Abstract:
OBJECTIVE:To determine if asthma control improves in patients who receive physician-pharmacist collaborative management (PPCM) during visits to primary care medical offices. DESIGN:Prospective pre-post study of patients who received the intervention in primary care offices for 9 months. The primary outcome was the sum of asthma-related emergency department (ED) visits and hospitalizations at 9 months before, 9 months during, and 9 months after the intervention. Events were analyzed using linear mixed-effects regression. Secondary analysis was conducted for patients with uncontrolled asthma (Asthma Control Test [ACT] less than 20). Additional secondary outcomes included the ACT, the Asthma Quality of Life Questionnaire by Marks (AQLQ-M) scores, and medication changes. INTERVENTION:Pharmacists provided patients with an asthma self-management plan and education and made pharmacotherapy recommendations to physicians when appropriate. RESULTS:Of 126 patients, the number of emergency department (ED) visits and/or hospitalizations decreased 30% during the intervention (p=0.052) and then returned to preenrollment levels after the intervention was discontinued (p=0.83). Secondary analysis of patients with uncontrolled asthma at baseline (ACT less than 20), showed 37 ED visits and hospitalizations before the intervention, 21 during the intervention, and 33 after the intervention was discontinued (p=0.019). ACT and AQLQ-M scores improved during the intervention (ACT mean absolute increase of 2.11, AQLQ-M mean absolute decrease of 4.86, p<0.0001) and sustained a stable effect after discontinuation of the intervention. Inhaled corticosteroid use increased during the intervention (p=0.024). CONCLUSIONS:The PPCM care model reduced asthma-related ED visits and hospitalizations and improved asthma control and quality of life. However, the primary outcome was not statistically significant for all patients. There was a significant reduction in ED visits and hospitalizations during the intervention for patients with uncontrolled asthma at baseline. Our findings support the need for further studies to investigate asthma outcomes achievable with the PPCM model.
journal_name
Pharmacotherapyjournal_title
Pharmacotherapyauthors
Gums TH,Carter BL,Milavetz G,Buys L,Rosenkrans K,Uribe L,Coffey C,MacLaughlin EJ,Young RB,Ables AZ,Patel-Shori N,Wisniewski Adoi
10.1002/phar.1468subject
Has Abstractpub_date
2014-10-01 00:00:00pages
1033-42issue
10eissn
0277-0008issn
1875-9114journal_volume
34pub_type
杂志文章,多中心研究,随机对照试验相关文献
PHARMACOTHERAPY文献大全abstract::Patient-controlled analgesia is a relatively new method of administering intravenous narcotics for postoperative pain relief. The technique involves the self-administration of a given analgesic in a bolus dose with the aid of a timed infusion and sequencing device. Ten morbidity obese patients undergoing elective gast...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/j.1875-9114.1982.tb03172.x
更新日期:1982-01-01 00:00:00
abstract::Idiopathic recurrent pericarditis (IRP) can be challenging to treat. Even after guideline-directed first-line treatment consisting of aspirin (ASA) or a nonsteroidal antiinflammatory drug (NSAID) in combination with colchicine therapy, recurrences still occur in greater than 20% of patients. Many patients then require...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1897
更新日期:2017-03-01 00:00:00
abstract::Albuterol is a 50:50 mixture of R-albuterol, the active enantiomer, and S-albuterol, which appears to be inactive in humans. The Food and Drug Administration recently approved levalbuterol, the pure R-isomer, as a preservative-free nebulizer solution. Published studies indicate that it is neither safer nor more effect...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.20.3.123.34776
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:It is known that γ-glutamyl hydrolase (GGH) is involved in the disposition of methotrexate (MTX), and GGH activity is regulated by DNA methylation in acute lymphoblastic leukemia (ALL) cells. The present study explores the methylation status of the GGH promoter in peripheral blood and its association with MT...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.2430
更新日期:2020-07-01 00:00:00
abstract::Fluoxetine hydrochloride is the sixth most prescribed drug in the United States and is administered to treat major depression. A cadaveric skin donation was obtained from a 46-year-old woman who died as a result of a fluoxetine overdose. Due to the potential penetration of the drug and its major metabolite, norfluoxet...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1998-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether a relationship exists between medication adherence to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) and distance to dispensing pharmacies and prescribers among an urban public aid population with diabetes mellitus. DESIGN:Retrospective...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1757
更新日期:2016-06-01 00:00:00
abstract::We compared total costs and adherence to the regimen of older versus newer angiotensin-converting enzyme (ACE) inhibitors for the treatment of elderly patients with hypertension. A computer search using the data base of a health care insurer identified 6176 subjects age 65 years or older who had ICD-9 coding for hyper...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-09-01 00:00:00
abstract::The purpose of the American College of Clinical Pharmacy (ACCP) is to advance human health by extending the frontiers of clinical pharmacy. Consistent with this mission and its core values, ACCP is committed to ensuring that clinical pharmacists possess the knowledge, skills, attitudes, and behaviors necessary to deli...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1923
更新日期:2017-05-01 00:00:00
abstract::The objective of this study was to describe the postinduction clearance of carbamazepine (CBZ) in adult psychiatric patients by population pharmacokinetic analysis using the NONMEM program. Specifically, an estimate of CBZ clearance and insight into the effect of common patient characteristics on clearance were sought...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Therapeutic goals for atrial fibrillation (AF) include ventricular rate control, stroke prevention, conversion to normal sinus rhythm, and maintenance of normal sinus rhythm. The optimal strategy of rate versus rhythm control for acute management of patients with AF is a continuing debate. However, selected patients m...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.24.8.792.36065
更新日期:2004-06-01 00:00:00
abstract::Agitation in the elderly, manifested by verbal and physical aggression, frequently results in increased morbidity and mortality for nursing home residents and reduced morale for the family and nursing home staff. It is also responsible for increased costs associated with caring for these residents. Pharmacologic inter...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-01 00:00:00
abstract::Good admissions decisions are essential for identifying successful students and good practitioners. Various parameters have been shown to have predictive power for academic success. Previous academic performance, the Pharmacy College Admissions Test (PCAT), and specific prepharmacy courses have been suggested as acade...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.21.9.842.34566
更新日期:2001-07-01 00:00:00
abstract::Staphylococcus aureus (S. aureus) has proven to be a major pathogen with the emergence of methicillin-resistant S. aureus (MRSA) infections and recently with heteroresistant vancomycin-intermediate S. aureus (hVISA) and vancomycin-intermediate S. aureus (VISA) infections. Although vancomycin is traditionally a first-l...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1577
更新日期:2015-04-01 00:00:00
abstract::Infection due to Mycobacterium tuberculosis continues to plague humanity. In the United States, conditions have taken a decided turn for the worse, with an increasing frequency of infection and the spread of multiple-drug-resistant strains. A number of strategies are available to improve the management of this epidemi...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the absorption profile of cyclosporine after preprandial administration with that after postprandial administration, and to determine which administration time resulted in a more stable absorption profile and the timing of the drug concentration that was the most reliable marker for monitorin...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.25.1.52.55617
更新日期:2005-01-01 00:00:00
abstract::Beta-blockers are an important cardiovascular drug class, recommended as first-line treatment of numerous diseases such as heart failure, hypertension, and angina, as well as treatment after myocardial infarction. However, responses to a beta-blocker are variable among patients. Results of numerous studies now suggest...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.27.6.874
更新日期:2007-06-01 00:00:00
abstract::We characterized the effects of peracetic acid-hydrogen peroxide (PAHP) reprocessing on hemodialyzer permeability to water and solutes of various molecular weights and compared these effects within and between dialyzers. An aqueous-based solution containing urea, creatinine, vancomycin, inulin, myoglobin, and albumin ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.19.13.1042.31587
更新日期:1999-09-01 00:00:00
abstract:STUDY OBJECTIVE:Evaluate dabigatran adverse event reports with a reported bleeding event and/or reported fatal outcome compared with warfarin. DESIGN:Retrospective analysis of the FDA Adverse Event Reporting System (FAERS) database. MEASUREMENTS AND MAIN RESULTS:We identified reports from October 1, 2010, through Dec...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1415
