Lisa Boothby | Indiana University Kokomo (original) (raw)

Papers by Lisa Boothby

Hospital Pharmacy, 2003

... Lisa Anne Boothby, PharmD,BCPS* Paul L. Doering, MS, FAPhA†, and Randy C. Hatton, PharmD, BCP... more ... Lisa Anne Boothby, PharmD,BCPS* Paul L. Doering, MS, FAPhA†, and Randy C. Hatton, PharmD, BCPS, FCCP‡ ... to be no compelling rea-son to have this product available in the hospital, the Pharmacy and Therapeu-tics (P&T) Committee reviewed the pol-icy to determine if ...

The Annals of Pharmacotherapy, 2002

The Journal of Pharmacy Technology Jpt Official Publication of the Association of Pharmacy Technicians, Jul 1, 2004

ABSTRACT Objective: To determine local pharmacists' willingness to recommend/allow the us... more ABSTRACT Objective: To determine local pharmacists' willingness to recommend/allow the use of OTC ibuprofen when prescription-strength ibuprofen had been prescribed for symptomatic relief of rheumatoid arthritis, to examine the evidence-based medicine supporting the use of ibuprofen for rheumatoid arthritis treatment, and to determine the impact this evidence has for nonprescription ibuprofen drug labeling.

Journal of Pharmacy Technology, 2004

ABSTRACT Objective: To determine local pharmacists' willingness to recommend/allow the us... more ABSTRACT Objective: To determine local pharmacists' willingness to recommend/allow the use of OTC ibuprofen when prescription-strength ibuprofen had been prescribed for symptomatic relief of rheumatoid arthritis, to examine the evidence-based medicine supporting the use of ibuprofen for rheumatoid arthritis treatment, and to determine the impact this evidence has for nonprescription ibuprofen drug labeling.

Annals of Pharmacotherapy, 2002

To review the drug therapy for the treatment of itching associated with intrahepatic cholestasis ... more To review the drug therapy for the treatment of itching associated with intrahepatic cholestasis of pregnancy (ICP). A comprehensive literature search was conducted in MEDLINE (1966-July 2002) using the following MeSH terms: pregnancy, itching, intrahepatic cholestasis, cholestyramine, ursodeoxycholic acid, and phenobarbital. Current Contents (1966-July 2002), International Pharmaceutical Abstracts (1970-June 2002), and Cochrane Database were also searched using those terms. Web of Science search was used to search references found in articles. Eight clinical trials and several observational studies were identified evaluating the safety and efficacy of ursodeoxycholic acid (UDCA) in the treatment of ICP. Although these studies were small and inconsistent, improvement in maternal and fetal morbidity was demonstrated. Observational studies suggest that cholestyramine may be associated with improved maternal morbidity without a documented improvement in fetal outcome. Two observational studies evaluated the efficacy of phenobarbital for ICP treatment. Phenobarbital use was not associated with improved maternal or fetal morbidity/mortality. Data from large, well-designed, randomized, controlled trials of treatment of ICP are lacking. Data that are available support the use of UDCA as a first-line agent and cholestyramine as a second-line agent for treatment of ICP. There is little evidence to recommend phenobarbital in the treatment of itching associated with that condition.

Annals of Pharmacotherapy, 2002

To review the drug therapy for the treatment of itching associated with intrahepatic cholestasis ... more To review the drug therapy for the treatment of itching associated with intrahepatic cholestasis of pregnancy (ICP). A comprehensive literature search was conducted in MEDLINE (1966-July 2002) using the following MeSH terms: pregnancy, itching, intrahepatic cholestasis, cholestyramine, ursodeoxycholic acid, and phenobarbital. Current Contents (1966-July 2002), International Pharmaceutical Abstracts (1970-June 2002), and Cochrane Database were also searched using those terms. Web of Science search was used to search references found in articles. Eight clinical trials and several observational studies were identified evaluating the safety and efficacy of ursodeoxycholic acid (UDCA) in the treatment of ICP. Although these studies were small and inconsistent, improvement in maternal and fetal morbidity was demonstrated. Observational studies suggest that cholestyramine may be associated with improved maternal morbidity without a documented improvement in fetal outcome. Two observational studies evaluated the efficacy of phenobarbital for ICP treatment. Phenobarbital use was not associated with improved maternal or fetal morbidity/mortality. Data from large, well-designed, randomized, controlled trials of treatment of ICP are lacking. Data that are available support the use of UDCA as a first-line agent and cholestyramine as a second-line agent for treatment of ICP. There is little evidence to recommend phenobarbital in the treatment of itching associated with that condition.

International Journal of Clinical Practice, 2007

Although preventability criteria have been assessed for all adverse drug reactions (ADRs) investi... more Although preventability criteria have been assessed for all adverse drug reactions (ADRs) investigated at our institution over the past 12 years, a systematic evaluation of the data had not been performed. This project analysed preventability data previously collected to identify the potential areas for process improvements. A 3-year retrospective analysis was performed. All ADRs were categorised by drug, drug class, severity, probability of causality and preventability. Factors involved in preventability were assessed and tallied. Descriptive statistics was used to analyse the data. Most ADRs occurred prior to admission. In the outpatient setting, anticoagulants and anticonvulsants were associated with more preventable ADRs (pADRs) than other drug classes, followed by cardiotonic agents and non-steroidal anti-inflammatory drugs (NSAIDs). For ADRs that occurred in hospitalised patients, antibiotics and opiates were associated with approximately half of all pADRs. The preventability categories most frequently associated with ADRs prior to admission were presence of a toxic drug level and drug–drug interactions, while inappropriate dose, route or frequency was the most common preventability category for inpatient ADRs. The majority of pADRs were moderate in severity in both the in- and outpatient settings. Drugs and drug classes involved in pADRs differ in the in- and outpatient settings. Preventability categories also differ by setting. Most pADRs occur prior to admission in our healthcare system. This presents a challenge in terms of implementing the process changes to reduce the pADRs, as patients in the community are outside our control.

Annals of Pharmacotherapy, 2005

To evaluate the literature on supplemental vitamin C and vitamin E therapy in the prevention and ... more To evaluate the literature on supplemental vitamin C and vitamin E therapy in the prevention and treatment of Alzheimer's disease (AD). Literature retrieval was accessed through MEDLINE (1966-March 2005) using the key words antioxidants, vitamin C, vitamin E, Alzheimer's disease, and dementia. International Pharmaceutical Abstracts (1970-March 2005), Current Contents (1996-March 2005), Cochrane Database of Systematic Reviews (1994-March 2005), and Ebsco's Academic Search Elite (1975-March 2005) were searched with the same key words. Articles related to the objective that were identified through PubMed were included. Oral supplementation of vitamin C (ascorbic acid) and vitamin E (D-alfa-tocopherol acetate) alone and in combination have been shown to decrease oxidative DNA damage in animal studies in vivo, in vitro, and in situ. Recent results of a prospective observational study (n = 4740) suggest that the combined use of vitamin E 400 IU daily and vitamin C 500 mg daily for at least 3 years was associated with the reduction of AD prevalence (OR 0.22; 95% CI 0.05 to 0.60) and incidence (HR 0.36; 95% CI 0.09 to 0.99). Contradicting this is a previous prospective observational study (n = 980) evaluating the relationship between 4 years of vitamin C and E intake and the incidence of AD, which detected no difference in the incidence of AD during the 4-year follow-up. Recent meta-analysis results suggest that doses of vitamin E > or =400 IU daily for more than one year are associated with increased all-cause mortality. Mega-trial results suggest that vitamin E doses > or =400 IU daily for 6.9 years in patients with preexisting vascular disease or diabetes mellitus increase the incidence of heart failure, with no other outcome benefits noted. In the absence of prospective, randomized, controlled clinical trials documenting benefits that outweigh recently documented morbidity and mortality risks, vitamin E supplements should not be recommended for primary or secondary prevention of AD. Although the risks of taking high doses of vitamin C are lower than those with vitamin E, the lack of consistent efficacy data for vitamin C in preventing or treating AD should discourage its routine use for this purpose.

American Journal of Health-system Pharmacy, 2007

The clinical issues surrounding the use of buprenorphine for the treatment of opioid dependence a... more The clinical issues surrounding the use of buprenorphine for the treatment of opioid dependence are reviewed. Opioids continue to be some of the most frequently reported prescription medications in substance abuse- related cases. A semisynthetic derivative of thebaine, buprenorphine hydrochloride is a partial mu-opioid receptor agonist and kappa-receptor antagonist with a long duration of action. The pharmacokinetic and pharmacodynamic profiles of buprenorphine are not well characterized. The ethical and legal issues associated with the maintenance treatment of opioid dependence are complex. Clinical trials have compared the efficacy of methadone, buprenorphine, and buprenorphine-naloxone for the detoxification and maintenance treatment of opioid dependence. Based on the available literature, it appears that buprenorphine, buprenorphine-naloxone, and methadone are similarly efficacious for the treatment of opioid-dependent patients. Buprenorphine-naloxone has less potential for abuse and diversion. The adverse-effect profiles for buprenorphine, buprenorphine-naloxone, and methadone are similar. Once-weekly office visits for patient evaluation and dispensing of buprenorphine seem feasible and convenient for both practitioners and patients. The three phases of opioid maintenance treatment are induction, stabilization, and maintenance. It is good practice for the admitting physician to consult with the patient's addiction treatment provider, when possible, to obtain the patient's treatment history. Buprenorphine is an attractive option for the pharmacologic treatment of opioid dependence. Compliance and adherence to buprenorphine therapy for opioid-dependent patients remain clinical issues. Future research efforts should focus on improving compliance and adherence to buprenorphine therapy.

Annals of Pharmacotherapy, 2002

Annals of Pharmacotherapy, 2001

American Journal of Obstetrics and Gynecology, 2002

Evidence-based medicine that is designed to guide benefit/risk drug therapy decisions does not ex... more Evidence-based medicine that is designed to guide benefit/risk drug therapy decisions does not exist for pregnant women. The types of studies that do exist are usually conducted in animals, which may not reflect human benefits and risks. The types of studies that do exist in humans are typically limited and, at best, may show an "association" between a particular drug therapy and an undesirable effect. This review outlines the difficulties that are associated with the assessment of the benefits/risks of drug therapy during pregnancy, the history of the Food and Drug Administration regulations for labeling prescription drugs, and the strengths and weaknesses of the current Food and Drug Administration pregnancy labeling system. Proposed changes to the current system are reviewed.

Gamma-hydroxybutyrate (GHB) intoxication is a significant cause of morbidity and mortality in pat... more Gamma-hydroxybutyrate (GHB) intoxication is a significant cause of morbidity and mortality in patients taking the drug for recreational purposes. Due to the recent increase in emergency room visits, hospital admissions, and deaths, it has become necessary to re-examine the pharmacology, pharmacokinetics, pharmacodynamics, clinical manifestations, and potential adverse effects associated with GHB use. We present an important pharmacologic and clinical update on GHB.

International Journal of Clinical Practice, 2007

Attention-deficit/hyperactivity disorder is a highly diagnosed psychiatric disorder in children. ... more Attention-deficit/hyperactivity disorder is a highly diagnosed psychiatric disorder in children. This widespread and complex condition requires extensive evaluation involving clinicians, parents and teachers. Proper management involves individual assessment and treatment. Psychostimulants remain the primary medication of choice as they have been shown to be efficacious for this condition. Newer, long-acting medications are providing expanded options for children and their caregivers. Failure to assess and treat can lead to serious long-term effects later in life.

Hospital Pharmacy, 2006

Lisa A. Boothby, PharmD, BCPS,* Rajanikanth Madabushi, PhD,‡ Vipul Kumar, PhD,‡ Burnis D. Breland... more Lisa A. Boothby, PharmD, BCPS,* Rajanikanth Madabushi, PhD,‡ Vipul Kumar, PhD,‡ Burnis D. Breland, MS, PharmD, FASHP,§ Randy C. Hatton, PharmD, FCCP, BCPS,** Paul L. Doering, MS, FAPhA;†† and Hartmut Derendorf, PhD ... Hospital Pharmacy Volume 41, ...

Menopause-the Journal of The North American Menopause Society, 2004

Objective: The terms "natural" or "bioidentical" hormone therapy (NHT) are used to describe hormo... more Objective: The terms "natural" or "bioidentical" hormone therapy (NHT) are used to describe hormone treatment with individually compounded recipes of certain steroids in various dosage forms, including dehydroepiandrosterone, pregnenolone, testosterone, progesterone, estrone, estradiol, and estriol. Based on the results of a person's salivary hormone levels, the final composition of the compounded dosage form is individualized to that specific person. Proponents claim that NHT is better tolerated than manufactured products. This paper is intended to review the concept of NHT and to determine whether there is sufficient scientific evidence to support its use.

