Study cautions against overtreatment when adopting new NCEP III guidelines
February 1st 2002Clinicians must use caution in adopting newly revised national guidelines for treating elevated cholesterol, concludes a new study from the University of Maryland Pharmaceutical Health Services Research Department.
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Investigational antiviral reduces duration, eases severity of viral respiratory infections
February 1st 2002An experimental antiviral medication can shorten the duration of colds and reduce the severity of cold symptoms, reported Frederick Hayden, MD. He presented a pooled analysis of data from two phase III trials of the drug at the 41st annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), held recently in Chicago.
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Update on the benefits and risks of hormone replacement therapy (PDF)
February 1st 2002Emerging data are continually refining our understanding of the risks and benefits of hormone replacement therapy (HRT) in postmenopausal women. This review assesses the current state of evidence on these various risks and benefits, concluding with an outline of what's established and where varying degrees of uncertainty remain. Algorithms for use of HRT for several established indications are featured.
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Success of a P & T policy for use of a second ACE inhibitor before switching to an ARB
February 1st 2002VA Medical Center, Miami-ACE inhibitor therapy is recognized as the gold standard treatment for congestive heart failure (CHF) as well as diabetic nephropathy due to its effect on the morbidity and mortality associated with these conditions.
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Acute migraine therapy: Triptan quantity limit maintains total health care savings 1 year out
January 1st 2002Prime Therapeutics, St. Paul, MN-Do quantity limits on abortive migraine medications (ie, triptans) and educational efforts to increase the use of prophylactic therapy reduce total health care costs over the long term?
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Conversion to a computerized clinical intervention documentation process: What are the gains?
January 1st 2002ValleyCare Health System, Pleasanton, CA-The expansion of decentralized clinical pharmacy services at this health system served as the impetus to improve their clinical intervention documentation process.
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Infliximab and etanercept largely comparable in two real-world rheumatoid arthritis studies
January 1st 2002Two new real-world comparisons of the tumor necrosis factor (TNF) blockers infliximab (Remicade) and etanercept (Enbrel) show that the two agents are highly comparable treatments for rheumatoid arthritis
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Ranolazine enhances exercise performance when added to standard medications
January 1st 2002Ranolazine, the first in a new class of antianginal agents called the partialfatty acid oxidation (pFOX) inhibitors, improves exercise performance andreduces angina frequency in patients who still have symptoms despite treatmentwith other antianginal medications, according to Bernard Chaitman, MD. Hereported the results of a Phase III study called the Combination Assessmentof Ranolazine in Stable Angina (CARISA).
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For first time, an antianginal agent shown to improve clinical outcomes
January 1st 2002An agent developed specifically for the treatment of angina reduces theincidence of major coronary events, reported Henry Dargie, MD, who presentedthe results of a trial known as the Impact of Nicorandil in Angina (IONA).It is believed to be the first large-scale trial to report on the effectsof a specific antianginal drug on clinical outcome.
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Real-world study finds "unequivocal"lack of difference among SSRIs
January 1st 2002The selective serotonin reuptake inhibitors (SSRIs) fluoxetine, sertraline,and paroxetine are equally effective and tolerated in depressed patientsacross a broad range of outcome measures. So finds an open-label, randomizedstudy in 573 patients treated for depression for 9 months in a primary caresetting.
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Application of probabilistic sensitivity analysis in decision analytic modeling (PDF)
January 1st 2002Although sensitivity analysis is a widely used technique for testing the uncertainty in pharmacoeconomic modeling parameters, it does have limitations. This month's column introduces probabilistic sensitivity analysis as an alternative method for examining uncertainty.
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Tenofovir disoproxil fumarate (Viread) recently gained accelerated FDA approval. It is the first member of a new antiretroviral class and also the first antiretroviral approved on the basis of efficacy trials conducted almost exclusively in treatment-experienced patients. This Focus article reviews these studies and considers how other pending and planned trials may refine tenofovir's role.
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Emerging uses of the new anticonvulsants: What's the state of the evidence? (PDF)
January 1st 2002Like their older counterparts, the newer anticonvulsants gabapentin, lamotrigine, and topiramate show promise for treating various off-label psychiatric and neurologic disorders. This review examines the quality of current evidence for these new uses, identifies where gaps in the evidence lie, and discusses which emerging uses of individual agents appear most justified.
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Automatic interchange of the ACE inhibitors: Decision-making process and initial results (PDF)
January 1st 2002Clinicians at Nebraska Methodist Hospital, a not-for-profit acute care facility, developed and implemented an automatic interchange program for the ACE inhibitor class of drugs. This article presents the ACE inhibitor review upon which the formulary decisions were based as well as the initial clinical and economic results of the interchange program. (This pdf version includes an appendix that was not included in the print issue)
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Managing America's toughest challenges
January 1st 2002Perhaps the greatest criticism leveled at America's healthcare system is the fact that millions of people have no healthcare insurance at all. Our physicians are among the best trained in the world, and the equipment and technology they work with is state of the art. But those things are meaningless to patients who fall between the cracks of the system and can't access that care.
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