2 research outputs found
Improving outpatient primary medication adherence with physician guided, automated dispensing
No full textJacob G Moroshek1,2 1Bioinformatics and Computational Biology, 2Carlson School of Management, University of Minnesota, Minneapolis, MN, USA Background: Physician dispensing, different from pharmacist dispensing, is a way for practitioners to supply their patients with medications, at the point of care. The InstyMeds dispenser and logistics system can automate much of the dispensing, insurance adjudication, inventory management, and regulatory reporting that is required of physician dispensing. Objective: To understand the percentage of patients that exhibit primary adherence to medication in the outpatient setting when choosing InstyMeds. Method: The InstyMeds dispensing database was de-identified and analyzed for primary adherence. This is the ratio of patients who dispensed their medication to those who received an eligible prescription. Results: The average InstyMeds emergency department installation has a primary adherence rate of 91.7%. The maximum rate for an installed device was 98.5%. Conclusion: Although national rates of primary adherence have been found to be in the range of 70%, automated physician dispensing vastly improves the rate of adherence. Improved adherence should lead to better patient outcomes, fewer return visits, and lower healthcare costs. Keywords: automated dispensing, adherence, compliance, medication, physician dispensing, InstyMed
Assessing the Radiation Response of Lung Cancer with Different Gene Mutations Using Genetically Engineered Mice
No full textPurpose: Non-small cell lung cancers (NSCLC) are a heterogeneous group of carcinomas harboring a variety of different gene mutations. We have utilized two distinct genetically engineered mouse models of human NSCLC (adenocarcinoma) to investigate how genetic factors within tumor parenchymal cells influence the in vivo tumor growth delay after one or two fractions of radiation therapy (RT). Methods and Materials: Primary lung adenocarcinomas were generated in vivo in mice by intra-nasal delivery of an adenovirus expressing Cre-recombinase. Lung cancers expressed oncogenic K-rasG12D and were also deficient in one of two tumor suppressor genes: p53 or Ink4a/ARF. Mice received no radiation treatment or whole lung irradiation in a single fraction (11.6 Gy) or in two 7.3 Gy fractions (14.6 Gy total) separated by 24 hours. In each case, the biologically effective dose (BED) equaled 25 Gy10. Response to RT was assessed by micro-CT two weeks after treatment. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and immunohistochemical staining were performed to assess the integrity of the p53 pathway, the G1 cell-cycle checkpoint, and apoptosis. Results: Tumor growth rates prior to RT were similar for the two genetic variants of lung adenocarcinoma. Lung cancers with wild-type p53 (LSL-Kras; Ink4a/ARFFL/FL mice) responded better to two daily fractions of 7.3 Gy compared to a single fraction of 11.6 Gy (P=0.002). There was no statistically significant difference in the response of lung cancers deficient in p53 (LSL-Kras; p53FL/FL mice) to a single fraction (11.6 Gy) compared to 7.3 Gy x 2 (P=0.23). Expression of the p53 target genes p21 and PUMA were higher and BrdU uptake was lower after RT in tumors with wild-type p53. Conclusions: Using an in vivo model of malignant lung cancer in mice, we demonstrate that the response of primary lung cancers to one or two fractions of RT can be influenced by specific gene mutations
