Drugs online research references
musc.edu
Family physicians should take advantage of each contact with smokers to encourage and support smoking cessation. Once a patient is identified as a smoker, tools are available to assess readiness for change. Using motivational interviewing techniques, the physician can help the patient move from the precontemplation stage through the contemplation stage to the preparation stage, where plans are made for the initiation of nicotine replacement and/or bupropion therapy when indicated. Continued motivational techniques and support are needed in the action stage, when the patient stops smoking. Group or individual behavioral counseling can facilitate smoking cessation and improve quit rates. Combined use of behavioral and drug therapies can dramatically improve the patient's chance of quitting smoking. A plan should be in place for recycling the patient through the appropriate stages if relapse should occur.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11925087&dopt=Abstract
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Can J Psychiatry. 2002 Mar;47(2):174-80.
Antidepressant side effects in depression patients treated in a naturalistic setting: a study of bupropion, moclobemide, paroxetine, sertraline, and venlafaxine.
Vanderkooy JD, Kennedy SH, Bagby RM.
Queen's University, Kingston, Ontario.
OBJECTIVE: There is no commonly accepted standard for comparing antidepressant-induced side effects. This study evaluates a clinician-administered scale, the Toronto Side Effect Scale (TSES), in a natural practice clinic. METHOD: We used the TSES to assess side effects in 193 depression patients who completed 8 weeks of treatment with either bupropion, moclobemide, paroxetine, sertraline, or venlafaxine. RESULTS: Rates of remission (Hamilton Rating Scale for Depression [HRSD] < 7) did not differ across drugs after 8 weeks of treatment. Paired drug comparisons yielded significant differences in 16 of the 32 side effects. We present differences between pairs of the 5 antidepressants in Central Nervous System (CNS), gastrointestinal (GI), and sexual side effects. A measure of side-effect intensity distinguished paroxetine from the other antidepressants on a measure of sexual dysfunction. CONCLUSIONS: These results confirm the clinical utility of the TSES as a simple, clinician-administered antidepressant side-effect scale.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11926080&dopt=Abstract
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mmc.org
Academic detailing and data feedback are two methods that have been used to change provider behavior. Academic profiling is proposed as an intervention that combines provider educational outreach and peer-comparison feedback of data generated from chart reviews and health plans. This project assessed the feasibility of academic profiling, using baseline measures to assess provider performance in identifying and treating patients who smoke. The pilot study was undertaken with four primary care practices in Maine. Two health plans shared administrative claims data on adult patients of participating providers. Two educational sessions were conducted: one including feedback of tobacco-related chart documentation and claims for nicotine replacement and bupropion (Zyban), and the other, coding for tobacco use (ICD-9 305.1) in adults enrolled in two health plans during 1998. A mailed survey assessed provider attitudes following the intervention. Among 24 providers, 80% attended the first session and 70% attended the second session. Provider documentation of tobacco status in the medical records varied from 68% to 100%. The frequency of tobacco pharmacotherapy claims for adult health plan enrollees having a provider visit in 1998 varied from 0% to 4.6% (mean 1.5%) by provider. The frequency of tobacco use diagnosis claims (ICD-9 305.1) varied from 0% to 19.8% by provider. More than 90% of the providers who reviewed the profiling graphs found the data were understandable, and 66% reported that the sessions helped them improve the ways they interact with patients who smoke. Practices vary in tobacco-related documentation, the prescribing of tobacco pharmacotherapy, and the coding for tobacco use. Providers are willing to participate in educational outreach using peer-comparison feedback, presenting opportunities to improve performance in the treatment of tobacco dependence.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11945218&dopt=Abstract
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