Anthony Morreale - Academia.edu (original) (raw)

Papers by Anthony Morreale

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2002

... Justifying a multidisciplinary high-intensity hepatitis C clinic by using decision analysis. ... more ... Justifying a multidisciplinary high-intensity hepatitis C clinic by using decision analysis. Auteur(s) / Author(s). DOLDER Nicole M. (1) ; WILHARDT Michelle S. (2) ; MORREALE Anthony P. (3) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ...

The Journal of Clinical Pharmacology, 1999

Forty-six adult patients maintained on warfarin therapy were converted from pravastatin to simvas... more Forty-six adult patients maintained on warfarin therapy were converted from pravastatin to simvastatin. Mean international normalized ratio (INR) significantly increased from 2.42 to 2.74, p = 0.002. Although warfarin doses were reduced in 7 patients and increased in 4 patients following the post-conversion INR measurements, the pre- and postconversion median weekly warfarin dose of all 46 patients did not differ significantly. The number of patients with an INR > 3.0 increased significantly from 6 to 16 following the conversion. There was no report of unusual episodes of bleeding. The results indicate that antihyperlipidemic therapy can be changed safely from pravastatin to simvastatin in patients who are taking warfarin concomitantly. Additional anticoagulation monitoring is not necessary in institutions where patients are followed in formal anticoagulation clinics.

American Journal of Health-System Pharmacy

... Justifying a multidisciplinary high-intensity hepatitis C clinic by using decision analysis. ... more ... Justifying a multidisciplinary high-intensity hepatitis C clinic by using decision analysis. Auteur(s) / Author(s). DOLDER Nicole M. (1) ; WILHARDT Michelle S. (2) ; MORREALE Anthony P. (3) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ...

American Journal of Health-System Pharmacy

American Journal of Health-System Pharmacy Society Logo Skip to main page content. HOME; CURRENT ... more American Journal of Health-System Pharmacy Society Logo Skip to main page content. HOME; CURRENT ISSUE; PAST ISSUES; SUPPLEMENTS; REPRINTS; ALERTS. KEYWORDS GO. Advanced Search ». Advertisement: Articles ...

American Journal of Health-System Pharmacy

American Journal of Health-System Pharmacy Society Logo Skip to main page content. HOME; CURRENT ... more American Journal of Health-System Pharmacy Society Logo Skip to main page content. HOME; CURRENT ISSUE; PAST ISSUES; SUPPLEMENTS; REPRINTS; ALERTS. KEYWORDS GO. Advanced Search ». Advertisement: Articles ...

American Journal of Health-System Pharmacy

Background VA Clinical Pharmacists play an important role in assuring medication safety and impro... more Background VA Clinical Pharmacists play an important role in assuring medication safety and improving clinical outcomes. Although the use of clinical pharmacists in VA is widespread, systematic documentation of their workload, interventions and resultant outcomes has been lacking. The Pharmacists Achieve Results with Medications Documentation (PhARMD) Project is an operational project which nationally deployed a data collection tool to document specific interventions and patient outcomes, made by clinical pharmacists in their role as non-physician providers. Archimedes software is a validated pharmacoeconomic tool which can accurately project long term clinical and economic consequences of changes in a given population demographic. Objective Clinical pharmacist intervention and outcome data derived from the PhARMD tool was used to populate the well validated Archimedes modeling program to predict the long-term impact of pharmacist provided pharmacotherapy management on patient outco...

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2004

... Healthcare System, San Diego, CA. Address correspondence to Dr. Morreale at the VA San Diego ... more ... Healthcare System, San Diego, CA. Address correspondence to Dr. Morreale at the VA San Diego Healthcare System (119), 3350 La Jolla Village Drive, San Diego, CA 92161 (anthony.morreale@med.va.gov). Quantity and cost of commonly used ...

