Medical Affairs

This study aimed to examine the impact of ziprasidone and olanzapine on QTc interval, weight and metabolic parameters in adults with schizophrenia and other psychoses. A retrospective cohort chart review was performed of 191 randomly selected patients who were being treated with ziprasidone or olanzapine in an integrated health care system. Significant differences on QTc interval were not observed. A significant weight gain was observed in olanzapine-treated patients (P<0.001) but not in the ziprasidone-treated cohort (P>0.05). Furthermore, adverse metabolic changes associated with olanzapine administration were significant with respect to effects on total cholesterol (P=0.01), triglycerides (P=0.05) and haemoglobin A1C (HbA1C) (P<0.05), whereas significant favourable metabolic effects were observed in ziprasidone-treated patients with regard to total cholesterol (P<0.05), low-density lipoprotein (LDL) (P<0.01), high-density lipoprotein (HDL) (P<0.05) and HbA1c (P<0.05). Our results suggest that these two atypical antipsychotics are safe and well tolerated from a cardiovascular standpoint, with no differences in QTc interval prolongation being observed. Olanzapine-treated patients exhibited significant weight increases, whereas ziprasidone-treated patients exhibited weight loss. Olanzapine treatment was also associated with significant adverse effect on patient's lipid profile and HbA1c. These adverse metabolic effects were not observed in ziprasidone-treated patients although favourable effects were observed with regard to effect on total cholesterol, LDL, HDL and HbA1c.

To compare demographics and treatment patterns for dementia patients residing in assisted living facilities (ALF) and skilled-nursing facilities (SNF). Cross-sectional, retrospective chart review. Patients with dementia residing in five assisted living and six skilled-nursing facilities in Western Oregon and Tacoma, Washington. 119 assisted living and 190 SNF nursing patients with a diagnosis of dementia. Similarities and differences in patient demographics, underlying comorbidity, duration of disease, and treatment characteristics for dementia. The analysis revealed higher prevalence of non- Alzheimer's dementia, history of cerebral vascular accident, depression, and diabetes in the SNF cohort. There were higher proportions of assisted living patients having dementia of less than one-year's duration. Low proportions of patients in both settings were receiving treatment (44% of assisted living patients and 11% of SNF), despite the finding that 78% and 62% of assisted living ...

OBJECTIVE To determine the proportion of diabetic patients with and without coronary heart disease (CHD) who attained the American Diabetes Association recommended low-density lipoprotein cholesterol (LDL-C) target level of < or = 2.60 mmol/L (< or = 100 mg/dL). STUDY DESIGN Retrospective cross-sectional study. METHODS Patients were identified by searching an electronic medical record database from March 1997 through March 2001. Search strategies included a problem list entry of diabetes mellitus or CHD, a medication in the antidiabetic or nitrate class, or a glycosylated hemoglobin value of > or = 7.0%. Additional information included patient demographics, last LDL-C level, and use of a lipid-lowering agent. RESULTS The study identified 10,201 patients (4844 with diabetes only, 1243 with diabetes plus CHD, and 4114 with CHD only). A greater proportion of patients who had diabetes and CHD attained the LDL-C target goal compared with patients who had diabetes only (32.1% vs ...