Case cancellations have a negative financial impact due to revenue loss and the potential costs of underutilized time. The goals of this study at a recently opened hospital in the Middle East were to measure the cancellation rates for elective surgical or endoscopic cases and to identify the reasons for cancellation. During the 1-month study period, 170 (22.4%) of the 760 scheduled cases were cancelled. Cultural norms and patient no-shows on the day of surgery accounted for the majority of case cancellations. Understanding local factors on hospital functions may be vital for organizations expanding into new geographic areas.

Background The prevalence of hepatitis-C-virus (HCV) infections is high among opioid-dependent individuals. Prior research on the simultaneous treatment of both conditions has primarily assessed success as it pertains to HCV; although, it has been noted that favorable substance-use-therapy outcomes may improve the likelihood of HCV-treatment initiation and success. Therefore, current guidelines for the treatment of HCV among illicit drug users suggest that treatment for addiction be given the highest priority. Objectives To determine whether opioid-dependent participants in a clinical trial of buprenorphine-treatment tapering regimens, who tested positive for the HCV antibody, experienced significantly different levels of opioid abstinence than those not infected. Methods Data came from the National Drug Abuse Treatment Clinical Trial Network study 0003, in which 516 eligible opioid-dependent participants were randomized to either a 7-day or 28-day buprenorphine tapering schedule following a 4-week buprenorphine stabilization period. Generalized estimating equations were used to test the research question. Results Participants with the HCV antibody were significantly less likely to submit opioid-negative urine analyses during and/or immediately following active treatment [OR = 0.69; CI = 0.51–0.93], which indicates a higher rate of opioid use among this group. Conclusion Individualized opioid-dependence treatment strategies may be required for opioid-dependent individuals who test positive for the HCV antibody in order to ensure resources for both opioid-dependence and HCV therapies are used efficiently.

Pharmaceutical companies have designed prescription drug coupons and copay cards (CCCs) programs to maintain brand name medication loyalty, especially for medications that have just, or are about to lose their patent. The objective of this study is to evaluate perceptions of retail pharmacists about coupon and copay card (CCC) programs. METHODS: Pharmacists in the state of Arkansas, USA, were surveyed online. Questions on 5-point likert scale focused on pharmacist's perceptions towards CCC's regarding benefits to patients, public health, medication compliance, pharmacist workload, as well as barriers to pharmacy practice. Chi-square and multivariate logistic models were used to analyze the data. RESULTS: Of the approximately 1200 subjects 325 took the survey. Excluding missing values, 214 subjects were included in final analysis. Of these, 56% were male, 47% were less than 35 years of age, and 46% worked in a franchise or chain pharmacy, 40% were located in urban or suburban areas, 60% were in semi-urban or rural areas. Regression results indicated that full-time pharmacist practicing in larger pharmacies and processing higher numbers of CCCs had more favorable views towards patient satisfaction with CCCs (all p-values<0.05). Most pharmacists were reluctant to express that CCCs saved patients money, were good for public health, or improved medication compliance. Most pharmacists agreed that CCCs increased pharmacy workload, however highly satisfied pharmacist with proper staffing disagreed. Female pharmacists were more likely to explain CCC use to patients. Pharmacists working in high-volume chain and urban environments were least likely to state difficulties processing CCC transactions. All p-values in regression results reported above were <0.05 with odds ratios ranging from 1.05 to 2.5 (note: individual p-values and odds ratios are too many to report because of word limit). CONCLUSIONS: With increasing prevalence of CCCs, this study provides key insights into perceptions of pharmacists.