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2004

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2003

The interaction of celecoxib and rofecoxib with warfarin was studied. Patients stable on warfarin... more The interaction of celecoxib and rofecoxib with warfarin was studied. Patients stable on warfarin therapy and concurrently taking a cyclooxygenase-2 (COX-2) inhibitor comparator (traditional nonsteroidal antiinflammatory medications, salsalate, or acetaminophen) randomly received celecoxib 200 mg/day or rofecoxib 25 mg/day for three weeks. After a one-week washout period, the patients were crossed over to treatment with the opposite COX-2 inhibitor for three more weeks. The International Normalized Ratio (INR) was measured at baseline and at weeks 1, 2, and 3 of therapy with each COX-2 inhibitor by testing blood samples obtained by finger stick. Data for 16 patients were analyzed. The INR increased by 13%, 6%, and 5% on average in patients taking celecoxib at weeks 1, 2, and 3, respectively, and by 5%, 9%, and 5% in patients taking rofecoxib. Changes in the INR were statistically significant at week 1 for celecoxib and at week 2 for rofecoxib. Of the 12 subjects who had a clinically...

Value in Health, 2009

OBJECTIVES: The aim of this study was to review the existing treatment patterns for patients diag... more OBJECTIVES: The aim of this study was to review the existing treatment patterns for patients diagnosed with pulmonary arterial hypertension in the UK, France and Germany. METHODS: IMS Disease Analyzer, a longitudinal patient database providing information from continuing physician-patient interaction on consultations, diagnoses and treatment within Primary Care, was used to review the treatment patterns for PAH patients in the UK, France and Germany over a two year period, in order to describe: 1) different therapies used; 2) combination therapies; 3) clinical and economic outcomes of different therapies; 4) dose and drug utilization patterns; and 5) resource utilization. RESULTS: In all three countries, the prevalence of PAH was found to increase with age, with two-thirds of PAH patients being 60 years of age or older, with more female than male patients being diagnosed with PAH. PAH patients were also found to have been prescribed at least one medication, with 23% in France, 15% in Germany and 56% of patients in the UK being prescribed between 3 and 6 medications. In the UK, most prescriptions were found to refer to diuretics, calcium channel blockers and anti-thrombotic agents. In France, most prescriptions referred to beta-blockers, angiotensin receptor blockers and diuretics. In Germany, most prescriptions referred to diuretics, calcium channel blockers and beta blockers. For PAH patients in both France and Germany the median number of days receiving therapy over the 2 year period was found to be 100 days, whereas in the UK, this fi gure rose to 500 days. CONCLUSIONS: Whilst there were many similarities in the sociodemographic profi le of PAH patients, many differences in the treatment patterns for patients diagnosed with PAH in the UK, France, and Germany were found.

Value in Health, 2001

Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year perio... more Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year period. Results were driven by the impact of ICS on quality of life, rather than on mortality. Findings were stable over most input data ranges. However, at efficacy levels below 3% and toxicity rates greater than 2.9%, the cost-effectiveness estimate exceeded $100,000/QALY. CONCLUSION: Results suggest that inhaled steroids deliver good comparative value in mild-to-moderate adult asthma. More research is needed, however, on the impact of ICS toxicity on patient preferences.

Value in Health, 2006

Patients were stratified into 2 cohorts: those receiving OAB pharmacotherapy, including long-acti... more Patients were stratified into 2 cohorts: those receiving OAB pharmacotherapy, including long-acting tolterodine or immediate-or extended-release oxybutynin and those receiving non-pharmacologic management. Patients were matched 1 : 1 by the estimated propensity score for OAB pharmacotherapy using a logistic regression model incorporating selected demographic and clinical characteristics. Differences in direct medical costs during follow-up were assessed using descriptive statistics (Wilcoxon rank-sum tests) and multivariate statistical techniques to adjust for differences in demographic and clinical characteristics. RESULTS: A total of 1681 matched pairs were identified. Patients' mean ± SD age was 78 ± 8 years; 60% were women. ). After adjusting for prognostic factors, total direct costs were significantly higher for NPM patients in multivariate analyses (p = 0.0091). CONCLUSIONS: Elderly patients receiving OAB pharmacotherapy appear to have lower annual direct medical costs compared with patients receiving non-pharmacologic management. Careful consideration should be given to the selection of OAB treatment options from both clinical and economic perspectives.

