Utility of a transdermal delivery system for antihypertensive therapy: part 2
Article Abstract:
A significant problem facing medical practitioners is that patients do not always follow directions. This is particularly true for patients with high blood pressure (hypertension). Since hypertension itself has no symptoms, patients often do not take their medication. Furthermore, many patients with high blood pressure are treated with several drugs; as the complexity of the treatment increases, so do the problems of patient compliance. Patients who take their medications regularly renew their prescriptions more often than those who do not. For organizations such as Medicaid, which help support the cost of prescriptions, this means greater expenditures. However, investigation of Medicaid records shows that although greater patient compliance means more money spent on drugs, the reductions in complications of hypertension more than compensate for the drug cost. The net effect of greater patient compliance is a savings of money. In a study of Medicaid recipients in the state of South Carolina, the costs associated with the use of nine different antihypertensive drugs were analyzed. Among a total of 8,894 beneficiaries receiving antihypertensive drugs, the 278 using the transdermal clonidine patch showed significantly greater patient compliance, as evidence by prescription renewals. The transdermal patch, which is worn for a week, was associated with better compliance even when used as a part of a multi-drug regimen. The health care expenditures for patients using the transdermal patch were significantly less than for those patients who were advised to take antihypertensive medication more than once a day. There was no significant difference, however, between patients using the transdermal patch and patients whose antihypertensive regimen required only one dose per day. The results indicate that simpler drug regimens are more likely to result in patient compliance. Such regimens result in an overall cost savings for medical care. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Effects of diuresis on the characteristics of pleural fluid in patients with congestive heart failure
Article Abstract:
Congestive heart failure is the inability of the heart to pump blood efficiently, and is associated with the accumulation of fluid in the lungs. This liquid, called pleural fluid, is often in the form of a transudate, or fluid capable of passing through membranes such as the walls of small blood vessels. The levels of protein and the enzyme lactic acid dehydrogenase determine whether the pleural fluid is a transudate. Diuresis, the process of eliminating water from the body, may cause the pleural fluid to change from a transudate to an exudate, which is a thicker fluid with more cellular elements and higher specific gravity. The influence of aggressive diuresis on pleural fluid characteristics was assessed in 12 patients with severe congestive heart failure. Samples of the pleural fluid were obtained, followed by 12 to 48 hours of diuresis, during which time samples of pleural fluid were again taken. The average weight loss of patients during the study was 10 pounds. After diuresis, the levels of lactic acid dehydrogenase and protein in the pleural fluid had increased. The pleural fluid was transudate in nature at the beginning of the study, but became an exudate after diuresis in only one case. The results show that it is unusual for a transudative pleural fluid to become an exudate after diuresis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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