摘要:

AbstractMuch controversy has surrounded triazolam since it was marketed in the late 1970s. In spite of ongoing debate no major pharmacoepidiomological study has been published, comparing triazolam to other benzodiazepines (BZD). The present study examines the occurrence of medical events after a prescription for one of five BZD. Data was obtained from the Saskatchewan Health Data Bases on all persons who received a prescription for one of triazolam, flurazepam, oxazepam, lorazepam or diazepam, not having had a prescription for any of these in the previous six months. These persons were monitored for eight types of medical events. (1. suicides and attempts, 2. depression, 3. other psychiatric condition, 4. traffic accident injury, 5. injury due to falls, 6. injury due to poisoning, 7. seizures, 8. allergic reactions) for three weeks after their prescription for the BZD. Rates for medical events were compared to those in an unexposed population sample. It was concluded that, on the whole, triazolam does not appear to show a record of hospitalization worse than the other five BZD tested. In general, BZD should be used cautiously, judiciously and at the lowest possible dose.

ISSN:1053-8569    

DOI:10.1002/pds.2630040202

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThis paper presents the design and methodology of a large scale information dissemination experiment in Swedish primary care, executed in collaboration with policy makers and information pharmacists, and focused on the effects of an information package presented verbally by community pharmacists, with regard to the doctors' knowledge, attitudes, perceptions and practice in the treatment of hyperlipidaemia.The main study group comprised 570 doctors, belonging to 67 matched pairs of community health centres (CHCs), randomization being performed at group (i.e. CHC) level to minimize ethical and practical problems. The information derived from national expert guidelines, and was presented at four group sessions during six months at each of the intervention group CHCs, 79% of which fulfilled this requirement. Baseline and outcome data were collected from prescriptions, serum cholesterol test results, questionnaires on attitudes and case‐management evaluation. Moreover, interviews and field observations were conducted in a subsample of CHCs. We demonstrate ways of overcoming methodological problems such as minimizing the Hawthorne effect by introducing an extra, control group and the expectancy effect by not obtaining informed consent until the end of the study period.There was a non‐respondence rate of 21% which is similar to results in trials on drug efficacy. The acceptance ratevis‐à‐visthe study evaluation was 86%, but might have been higher had the ethical and methodological aspects special to experiments with treatment information been better understood. The information model has afterwards been used in Sweden for information campaigns focused on therapeutic gu

ISSN:1053-8569    

DOI:10.1002/pds.2630040203

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThis is a matched case‐control study, using spontaneously reported data, to examine the effect of concomitant oral contraceptives on hypertriglyceridemia (HTG) and hypercholesterolemia (HCHL) among female patients who received isotretinoin therapy. Study subjects included all female isotretinoin users, aged 15 to 55, who experienced an adverse event following isotretinoin therapy and were reported to the manufacturer between January 1, 1982 and July 31, 1993. Cases were women who experienced HTG, HCHL, or both and were further classified into three groups ‘HTG only’, ‘HCHL only’, and ‘both HTG and HCHL’. Controls were women who experienced any adverse events other than HTG, HCHL, alopecia, diabetes mellitus, pancreatitis, and obesity. Two controls were randomly selected to match with each case by age (+/‐ 2 years) and by year of commencement of isotretinoin therapy. Statistically significant association was observed between concomitant OC use and HTG (OR = 3.36, 95 per cent CI = 1.30–8.65) as well as between concomitant OC use and HCHL (OR = 2.30, 95 per cent CI = 1.36–3.87) among female isotretinoin users. There was an unusual high frequency of concomitant OC use (OR = 12.0, 95 per cent CI = 3.12–45.36) among ‘both HTG and HCHL’ patients comparing to that of controls. These results suggest a possible interactive effect between oral contraceptives and isotretinoin on the elevation of serum triglycer

ISSN:1053-8569    

DOI:10.1002/pds.2630040204

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractA study of adverse drug reactions to anti tuberculosis therapy in the medical outpatients showed that the overall incidence of adverse reactions was 26 per cent. Side‐effects to isoniazid and rifampicin were mainly hepatitis, nausea, vomiting. Ethambutol caused reversible optic neuritis in 7.9 per cent cases. Most adverse drug reactions occurred during the first 3 months of treatmen

ISSN:1053-8569    

DOI:10.1002/pds.2630040205

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground— Adverse event (AE) underreporting is a serious obstacle to drug safety monitoring in hospitalized patients, and it is necessary to find new approaches for improving the situation. The aim of the present study was to try to improve reporting and to evaluate the difference between actual and expected reporting.Methods— The drug surveillance programme was implemented in a 72‐bed internal medicine ward. A simple algorithm was printed on each page of the progress notes of the patients' medical record, which the physicians were asked to use in choosing the AEs to be reported to the drug surveillance system. The actual reporting was evaluated for a period of 12 months (1203 patients). Using the same algorithm, two reviewing doctors evaluated expected reporting by analysing all of the AEs deduced from the records of 120 randomly selected patients.Results— Actual reporting: over a period of 12 months, the doctors reported 89 AEs (7.4 per 100 patients), whereas no event had been reported to the national drug surveillance system in the twelve months preceding the introduction of the project. Actual versus expected reporting: in 120 randomly selected patients, 22 AEs were considered by the reviewers as constituting the expected reporting; nine were actually reported.Conclusions— The described drug surveillance programme led to a substantial improvement in adverse event reporting, although a considerable difference still remains between expected and actual

ISSN:1053-8569    

DOI:10.1002/pds.2630040206

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:1053-8569    

DOI:10.1002/pds.2630040208

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:1053-8569    

DOI:10.1002/pds.2630040209

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:1053-8569    

DOI:10.1002/pds.2630040201

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY