Abstract:
:A study was carried out analysing the operation of a drug rationalisation programme in a central London teaching district that had evolved from experience over 17 years. Creation of a limited list of about 700 drugs had been achieved by local consensus. Drug selection was based on appraisal of efficacy, safety, and cost and was undertaken by means of collaborative participation of most consultant specialists in the district. Educative and other non-restrictive strategies for reinforcing the rationalisation policy had achieved a consistently high rate of compliance in prescribing recommended drugs. The concept of selectivity in drug use and its continuous local reappraisal had a beneficial impact on the prescribing habits of doctors at all levels of seniority as well as on the training of medical undergraduates and nurses in the therapeutic use of medicines. Peer review and self audit were encouraged by use of an extensive monitoring system which incorporated continuous "facilitative" dialogue between ward pharmacists and prescribers. Two models of drug rationalisation programme were studied, the second of which together with other local initiatives had been associated with substantial and sustained reductions in drug spending each year over nine years since 1978. It is concluded that the second drug rationalisation programme model substantially improves the cost effective use of drugs in hospital and furthermore has the potential of being extended to general practice, especially in types of prescribing that are common to both forms of patient care.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Baker JA,Lant AF,Sutters CAdoi
10.1136/bmj.297.6646.465subject
Has Abstractpub_date
1988-08-13 00:00:00pages
465-9issue
6646eissn
0959-8138issn
1756-1833journal_volume
297pub_type
杂志文章abstract:OBJECTIVE:To see whether the issue of AIDS has influenced the observed decline in blood donation in Scotland. DESIGN:Two methods: a quantitative survey using personal interviews based on a questionnaire and a qualitative survey based on group discussions. SETTING:Interviews based on the questionnaire were conducted i...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6679.1012
更新日期:1989-04-15 00:00:00
abstract:OBJECTIVE:To compare neonatal mortality and morbidity in term infants presenting by the breech and delivered vaginally or by caesarean section. DESIGN:Population based comparison of outcomes. Data derived from the St Mary's maternity information system. SETTING:North West Thames Regional Health Authority, 1988-90. S...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6856.746
更新日期:1992-09-26 00:00:00
abstract:OBJECTIVE:To investigate the effect of vitamin A supplementation and BCG vaccination at birth in low birthweight neonates. DESIGN:Randomised, placebo controlled, two by two factorial trial. SETTING:Bissau, Guinea-Bissau. PARTICIPANTS:1717 low birthweight neonates born at the national hospital. INTERVENTION:Neonates...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.c1101
更新日期:2010-03-09 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of a monovalent rotavirus vaccine against severe rotavirus disease and to assess its impact on diarrhoea in children aged less than 2 years after national introduction in El Salvador, a low-middle income country in Central America. DESIGN:Matched case-control study. SETTING:Sev...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c2825
更新日期:2010-06-15 00:00:00
abstract:OBJECTIVE:To determine the clinical and cost effectiveness of booklet based vestibular rehabilitation with and without telephone support for chronic dizziness, compared with routine care. DESIGN:Single blind, parallel group, pragmatic, randomised controlled trial. SETTING:35 general practices across southern England ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.e2237
更新日期:2012-06-06 00:00:00
abstract:OBJECTIVE:To assess the performance and impact of a two tier neonatal screening programme for cystic fibrosis based on an initial estimation of immunoreactive trypsinogen followed by direct gene analysis. DESIGN:Four year prospective study of two tier screening strategy. First tier: immunoreactive trypsinogen measured...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6942.1469
更新日期:1994-06-04 00:00:00
abstract:OBJECTIVE:To study the impact of skin surgery in general practice on the workload of a pathology laboratory and to identify what further training might be helpful. DESIGN:Analysis of skin biopsy specimens from general practitioners before and after their new contract to determine numbers of specimens, changes in diagn...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6819.93
更新日期:1992-01-11 00:00:00