更新日期:2014-06-01 00:00:00
abstract::3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are a frequently prescribed class of drugs that are generally well tolerated by most patients. A rare, yet serious side effect associated with these drugs is rhabdomyolysis. Although all HMG-CoA reductase inhibitors can cause this adverse effect, pre...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.22.7.533.33674
更新日期:2002-04-01 00:00:00
abstract::Central nervous system stimulants are a commonly used first-line treatment option for attention-deficit/hyperactivity disorder (ADHD). Stimulants are generally well tolerated, with anorexia and insomnia the most common adverse effects. However, there are some concerns with long-term use of stimulants, such as potentia...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.2192
更新日期:2019-06-01 00:00:00
abstract::Cyclosporine can be given intravenously or orally, as a solution or soft gelatin capsule. Because of the drug's poor water solubility, ethoxylated plant fats and ethanol are added to the commercially available dosage forms. ...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::Antithrombin deficiency is a hypercoagulable state that can increase the risk for thrombosis, especially in the presence of other procoagulant triggers. Unfractionated heparin and low-molecular-weight heparins may not provide effective anticoagulation since they require antithrombin for activity. Direct thrombin inhib...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.24.6.659.34745
更新日期:2004-05-01 00:00:00
abstract::The management of heart failure is complex. Initiating and maintaining drug therapy in patients with heart failure can be challenging. Many factors influence the heart failure syndrome and are important to account for when evaluating these patients. Concomitant diseases such as ischemic heart disease and hypertension ...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.20.18.385s.34609
更新日期:2000-11-01 00:00:00
abstract::Clinical pharmacists must often interpret and use data derived from observational studies when making clinical decisions and recommendations, answering drug information questions, and educating patients about drug therapy. This is the third article in a three-part series intended to enhance clinical pharmacists' under...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.31.2.115
更新日期:2011-02-01 00:00:00
abstract::Death is the ultimate adverse drug event. Despite its importance, the frequency of fatal adverse drug events is unknown. Estimates in the United States are as high as 140,000/year, although this number is heavily disputed. Potential reasons and risks for fatal adverse drug events, as well as epidemiologic designs for ...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.21.6.521.34540
更新日期:2001-05-01 00:00:00
abstract::The effects of proton pump inhibitors on the pharmacokinetics of atazanavir and amprenavir (administered as fosamprenavir) were rigorously evaluated in healthy volunteers in two studies, but formal studies in persons infected with human immunodeficiency virus (HIV) are lacking. We describe a 65-year-old man with HIV w...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.26.4.511
更新日期:2006-04-01 00:00:00
abstract::Two drugs commonly used in triple-drug therapy for treatment of a Helicobacter pylori infection, clarithromycin and omeprazole, have rarely been associated with hypoglycemia when given alone. No documented interactions between H. pylori treatment with clarithromycin, amoxicillin, and omeprazole and insulin detemir hav...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1228
更新日期:2013-04-01 00:00:00
abstract::Addressing the issue of unintended pregnancy is a national priority. One proposed strategy to reduce unintended pregnancy is to improve access to oral contraceptives by changing them to over-the-counter (OTC) status. Existing data indicate that oral contraceptives meet safety criteria required of OTC products. Availab...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.31.4.424
更新日期:2011-04-01 00:00:00
abstract:STUDY OBJECTIVE:To characterize a time-dependent disposition of oral tacrolimus and its relationship with plasma endothelin-1 concentrations. DESIGN:Randomized, crossover study. SETTING:Clinical research center of a university-affiliated hospital. PATIENTS:Twelve stable liver transplant recipients. INTERVENTIONS:In...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1997-05-01 00:00:00
abstract:STUDY OBJECTIVES:To determine if low-dose lovastatin in combination with niacin causes a greater percentage reduction in low-density lipoprotein (LDL) cholesterol than lovastatin alone, and to determine if the combination increases the risk of serious adverse effects. design. Prospective, randomized, open-label, clinic...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1996-05-01 00:00:00