American Journal of Health-System Pharmacy

Page 1. NOTES 1482 Am J Health-Syst Pharm—Vol 61 Jul 15, 2004 Valdecoxib Accuracy of splitting un... more Page 1. NOTES 1482 Am J Health-Syst Pharm—Vol 61 Jul 15, 2004 Valdecoxib Accuracy of splitting unscored valdecoxib tablets D ANIEL T. B OGGIE , M ELISSA L. D E L ATTRE , M ONICA G. S CHAEFER , A NTHONY P. M ORREALE , AND B RIAN K. P LOWMAN ...

American Journal of Health-System Pharmacy

Page 1. 1343 Am J Health-Syst Pharm—Vol 60 Jul 1, 2003 NOTES xxxx NOTES Digoxin–rabeprazole inter... more Page 1. 1343 Am J Health-Syst Pharm—Vol 60 Jul 1, 2003 NOTES xxxx NOTES Digoxin–rabeprazole interaction NOTES The Notes section welcomes the following types of contributions: (1) practical innovations or solutions ...

American Journal of Health-System Pharmacy

Page 1. NOTES 1391 Am J Health-Syst Pharm—Vol 61 Jul 1, 2004 Therapeutic interchange NOTES Therap... more Page 1. NOTES 1391 Am J Health-Syst Pharm—Vol 61 Jul 1, 2004 Therapeutic interchange NOTES Therapeutic interchange involving replacement of rofecoxib or celecoxib with valdecoxib F IONNA T RAN , D ANIEL T. B OGGIE , M ELISSA L. D ELATTRE , ...

American Journal of Health-System Pharmacy

Page 1. CLINICAL CONSULTATION Dosage Conversions 537 Am J Health-Syst Pharm—Vol 62 Mar 1, 2005 CL... more Page 1. CLINICAL CONSULTATION Dosage Conversions 537 Am J Health-Syst Pharm—Vol 62 Mar 1, 2005 CLINICAL CONSULTATION Dopamine-receptor agonists CLINICALCONSU LTAT ION Sleep attacks in patients receiving dopamine-receptor agonists ...

Research in Social and Administrative Pharmacy, 2015

Previous studies have found clinical pharmacists (CPs) and clinical pharmacy specialists (CPSs) i... more Previous studies have found clinical pharmacists (CPs) and clinical pharmacy specialists (CPSs) in direct patient care have positive effects across various patient outcomes. However, there are also other kinds of care-taking occurring in pharmacy-run clinic appointments that produce value for patients. To identify and characterize how CPs/CPSs in direct care clinics develop and practice care-taking behaviors which advance the pharmacist-patient relationship. Semi-structured CP/CPS interviews were conducted once per year for two years (46 year 1, 50 year 2) along with direct observations of clinical pharmacy work as part of an anticoagulation improvement intervention. Participants were from Veterans Health Administration (VHA) medical centers and VHA community-based outpatient clinics in the Northeastern U.S. Interviews were transcribed verbatim and thematically analyzed using NVIVO 10 software. It was found that CPs/CPSs practice "knowing the patient" in ways related to, but distinct from this practice in the nursing literature. For CPs/CPSs, knowing the patient occurred over time, and it produced familiarity and trust between CPs/CPs and patients. A reciprocal relationship developed in which patients came to rely on CP/CPSs for other types of assistance. Patterns of knowing the patient and being known by the patient manifested in three distinct ways: 1) identifying the patient's unmet needs, 2) explaining other medications, and 3) helping the patient navigate the system. This research identifies an action, knowing the patient, whereby CPs use their knowledge of the patient to deliver individualized care. This study contributes to the developing literature on pharmacist-patient relationships and pharmacist-patient communication.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2002

... Justifying a multidisciplinary high-intensity hepatitis C clinic by using decision analysis. ... more ... Justifying a multidisciplinary high-intensity hepatitis C clinic by using decision analysis. Auteur(s) / Author(s). DOLDER Nicole M. (1) ; WILHARDT Michelle S. (2) ; MORREALE Anthony P. (3) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ...

