Pamela A. Foral

Patient satisfaction and costs associated with insulin administered by pen device or syringe during hospitalization.

PURPOSE Patient satisfaction, safety and efficacy outcomes, and cost savings with insulin pens versus conventional insulin delivery via vials and syringes in hospitalized patients with diabetes were compared. METHODS Patients were recruited from two general medical-surgical units from July 2005 to May 2006. Patients completed a survey regarding satisfaction with the method in which insulin was administered before discharge. Patients completed a telephone survey approximately four weeks after discharge to determine home insulin use. Cost savings were determined using the average wholesale price of insulin vials and syringes, pens, and pen needles. RESULTS A total of 94 patients were randomized to receive insulin administered via pen devices (n = 49) or using conventional vials and syringes (n = 45). Significantly more subjects in the pen group prepared or self-injected at least one dose of insulin during hospitalization, wanted to continue taking insulin at home using the method used during hospitalization, and would recommend their method of insulin administration used during hospitalization to other patients with diabetes compared with the vial and syringe group (p < 0.05). A cost saving of

Pharmacoeconomic Assessment of HMG‐CoA Reductase Inhibitor Therapy: An Analysis Based on the CURVES Study

36 per patient was projected if only insulin pens were dispensed during the entire hospital stay compared to insulin vials and syringes (p < 0.05). CONCLUSION Increased patient satisfaction and continuation of the method of insulin administration used in the hospital at home were reported by patients who received insulin pens compared with patients who received conventional vials and syringes during hospitalization. A substantial cost saving was projected for patients in the insulin pen group if insulin pens had been dispensed during their entire hospital stay.

Oxycodone accumulation in a hemodialysis patient.

We conducted a post hoc pharmacoeconomic analysis of a multicenter, open‐label, randomized, parallel‐group, 8‐week efficacy‐safety comparison of five HMG‐CoA reductase inhibitors—atorvastatin, fluvastatin, lovastatin, pravastatin, and simvastatin. The 534 patients requiring cholesterol‐lowering therapy took the drugs for 8 weeks with 15 different regimens. Low‐density lipoprotein (LDL) was measured after 6 weeks of diet (baseline) and after 8 weeks of treatment with a study drug. At dosages of 10, 20, and 40 mg/day, atorvastatin was associated with significantly greater reductions in LDL than equivalent dosages of the other agents. Cost‐effectiveness calculated as the annual acquisition cost/percentage LDL reduction was greatest with atorvastatin 10 mg (

Impact of nesiritide on health care resource utilization and complications in patients with decompensated heart failure.

17.96), fluvastatin 40 mg (

Personal Digital Assistant (PDA) Clinical Intervention Documentation System: Development, Implementation, and Comparison to a Previous Paper-Based System

19.83), atorvastatin 20 mg (

Vancomycin Removal during a Plasma Exchange Transfusion

22.85), and atorvastatin 40 mg (

Review of insulin therapy and pen use in hospitalized patients.

24.96). All other dosages were above

Management of Bacteriuria in Veterans Affairs Hospitals

25.00/year/percentage LDL reduction. Atorvastatin was the most cost‐effective HMG‐CoA reductase inhibitor. Fluvastatin 40 mg/day also had a favorable cost:effectiveness ratio but lowered LDL only by 23%.

Insomnia: a therapeutic review for pharmacists

Oxycodone and oxycodone-containing analgesics are often used for the relief of pain. In the presence of renal dysfunction, the half-life of oxycodone and metabolites can be prolonged. We describe the case of a 41-year-old chronic hemodialysis patient who received multiple doses of oxycodone/acetaminophen resulting in accumulation of the medication and consequent lethargy, hypotension and respiratory depression. These adverse effects were reversed with multiple bolus doses of naloxone, followed by a continuous infusion administered for 45 hours. Utilizing the Naranjo probability scale, the patient had a “probable” adverse drug reaction to the oxycodone. Oxycodone should be used with caution in patients with chronic renal failure.

Education and Communication in an Interprofessional Antimicrobial Stewardship Program

Study Objective. To determine the impact of nesiritide on health care resource utilization and complications in patients hospitalized with decompensated heart failure.