Annals of Pharmacotherapy, 2001

Hospital Pharmacy, 2003

... Lisa Anne Boothby, PharmD,BCPS* Paul L. Doering, MS, FAPhA†, and Randy C. Hatton, PharmD, BCP... more ... Lisa Anne Boothby, PharmD,BCPS* Paul L. Doering, MS, FAPhA†, and Randy C. Hatton, PharmD, BCPS, FCCP‡ ... to be no compelling rea-son to have this product available in the hospital, the Pharmacy and Therapeu-tics (P&T) Committee reviewed the pol-icy to determine if ...

The Annals of Pharmacotherapy, 2002

The Journal of Pharmacy Technology Jpt Official Publication of the Association of Pharmacy Technicians, Jul 1, 2004

ABSTRACT Objective: To determine local pharmacists' willingness to recommend/allow the us... more ABSTRACT Objective: To determine local pharmacists' willingness to recommend/allow the use of OTC ibuprofen when prescription-strength ibuprofen had been prescribed for symptomatic relief of rheumatoid arthritis, to examine the evidence-based medicine supporting the use of ibuprofen for rheumatoid arthritis treatment, and to determine the impact this evidence has for nonprescription ibuprofen drug labeling.

Journal of Pharmacy Technology, 2004

ABSTRACT Objective: To determine local pharmacists' willingness to recommend/allow the us... more ABSTRACT Objective: To determine local pharmacists' willingness to recommend/allow the use of OTC ibuprofen when prescription-strength ibuprofen had been prescribed for symptomatic relief of rheumatoid arthritis, to examine the evidence-based medicine supporting the use of ibuprofen for rheumatoid arthritis treatment, and to determine the impact this evidence has for nonprescription ibuprofen drug labeling.

Annals of Pharmacotherapy, 2002

To review the drug therapy for the treatment of itching associated with intrahepatic cholestasis ... more To review the drug therapy for the treatment of itching associated with intrahepatic cholestasis of pregnancy (ICP). A comprehensive literature search was conducted in MEDLINE (1966-July 2002) using the following MeSH terms: pregnancy, itching, intrahepatic cholestasis, cholestyramine, ursodeoxycholic acid, and phenobarbital. Current Contents (1966-July 2002), International Pharmaceutical Abstracts (1970-June 2002), and Cochrane Database were also searched using those terms. Web of Science search was used to search references found in articles. Eight clinical trials and several observational studies were identified evaluating the safety and efficacy of ursodeoxycholic acid (UDCA) in the treatment of ICP. Although these studies were small and inconsistent, improvement in maternal and fetal morbidity was demonstrated. Observational studies suggest that cholestyramine may be associated with improved maternal morbidity without a documented improvement in fetal outcome. Two observational studies evaluated the efficacy of phenobarbital for ICP treatment. Phenobarbital use was not associated with improved maternal or fetal morbidity/mortality. Data from large, well-designed, randomized, controlled trials of treatment of ICP are lacking. Data that are available support the use of UDCA as a first-line agent and cholestyramine as a second-line agent for treatment of ICP. There is little evidence to recommend phenobarbital in the treatment of itching associated with that condition.

Annals of Pharmacotherapy, 2002

To review the drug therapy for the treatment of itching associated with intrahepatic cholestasis ... more To review the drug therapy for the treatment of itching associated with intrahepatic cholestasis of pregnancy (ICP). A comprehensive literature search was conducted in MEDLINE (1966-July 2002) using the following MeSH terms: pregnancy, itching, intrahepatic cholestasis, cholestyramine, ursodeoxycholic acid, and phenobarbital. Current Contents (1966-July 2002), International Pharmaceutical Abstracts (1970-June 2002), and Cochrane Database were also searched using those terms. Web of Science search was used to search references found in articles. Eight clinical trials and several observational studies were identified evaluating the safety and efficacy of ursodeoxycholic acid (UDCA) in the treatment of ICP. Although these studies were small and inconsistent, improvement in maternal and fetal morbidity was demonstrated. Observational studies suggest that cholestyramine may be associated with improved maternal morbidity without a documented improvement in fetal outcome. Two observational studies evaluated the efficacy of phenobarbital for ICP treatment. Phenobarbital use was not associated with improved maternal or fetal morbidity/mortality. Data from large, well-designed, randomized, controlled trials of treatment of ICP are lacking. Data that are available support the use of UDCA as a first-line agent and cholestyramine as a second-line agent for treatment of ICP. There is little evidence to recommend phenobarbital in the treatment of itching associated with that condition.

International Journal of Clinical Practice, 2007

Although preventability criteria have been assessed for all adverse drug reactions (ADRs) investi... more Although preventability criteria have been assessed for all adverse drug reactions (ADRs) investigated at our institution over the past 12 years, a systematic evaluation of the data had not been performed. This project analysed preventability data previously collected to identify the potential areas for process improvements. A 3-year retrospective analysis was performed. All ADRs were categorised by drug, drug class, severity, probability of causality and preventability. Factors involved in preventability were assessed and tallied. Descriptive statistics was used to analyse the data. Most ADRs occurred prior to admission. In the outpatient setting, anticoagulants and anticonvulsants were associated with more preventable ADRs (pADRs) than other drug classes, followed by cardiotonic agents and non-steroidal anti-inflammatory drugs (NSAIDs). For ADRs that occurred in hospitalised patients, antibiotics and opiates were associated with approximately half of all pADRs. The preventability categories most frequently associated with ADRs prior to admission were presence of a toxic drug level and drug–drug interactions, while inappropriate dose, route or frequency was the most common preventability category for inpatient ADRs. The majority of pADRs were moderate in severity in both the in- and outpatient settings. Drugs and drug classes involved in pADRs differ in the in- and outpatient settings. Preventability categories also differ by setting. Most pADRs occur prior to admission in our healthcare system. This presents a challenge in terms of implementing the process changes to reduce the pADRs, as patients in the community are outside our control.

Annals of Pharmacotherapy, 2005

To evaluate the literature on supplemental vitamin C and vitamin E therapy in the prevention and ... more To evaluate the literature on supplemental vitamin C and vitamin E therapy in the prevention and treatment of Alzheimer's disease (AD). Literature retrieval was accessed through MEDLINE (1966-March 2005) using the key words antioxidants, vitamin C, vitamin E, Alzheimer's disease, and dementia. International Pharmaceutical Abstracts (1970-March 2005), Current Contents (1996-March 2005), Cochrane Database of Systematic Reviews (1994-March 2005), and Ebsco's Academic Search Elite (1975-March 2005) were searched with the same key words. Articles related to the objective that were identified through PubMed were included. Oral supplementation of vitamin C (ascorbic acid) and vitamin E (D-alfa-tocopherol acetate) alone and in combination have been shown to decrease oxidative DNA damage in animal studies in vivo, in vitro, and in situ. Recent results of a prospective observational study (n = 4740) suggest that the combined use of vitamin E 400 IU daily and vitamin C 500 mg daily for at least 3 years was associated with the reduction of AD prevalence (OR 0.22; 95% CI 0.05 to 0.60) and incidence (HR 0.36; 95% CI 0.09 to 0.99). Contradicting this is a previous prospective observational study (n = 980) evaluating the relationship between 4 years of vitamin C and E intake and the incidence of AD, which detected no difference in the incidence of AD during the 4-year follow-up. Recent meta-analysis results suggest that doses of vitamin E > or =400 IU daily for more than one year are associated with increased all-cause mortality. Mega-trial results suggest that vitamin E doses > or =400 IU daily for 6.9 years in patients with preexisting vascular disease or diabetes mellitus increase the incidence of heart failure, with no other outcome benefits noted. In the absence of prospective, randomized, controlled clinical trials documenting benefits that outweigh recently documented morbidity and mortality risks, vitamin E supplements should not be recommended for primary or secondary prevention of AD. Although the risks of taking high doses of vitamin C are lower than those with vitamin E, the lack of consistent efficacy data for vitamin C in preventing or treating AD should discourage its routine use for this purpose.

American Journal of Health-system Pharmacy, 2007

The clinical issues surrounding the use of buprenorphine for the treatment of opioid dependence a... more The clinical issues surrounding the use of buprenorphine for the treatment of opioid dependence are reviewed. Opioids continue to be some of the most frequently reported prescription medications in substance abuse- related cases. A semisynthetic derivative of thebaine, buprenorphine hydrochloride is a partial mu-opioid receptor agonist and kappa-receptor antagonist with a long duration of action. The pharmacokinetic and pharmacodynamic profiles of buprenorphine are not well characterized. The ethical and legal issues associated with the maintenance treatment of opioid dependence are complex. Clinical trials have compared the efficacy of methadone, buprenorphine, and buprenorphine-naloxone for the detoxification and maintenance treatment of opioid dependence. Based on the available literature, it appears that buprenorphine, buprenorphine-naloxone, and methadone are similarly efficacious for the treatment of opioid-dependent patients. Buprenorphine-naloxone has less potential for abuse and diversion. The adverse-effect profiles for buprenorphine, buprenorphine-naloxone, and methadone are similar. Once-weekly office visits for patient evaluation and dispensing of buprenorphine seem feasible and convenient for both practitioners and patients. The three phases of opioid maintenance treatment are induction, stabilization, and maintenance. It is good practice for the admitting physician to consult with the patient's addiction treatment provider, when possible, to obtain the patient's treatment history. Buprenorphine is an attractive option for the pharmacologic treatment of opioid dependence. Compliance and adherence to buprenorphine therapy for opioid-dependent patients remain clinical issues. Future research efforts should focus on improving compliance and adherence to buprenorphine therapy.

Annals of Pharmacotherapy, 2002

Annals of Pharmacotherapy, 2001

American Journal of Obstetrics and Gynecology, 2002

Evidence-based medicine that is designed to guide benefit/risk drug therapy decisions does not ex... more Evidence-based medicine that is designed to guide benefit/risk drug therapy decisions does not exist for pregnant women. The types of studies that do exist are usually conducted in animals, which may not reflect human benefits and risks. The types of studies that do exist in humans are typically limited and, at best, may show an "association" between a particular drug therapy and an undesirable effect. This review outlines the difficulties that are associated with the assessment of the benefits/risks of drug therapy during pregnancy, the history of the Food and Drug Administration regulations for labeling prescription drugs, and the strengths and weaknesses of the current Food and Drug Administration pregnancy labeling system. Proposed changes to the current system are reviewed.

Gamma-hydroxybutyrate (GHB) intoxication is a significant cause of morbidity and mortality in pat... more Gamma-hydroxybutyrate (GHB) intoxication is a significant cause of morbidity and mortality in patients taking the drug for recreational purposes. Due to the recent increase in emergency room visits, hospital admissions, and deaths, it has become necessary to re-examine the pharmacology, pharmacokinetics, pharmacodynamics, clinical manifestations, and potential adverse effects associated with GHB use. We present an important pharmacologic and clinical update on GHB.

International Journal of Clinical Practice, 2007

Attention-deficit/hyperactivity disorder is a highly diagnosed psychiatric disorder in children. ... more Attention-deficit/hyperactivity disorder is a highly diagnosed psychiatric disorder in children. This widespread and complex condition requires extensive evaluation involving clinicians, parents and teachers. Proper management involves individual assessment and treatment. Psychostimulants remain the primary medication of choice as they have been shown to be efficacious for this condition. Newer, long-acting medications are providing expanded options for children and their caregivers. Failure to assess and treat can lead to serious long-term effects later in life.

Hospital Pharmacy, 2006

Lisa A. Boothby, PharmD, BCPS,* Rajanikanth Madabushi, PhD,‡ Vipul Kumar, PhD,‡ Burnis D. Breland... more Lisa A. Boothby, PharmD, BCPS,* Rajanikanth Madabushi, PhD,‡ Vipul Kumar, PhD,‡ Burnis D. Breland, MS, PharmD, FASHP,§ Randy C. Hatton, PharmD, FCCP, BCPS,** Paul L. Doering, MS, FAPhA;†† and Hartmut Derendorf, PhD ... Hospital Pharmacy Volume 41, ...

Menopause-the Journal of The North American Menopause Society, 2004

Objective: The terms "natural" or "bioidentical" hormone therapy (NHT) are used to describe hormo... more Objective: The terms "natural" or "bioidentical" hormone therapy (NHT) are used to describe hormone treatment with individually compounded recipes of certain steroids in various dosage forms, including dehydroepiandrosterone, pregnenolone, testosterone, progesterone, estrone, estradiol, and estriol. Based on the results of a person's salivary hormone levels, the final composition of the compounded dosage form is individualized to that specific person. Proponents claim that NHT is better tolerated than manufactured products. This paper is intended to review the concept of NHT and to determine whether there is sufficient scientific evidence to support its use.

Annals of Pharmacotherapy, 2001