDate":"1992-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20992319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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