FARS and FFIRS
In: Main
11 Jul 2010The now-famous reports from the Institute of Medicine, “To Err is Human” (November 1999) and “Crossing the Quality Chasm” (March 2001), called for a top-down review of the American health care system. The review that these reports call for should include a detailed focus on error-reporting and prevention programs. These types of programs have been promulgated in other industries, especially in aviation and nuclear power, with key components including confidentiality, meaningful, rapid feedback to reporters, ease of reporting, and senior leadership support.
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- Tags: FARS, FFIRS
Meals at Medical Meetings: Mixed Messages
In: Health
10 Jul 2010A few months after the new cholesterol guidelines were announced last year, I went to a free educational luncheon semi- nar for physicians. It was sponsored by an unrestricted third-party grant from a pharmaceutical company; academic cardiologists from excellent universities made fair-balanced presentations on the subject of cholesterol-lowering drugs.
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- Tags: Medical Meetings
Evidence-Based Herbal Medicine
In: Health
9 Jul 2010
Evidence-based medicine (EBM) is defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available clinical evidence obtained from systematic research. Much of this evidence comes from the Cochrane Collaboration, which specifies certain precepts pertaining to evidence: a) a comprehensive record, b) using randomized controlled trials (RCTs) as the gold standard for evidence, and c) using a hierarchy of evidence as one of the criteria for inclusion.
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- Tags: Herbal Medicine
The American College of Cardiology: Beta Blockade in Severe Heart Failure and Extremely Depressed LVEF
In: Health
8 Jul 2010Speaker: Hugo A. Katus, MD, Professor of Medicine, Universitaets-Klinkenshubeck, Luebeck, Germany.
Meeting Highlights: American College of Cardiology
A subgroup analysis of data from the COPERNICUS (Carvedilol Prospective Randomized Cumulative Survival) trial demonstrated that treatment with the beta blocker carvedilol (Coreg medication, Glaxo SmithKline) is effective and well-tolerated in patients with severe heart failure (HF) symptoms and an extremely depressed left ventricular ejection fraction (LVEF).
The American College of Cardiology: Antiplatelet Therapy for In-Stent Restenosis Post-Brachytherapy
In: Health
7 Jul 2010Speaker: Ron Waksman, MD, Clinical Professor of Medicine (Cardiology), Georgetown University School of Medicine, and Associate Director of the Division of Cardiology, Washington Hospital Center, Washington, DC.
Data from a comparison of patient registries of two studies to assess the value of 12 months of therapy with clopidogrel (Plavix generic, Sanofi Synthelabo/Bristol Myers Squibb) in patients treated with intracoronary radiation therapy for the prevention of recurrent in-stent restenosis post-brachytherapy is safe and is associated with a strong trend in the reduction of late total occlusion (LTO) and a significant decrease in revascularization rates compared to six months of clopidogrel, supporting the use of at least 12 months of clopidogrel after coronary brachytherapy for in-stent restenosis.
The American College of Cardiology
In: Health
6 Jul 2010
Aldosterone Blocker in Diabetic Hypertensive Proteinuria
Speaker: Murray Epstein, MD, Professor of Medicine, Nephrology and Hypertension, University of Miami School of Medicine, Miami, Florida.
Eplerenone (Pharmacia), the first selective aldosterone blocker, provided substantial reduction in proteinuria in hypertensive patients with diabetes, compared to the ACE-inhibitor enalapril (Vasotec drug, Merck), with the two together being even more effective despite similar blood pressure (BP) lowering, thus indicating that renal protection is independent of BP reduction and that selective aldosterone antagonism is renoprotective.
The results of this study indicate that switching patients from amlodipine to either generic felodipine ER or nifedipine CC resulted in the expected reduction in acquisition costs for DHPs, but a significant increase in the overall cost of therapy for patients with hypertension or hypertension and angina. This rise in the overall cost of therapy resulted from increases in both the number and doses of additional CV medications required by patients who were switched from amlodipine. The use of concomitant CV medications increased from 52.2% of patients to 76.4% after the change in antihypertensive therapy. When patients who remained on amlodipine were removed from the analysis, the change was even more striking: 83.1% of the patients who were switched to felodipine ER and 86.8% of those treated with nifedipine CC required one or more concomitant CV medications. The percentages of patients in these two groups taking concomitant CV medications prior to the switch were 54.3% and 56.6%, respectively. Importantly, the increased requirement for concurrent CV drugs after the switch was noted for patients with hypertension alone as well as for those with hypertension and angina. Prior to the switch, 42.4% of hypertensive patients receiving amlodip-ine required at least one additional CV drug at an average daily cost of $0.05. After the switch, the respective values for the hypertensive patients who received felodipine ER were 77.6% and $0.21, and the values for the hypertensive patients treated with nifedipine CC were 84.1% and $0.28. An interesting point to consider is that drug costs were calculated using FSS pricing; however, most institutions do not qualify for FSS pricing. Thus, a higher drug acquisition cost would potentially create an even greater difference in overall costs.
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- FARS and FFIRS
- Meals at Medical Meetings: Mixed Messages
- Evidence-Based Herbal Medicine
- The American College of Cardiology: Beta Blockade in Severe Heart Failure and Extremely Depressed LVEF
- The American College of Cardiology: Antiplatelet Therapy for In-Stent Restenosis Post-Brachytherapy
- The American College of Cardiology
- A Cost Analysis of Switching Calcium Channel Blockers: DISCUSSION
- A Cost Analysis of Switching Calcium Channel Blockers: RESULTS
- A Cost Analysis of Switching Calcium Channel Blockers: Study Design
- A Cost Analysis of Switching Calcium Channel Blockers