abstract:OBJECTIVE:To investigate whether an important football match increases stress to such an extent that it triggers acute myocardial infarction and stroke. DESIGN:Longitudinal study of mortality around 22 June 1996 (the day the Dutch football team was eliminated from the European football championship). Mortality on 22 J...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7276.1552
更新日期:2000-12-23 00:00:00
abstract::Lifetime fertility, abortion rates, and the proportion of pregnancies resulting in induced abortion were investigated in 105 district health authorities in England. In 1995, a total of 147,851 abortions occurred among women living in England, compared with 613,257 live births; a ratio of 1:4. This was equivalent to ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7146.1711
更新日期:1998-06-06 00:00:00
abstract::Recent changes in the Russian government introduced by Boris Yeltsin include the appointment of Eduard Nechaev as health minister at the beginning of this year. The appointment received little publicity in the West, although his predecessor was sacked after only one year for failing to make any effort to improve healt...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6882.909
更新日期:1993-04-03 00:00:00
abstract:OBJECTIVE:To investigate the association between long term intake of dietary and supplemental calcium and death from all causes and cardiovascular disease. DESIGN:Prospective longitudinal cohort study. SETTING:Swedish mammography cohort, a population based cohort established in 1987-90. PARTICIPANTS:61 433 women (bo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f228
更新日期:2013-02-12 00:00:00
abstract:OBJECTIVES:To develop a systematic method for both summative and formative audit of practice audits, and to use the method to review Oxfordshire practice audits and to plan improvement. DESIGN:Development of a coding system for the audit cycle subsequently used prospectively to assess audits reported to medical audit ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.303.6812.1247
更新日期:1991-11-16 00:00:00
abstract:OBJECTIVE:To determine whether tobacco smoking causes increased DNA modification (adducts) in human cervical epithelium. DESIGN:Comparison of DNA adducts measured by the technique of postlabelling with phosphorus-32 in normal ectocervical epithelium of smokers and non-smokers. A questionnaire on smoking habit and a ur...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6890.1444
更新日期:1993-05-29 00:00:00
abstract:OBJECTIVE:To study the comparative importance of environment and genes in the development of islet cell autoimmunity associated with insulin dependent diabetes mellitus. DESIGN:Population based study of diabetic twins. SETTING:Danish population. SUBJECTS:18 monozygotic and 36 dizygotic twin pairs with one or both pa...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7094.1575
更新日期:1997-05-31 00:00:00
abstract:OBJECTIVE:To assess the relation between pretraumatic and trauma related headache in patients suffering from whiplash. DESIGN:Follow up study of patients examined a mean (SD) of 7.4 (4.2) days after trauma and again at three and six months. SETTING:Patients referred from primary care. SUBJECTS:117 patients (mean age...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6905.652
更新日期:1993-09-11 00:00:00
abstract:OBJECTIVES:To determine prospectively the rates of change in bone mineral density in elderly people and to examine the relation between lifestyle and demographic factors and these rates of change. DESIGN:Longitudinal population based study. SETTING:Dubbo, New South Wales, Australia. SUBJECTS:Representative sample (n...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:
更新日期:1994-09-17 00:00:00
abstract:OBJECTIVE:To evaluate the relative efficacy of programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PD-L1) inhibitors versus conventional drugs in patients with cancer that were PD-L1 positive and PD-L1 negative. DESIGN:Meta-analysis of randomised controlled trials. DATA SOURCES:PubMed, Embase, Cochrane ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.k3529
更新日期:2018-09-10 00:00:00
abstract::An investigation was conducted to determine the vehicle of infection of an outbreak of food poisoning in a large metropolitan building early in 1988. A questionnaire was distributed to 700 people who had eaten in the building during the week of the outbreak, and attack rates for specific food were calculated. Food and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6666.99
更新日期:1989-01-14 00:00:00
abstract:OBJECTIVE:To identify the number of patients who were misdiagnosed as being in the vegetative state and their characteristics. DESIGN:Retrospective study of the clinical records of the medical, occupational therapy, and clinical psychology departments. SETTING:20 bed unit specialising in the rehabilitation of patient...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7048.13
更新日期:1996-07-06 00:00:00
abstract:OBJECTIVES:To measure the potential for cadaver organ retrieval in New South Wales and to determine the reasons for potential donors failing to become actual donors. DESIGN:Prospective audit of all patients dying in five hospitals in New South Wales between 1 December 1989 and 30 November 1990; quality assurance of th...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6838.1339
更新日期:1992-05-23 00:00:00
abstract:OBJECTIVES:To compare the efficacy and tolerability of butterbur (Petasites hybridus) with cetirizine in patients with seasonal allergic rhinitis (hay fever). DESIGN:Randomised, double blind, parallel group comparison. SETTING:Four outpatient general medicine and allergy clinics in Switzerland and Germany. PARTICIPA...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7330.144
更新日期:2002-01-19 00:00:00
abstract:OBJECTIVES:To evaluate integrated care for diabetes in clinical, psychosocial, and economic terms. DESIGN:Pragmatic randomised trial. SETTING:Hospital diabetic clinic and three general practice groups in Grampian. PATIENTS:274 adult diabetic patients attending a hospital clinic and registered with one of three gener...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-05-07 00:00:00
abstract::The studyEveritt H, Landau G, Little P. Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT. Health Technol Assess 2019;23:1-154.This project was funded by the NIHR Health Technology Assessment Programme (project number 11...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.l4962
更新日期:2019-11-04 00:00:00
abstract::With the aim of promoting the informed choice of pregnant women, staff and pregnant women at two urban hospitals were offered leaflets summarising the best available evidence about the effectiveness of routine ultrasonography in early pregnancy. Ultrasonographers doubted the credibility of the evidence and were concer...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7067.1251a
更新日期:1996-11-16 00:00:00
abstract:OBJECTIVES:To determine the relation between the HIV/AIDS epidemic and support for dependent elderly people in Africa. DESIGN:Retrospective analysis using data from Demographic and Health Surveys. SETTING:22 African countries between 1991 and 2006. PARTICIPANTS:123,176 individuals over the age of 60. MAIN OUTCOME M...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.c2841
更新日期:2010-06-16 00:00:00
abstract::National allocation of resources to regional health authorities and by them to districts is now determined by a weighted capitation formula. The national formula was derived from regression analysis, with hospital utilisation as an index of need for health care--a method which has fundamental limitations. This paper a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6881.835
更新日期:1993-03-27 00:00:00
abstract:OBJECTIVE:To determine the outcome of administration of neuroleptics to patients with senile dementia of Lewy body type confirmed at necropsy. DESIGN:Retrospective analysis of clinical notes blind to neuropathological diagnosis. SETTING:Specialist psychogeriatric assessment units referring cases for necropsy to a tea...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6855.673
更新日期:1992-09-19 00:00:00
abstract:OBJECTIVES:To determine the impact on teenage pregnancy of interventions that address the social disadvantage associated with early parenthood and to assess the appropriateness of such interventions for young people in the United Kingdom. DESIGN:Systematic review, including a statistical meta-analysis of controlled tr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.b4254
更新日期:2009-11-12 00:00:00
abstract:OBJECTIVES:To assess incidence of and mortality from cancer in hypertensive patients taking atenolol, comparing the findings with two control populations and with hypertensive patients taking other drugs. DESIGN:Retrospective analysis of patients first seen in the Glasgow Blood Pressure Clinic between 1972 and 1990. P...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6878.609
更新日期:1993-03-06 00:00:00
abstract:OBJECTIVE:To investigate the association between cerebral palsy and direct evidence for perinatal exposure to neurotropic viruses. DESIGN:Population based case-control study. SETTING:Adelaide Women's and Children's Hospital Research Laboratory. PARTICIPANTS AND MAIN OUTCOME MEASURES:Newborn screening cards of 443 wh...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38668.616806.3A
更新日期:2006-01-14 00:00:00