3 results
Search Results
2. Factors influencing doctors' selection of dabigatran in non-valvular atrial fibrillation.
- Author
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Huang, Cindy, Siu, Michele, Vu, Lily, Wong, Soo, and Shin, Jaekyu
- Subjects
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DRUG therapy , *WARFARIN , *ATRIAL fibrillation , *BENZIMIDAZOLES , *CARDIOLOGY , *FISHER exact test , *INTERNAL medicine , *KIDNEY function tests , *MEDICAL prescriptions , *PHYSICIANS , *PYRIDINE , *QUESTIONNAIRES , *DECISION making in clinical medicine , *ELIGIBILITY (Social aspects) , *DATA analysis software , *DESCRIPTIVE statistics , *THERAPEUTICS - Abstract
Rationale, aims and objectives This study was designed to examine the factors that influence doctors' decision in initiating or switching from warfarin to dabigratran. Method A survey questionnaire was sent to 181 doctors who were most likely to prescribe dabigatran (e.g. cardiologists and general internists) at the University of California, San Francisco Medical Center between November 2011 and February 2012. Survey participants were asked to complete an electronic or a paper version of the questionnaire, which consisted of 17 multiple-choice questions. Fisher's exact test and Cochran- Mantel- Haenszel test were used to compare survey responses between cardiologists and general internists. Results A total of 65 survey responses were received (35.9% response rate). There were 13 cardiologists and 51 general internists who participated in the study. Cost (25%), renal function (21%) and CHADS2 score (18%) were the three factors doctors considered most often to determine a patient's eligibility for dabigatran in warfarin-naïve patients. On the other hand, histories of unstable international normalized ratio (37%) and missed appointments (17%) along with cost (19%) were most often considered in patients on warfarin. Cardiologists had prescribed dabigatran more often and had a significantly higher level of comfort with prescribing the drug than general internists ( P = 0.003; 77% vs. 27%). Conclusions Cost was the most important factor influencing doctors' decision to prescribe dabigatran. Safety and effectiveness of dabigatran as well as patient preference were additional factors influencing their decision. General internists were less comfortable with prescribing dabigatran than cardiologists. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
3. The NIDA Methamphetamine Clinical Trials Group: a strategy to increase clinical trials research capacity.
- Author
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Elkashef, Ahmed, Rawson, Richard A., Smith, Edwina, Pearce, Valerie, Flammino, Frank, Campbell, Jan, Donovick, Roger, Gorodetzky, Charles, Haning, William, Mawhinney, Joseph, McCann, Michael, Weis, Dennis, Williams, Lorie, Ling, Walter, and Vocci, Frank
- Subjects
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METHAMPHETAMINE abuse , *MEDICAL research , *CLINICAL trials , *DRUG addiction , *ADDICTION Severity Index , *MEDICAL experimentation on humans , *URINALYSIS , *THERAPEUTICS - Abstract
Aims In order to increase the number of investigative teams and sites conducting research on pharmacological treatments for methamphetamine use disorders, the National Institute on Drug Abuse (NIDA) established an infrastructure of clinical sites in areas where methamphetamine addiction is prevalent. This multi-site infrastructure would serve to run multiple Phases II and III protocols effectively and expeditiously. Methods NIDA collaborated with investigators from the University of California at Los Angeles (UCLA) to set up the Methamphetamine Clinical Trials Group (MCTG). This paper describes the development process, as well as data from a test trial to assess the capability of research-naive sites to recruit research participants and conduct study procedures according to research protocol. Subsequent trials are also described. Results A total of 151 candidates signed consent; 65 individuals were enrolled and 35 (53.8%) completed the 12 weeks' behavioral trial. Self-reported substance use report (SUR) showed comparable use of methamphetamine across sites with the individual site means ranging from 59% (site 5) to 80% (site 3). Drug use as measured by urinalysis was greatly reduced at week 13 compared to the baseline measure; the average rate of methamphetamine-free urine samples across all participants in sites at week 13 was 53%. The highest percentage of methamphetamine-free samples was 85% at site 5; the lowest was at site 1 (40%). Addiction severity index (ASI) composite scores at baseline and protocol completion for all participants demonstrated improvement in all categories over time, except for the medical composite score. The largest composite score reduction in baseline-protocol completion was in the drug domain (0.23 versus 0.15). The changes in the ASI scores from baseline to week 13 were consistent across all five sites. Conclusions Outcomes of the behavioral trial indicated that the MCTG recruited well; collected study data accurately and reliably; and created a vehicle that can assess promising pharmacotherapies for methamphetamine addiction treatment medications. The MCTG strategy appears to be a feasible approach to increase NIDA's capacity to conduct clinical trials to evaluate potential pharmacotherapies for methamphetamine addiction. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
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