The Journal of Clinical Pharmacology, 1999

Forty-six adult patients maintained on warfarin therapy were converted from pravastatin to simvas... more Forty-six adult patients maintained on warfarin therapy were converted from pravastatin to simvastatin. Mean international normalized ratio (INR) significantly increased from 2.42 to 2.74, p = 0.002. Although warfarin doses were reduced in 7 patients and increased in 4 patients following the post-conversion INR measurements, the pre- and postconversion median weekly warfarin dose of all 46 patients did not differ significantly. The number of patients with an INR > 3.0 increased significantly from 6 to 16 following the conversion. There was no report of unusual episodes of bleeding. The results indicate that antihyperlipidemic therapy can be changed safely from pravastatin to simvastatin in patients who are taking warfarin concomitantly. Additional anticoagulation monitoring is not necessary in institutions where patients are followed in formal anticoagulation clinics.

American Journal of Health-System Pharmacy

... Justifying a multidisciplinary high-intensity hepatitis C clinic by using decision analysis. ... more ... Justifying a multidisciplinary high-intensity hepatitis C clinic by using decision analysis. Auteur(s) / Author(s). DOLDER Nicole M. (1) ; WILHARDT Michelle S. (2) ; MORREALE Anthony P. (3) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ...

American Journal of Health-System Pharmacy

American Journal of Health-System Pharmacy Society Logo Skip to main page content. HOME; CURRENT ... more American Journal of Health-System Pharmacy Society Logo Skip to main page content. HOME; CURRENT ISSUE; PAST ISSUES; SUPPLEMENTS; REPRINTS; ALERTS. KEYWORDS GO. Advanced Search ». Advertisement: Articles ...

American Journal of Health-System Pharmacy

American Journal of Health-System Pharmacy Society Logo Skip to main page content. HOME; CURRENT ... more American Journal of Health-System Pharmacy Society Logo Skip to main page content. HOME; CURRENT ISSUE; PAST ISSUES; SUPPLEMENTS; REPRINTS; ALERTS. KEYWORDS GO. Advanced Search ». Advertisement: Articles ...

American Journal of Health-System Pharmacy

Background VA Clinical Pharmacists play an important role in assuring medication safety and impro... more Background VA Clinical Pharmacists play an important role in assuring medication safety and improving clinical outcomes. Although the use of clinical pharmacists in VA is widespread, systematic documentation of their workload, interventions and resultant outcomes has been lacking. The Pharmacists Achieve Results with Medications Documentation (PhARMD) Project is an operational project which nationally deployed a data collection tool to document specific interventions and patient outcomes, made by clinical pharmacists in their role as non-physician providers. Archimedes software is a validated pharmacoeconomic tool which can accurately project long term clinical and economic consequences of changes in a given population demographic. Objective Clinical pharmacist intervention and outcome data derived from the PhARMD tool was used to populate the well validated Archimedes modeling program to predict the long-term impact of pharmacist provided pharmacotherapy management on patient outco...

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2004

... Healthcare System, San Diego, CA. Address correspondence to Dr. Morreale at the VA San Diego ... more ... Healthcare System, San Diego, CA. Address correspondence to Dr. Morreale at the VA San Diego Healthcare System (119), 3350 La Jolla Village Drive, San Diego, CA 92161 (anthony.morreale@med.va.gov). Quantity and cost of commonly used ...

