The Annals of pharmacotherapy
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Multicenter Study Comparative Study
Factors that influence prescribing decisions.
Strategies to control the quality and cost of medication use are largely dependent on the ability to alter selection of medications. Previous models of prescribing behavior have focused on physicians. In the hospital setting, clinical pharmacists and formulary committee members are also key players in drug therapy decision-making. Differences between physicians, formulary committee members, and clinical pharmacists have not been compared. Knowledge of these differences could have importance in predicting the effectiveness of strategies designed to influence drug use in this setting. ⋯ Those who seek to implement programs to alter medication use should recognize and employ factors that are most influential in the decision-making process. Further, it may be important to consider differences that exist between key participants in the medication use process.
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Multicenter Study
Venous thromboembolic prophylaxis in hospitalized medical patients.
The risk for venous thromboembolism (VTE) in medical patients is similar to that in moderate-risk surgery patients. Pharmacologic thromboprophylaxis is recommended for certain medical patients, but its use in clinical practice is unknown. ⋯ There is significant underutilization of VTE prophylaxis in this patient population. Patients are not adequately assessed for bleeding risk factors, and a portion of prescribed regimens are not those that have been established in the literature. Expert consensus statements recommend that hospitals develop strategies to prevent VTE events in their patients. Strategies to improve patient screening and physicians' prescribing habits are needed.
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Multicenter Study Comparative Study
Opioid analgesics versus ketorolac in spine and joint procedures: impact on healthcare resources.
Ketorolac's efficacy as a postoperative analgesic has been shown to be comparable to that of narcotic analgesics, but with significantly fewer narcotic-related adverse events. ⋯ Despite the higher acquisition cost of medication, healthcare resource utilization and total per-patient cost of treatment were lower for patients in the ketorolac group compared with patients in the narcotic analgesic study group. The majority of patients in the ketorolac group were also given concurrent narcotic analgesics; therefore, the beneficial effects observed may be secondary to the combination of ketorolac and narcotic analgesics.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Cetirizine versus hydroxyzine and placebo in chronic idiopathic urticaria.
To compare the safety and efficacy of cetirizine with that of hydroxyzine and placebo in the treatment of chronic idiopathic urticaria. ⋯ Cetirizine 10 mg once daily was equivalent to hydroxyzine 25 mg tid in controlling the symptoms of patients with chronic urticaria, as assessed by patient and investigator evaluations.
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Multicenter Study
Multicenter postmarketing surveillance of ondansetron therapy in pediatric patients.
To identify prescribing patterns of ondansetron, to provide a general overview of the therapeutic responses and possible adverse effects to ondansetron in selected children's hospitals, and to evaluate this methodology of surveillance and assess its effectiveness as a means to collect postmarketing experience with a drug in pediatric patients. ⋯ This study documents off-label use of ondansetron in children. Further study of ondansetron use in children less than four years of age, and for indications other than chemotherapy-induced emesis, is needed. Additional evaluation into the most cost-effective dosing of ondansetron would also be valuable.