Safety Issues in the Pharmacologic Management of Chronic Pain in the Elderly

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90289/1/j.1875-9114.1998.tb03154.x.pd

A systematic approach to educating elderly patients about their medications

The purpose of this study was to evaluate a pharmacist-initiated, total package, patient education program based on the concepts described in the PRECEDE model. This program was directed towards 94 therapeutically complex elderly patients and consisted of a medication history, therapeutic evaluation, patient education needs assessment, patient education session, and a patient feedback/ satisfaction telephone interview. Pharmacists identified on average 5.6 medication-related problems and provided an average of 6.2 recommendations. Problems commonly identified involved inadequate drug knowledge (25.5%), noncompliance (22.7%), and inappropriate drug use (17.4%). Typical recommendations included altering drug use (35.9%), improving compliance behavior (18.1%), and improving communication with health professionals (18.1%). Patient satisfaction with the education session was overwhelmingly positive. Based on the findings of this study, it is apparent that a patient education program based on the PRECEDE model can be used successfully by pharmacists to prepare education plans that would benefit the therapeutically complex elderly patient.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30215/1/0000606.pd

Design and Results of a Group Counter-detailing DUR Educational Program

Purpose . The study objectives were to (1) design, (2) implement and (3) evaluate a multi-step educational program as an integral component of a Healthcare system's activities to improve medication use quality and control drug costs. Design and implementation of the educational program were based upon established principles of changing prescriber behavior. Two classes of oral medications, antihistamines and antibiotics, were targeted.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41448/1/11095_2004_Article_306740.pd

Rats don\u27t always respond faster for more food: the paradoxical incentive effect

Rats\u27 leverpressing was reinforced on variable-ratio (VR) schedules. As ratio values increased, response rates initially increased with them, then eventually decreased. In Experiment 1, rates were uniformly higher with one-pellet reinforcers than with two-pellet reinforcers- the paradoxical incentive effect. Killeen\u27s (1994) mathematical principles of reinforcement (MPR) described the data quantitatively but failed to predict the advantage for the one-pellet condition. In Experiment 2, rats received one-, two-, and three-pellet reinforcers with counterbalanced preloads of pellets; the continued superiority of the smaller reinforcers ruled out a satiation explanation. Experiment 3 introduced a 20-sec intertrial interval (ITI), and Experiment 4 filled the ITI with an alternate response to test a memorial/overshadowing explanation. In Experiment 5, the rats received one or two standard grain pellets or one sucrose pellet as reinforcers over an extended range of ratios. Once again, rates were higher for one than for two pellets at short to moderate VR values; thereafter, two pellets supported higher response rates. The diminution of the effect in Experiment 3 and its reversal in Experiment 4 and in Experiment 5 at large ratios provided evidence for overshadowing and reconciled the phenomenon with MPR