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2004

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2003

The interaction of celecoxib and rofecoxib with warfarin was studied. Patients stable on warfarin... more The interaction of celecoxib and rofecoxib with warfarin was studied. Patients stable on warfarin therapy and concurrently taking a cyclooxygenase-2 (COX-2) inhibitor comparator (traditional nonsteroidal antiinflammatory medications, salsalate, or acetaminophen) randomly received celecoxib 200 mg/day or rofecoxib 25 mg/day for three weeks. After a one-week washout period, the patients were crossed over to treatment with the opposite COX-2 inhibitor for three more weeks. The International Normalized Ratio (INR) was measured at baseline and at weeks 1, 2, and 3 of therapy with each COX-2 inhibitor by testing blood samples obtained by finger stick. Data for 16 patients were analyzed. The INR increased by 13%, 6%, and 5% on average in patients taking celecoxib at weeks 1, 2, and 3, respectively, and by 5%, 9%, and 5% in patients taking rofecoxib. Changes in the INR were statistically significant at week 1 for celecoxib and at week 2 for rofecoxib. Of the 12 subjects who had a clinically...

Value in Health, 2009

OBJECTIVES: The aim of this study was to review the existing treatment patterns for patients diag... more OBJECTIVES: The aim of this study was to review the existing treatment patterns for patients diagnosed with pulmonary arterial hypertension in the UK, France and Germany. METHODS: IMS Disease Analyzer, a longitudinal patient database providing information from continuing physician-patient interaction on consultations, diagnoses and treatment within Primary Care, was used to review the treatment patterns for PAH patients in the UK, France and Germany over a two year period, in order to describe: 1) different therapies used; 2) combination therapies; 3) clinical and economic outcomes of different therapies; 4) dose and drug utilization patterns; and 5) resource utilization. RESULTS: In all three countries, the prevalence of PAH was found to increase with age, with two-thirds of PAH patients being 60 years of age or older, with more female than male patients being diagnosed with PAH. PAH patients were also found to have been prescribed at least one medication, with 23% in France, 15% in Germany and 56% of patients in the UK being prescribed between 3 and 6 medications. In the UK, most prescriptions were found to refer to diuretics, calcium channel blockers and anti-thrombotic agents. In France, most prescriptions referred to beta-blockers, angiotensin receptor blockers and diuretics. In Germany, most prescriptions referred to diuretics, calcium channel blockers and beta blockers. For PAH patients in both France and Germany the median number of days receiving therapy over the 2 year period was found to be 100 days, whereas in the UK, this fi gure rose to 500 days. CONCLUSIONS: Whilst there were many similarities in the sociodemographic profi le of PAH patients, many differences in the treatment patterns for patients diagnosed with PAH in the UK, France, and Germany were found.

Value in Health, 2001

Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year perio... more Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year period. Results were driven by the impact of ICS on quality of life, rather than on mortality. Findings were stable over most input data ranges. However, at efficacy levels below 3% and toxicity rates greater than 2.9%, the cost-effectiveness estimate exceeded $100,000/QALY. CONCLUSION: Results suggest that inhaled steroids deliver good comparative value in mild-to-moderate adult asthma. More research is needed, however, on the impact of ICS toxicity on patient preferences.

Value in Health, 2006

Patients were stratified into 2 cohorts: those receiving OAB pharmacotherapy, including long-acti... more Patients were stratified into 2 cohorts: those receiving OAB pharmacotherapy, including long-acting tolterodine or immediate-or extended-release oxybutynin and those receiving non-pharmacologic management. Patients were matched 1 : 1 by the estimated propensity score for OAB pharmacotherapy using a logistic regression model incorporating selected demographic and clinical characteristics. Differences in direct medical costs during follow-up were assessed using descriptive statistics (Wilcoxon rank-sum tests) and multivariate statistical techniques to adjust for differences in demographic and clinical characteristics. RESULTS: A total of 1681 matched pairs were identified. Patients' mean ± SD age was 78 ± 8 years; 60% were women. ). After adjusting for prognostic factors, total direct costs were significantly higher for NPM patients in multivariate analyses (p = 0.0091). CONCLUSIONS: Elderly patients receiving OAB pharmacotherapy appear to have lower annual direct medical costs compared with patients receiving non-pharmacologic management. Careful consideration should be given to the selection of OAB treatment options from both clinical and economic perspectives.

American Journal of Health-System Pharmacy

Page 1. NOTES 1482 Am J Health-Syst Pharm—Vol 61 Jul 15, 2004 Valdecoxib Accuracy of splitting un... more Page 1. NOTES 1482 Am J Health-Syst Pharm—Vol 61 Jul 15, 2004 Valdecoxib Accuracy of splitting unscored valdecoxib tablets D ANIEL T. B OGGIE , M ELISSA L. D E L ATTRE , M ONICA G. S CHAEFER , A NTHONY P. M ORREALE , AND B RIAN K. P LOWMAN ...

American Journal of Health-System Pharmacy

Page 1. 1343 Am J Health-Syst Pharm—Vol 60 Jul 1, 2003 NOTES xxxx NOTES Digoxin–rabeprazole inter... more Page 1. 1343 Am J Health-Syst Pharm—Vol 60 Jul 1, 2003 NOTES xxxx NOTES Digoxin–rabeprazole interaction NOTES The Notes section welcomes the following types of contributions: (1) practical innovations or solutions ...

American Journal of Health-System Pharmacy

Page 1. NOTES 1391 Am J Health-Syst Pharm—Vol 61 Jul 1, 2004 Therapeutic interchange NOTES Therap... more Page 1. NOTES 1391 Am J Health-Syst Pharm—Vol 61 Jul 1, 2004 Therapeutic interchange NOTES Therapeutic interchange involving replacement of rofecoxib or celecoxib with valdecoxib F IONNA T RAN , D ANIEL T. B OGGIE , M ELISSA L. D ELATTRE , ...

American Journal of Health-System Pharmacy

Page 1. CLINICAL CONSULTATION Dosage Conversions 537 Am J Health-Syst Pharm—Vol 62 Mar 1, 2005 CL... more Page 1. CLINICAL CONSULTATION Dosage Conversions 537 Am J Health-Syst Pharm—Vol 62 Mar 1, 2005 CLINICAL CONSULTATION Dopamine-receptor agonists CLINICALCONSU LTAT ION Sleep attacks in patients receiving dopamine-receptor agonists ...

Research in Social and Administrative Pharmacy, 2015

Previous studies have found clinical pharmacists (CPs) and clinical pharmacy specialists (CPSs) i... more Previous studies have found clinical pharmacists (CPs) and clinical pharmacy specialists (CPSs) in direct patient care have positive effects across various patient outcomes. However, there are also other kinds of care-taking occurring in pharmacy-run clinic appointments that produce value for patients. To identify and characterize how CPs/CPSs in direct care clinics develop and practice care-taking behaviors which advance the pharmacist-patient relationship. Semi-structured CP/CPS interviews were conducted once per year for two years (46 year 1, 50 year 2) along with direct observations of clinical pharmacy work as part of an anticoagulation improvement intervention. Participants were from Veterans Health Administration (VHA) medical centers and VHA community-based outpatient clinics in the Northeastern U.S. Interviews were transcribed verbatim and thematically analyzed using NVIVO 10 software. It was found that CPs/CPSs practice "knowing the patient" in ways related to, but distinct from this practice in the nursing literature. For CPs/CPSs, knowing the patient occurred over time, and it produced familiarity and trust between CPs/CPs and patients. A reciprocal relationship developed in which patients came to rely on CP/CPSs for other types of assistance. Patterns of knowing the patient and being known by the patient manifested in three distinct ways: 1) identifying the patient's unmet needs, 2) explaining other medications, and 3) helping the patient navigate the system. This research identifies an action, knowing the patient, whereby CPs use their knowledge of the patient to deliver individualized care. This study contributes to the developing literature on pharmacist-patient relationships and pharmacist-patient communication.