Rural and urban nonphysician providers in Georgia.

Nonphysician providers make valuable contributions to health care in rural areas. This study examines provider and practice characteristics, location preference, and reasons for location preference among Georgia nurse practitioners (NPs), certified nurse midwives, and physician assistants (PAs) (N = 1,079). Data collected through a statewide survey revealed that providers were concentrated in urban areas. Rural providers tended to be older, less educated, possess fewer specialty credentials, and were employed longer than urban providers. NPs were significantly more likely to prefer smaller communities, and PAs were significantly more likely to prefer larger communities. Providers who preferred smaller communities were likely to practice in rural and urban areas, but providers who preferred larger communities were substantially more likely to practice in urban areas. Providers who preferred smaller communities were significantly more likely to mention the importance of community dynamics, while providers who preferred larger communities were significantly more likely to mention professional context.

Coping with the cost of prescription drugs.

African Americans have higher rates of nonprescription drug utilization than white Americans, but lower rates of prescription drug use. In light of this discrepancy, this study examines 281 lower income African American households in the rural South for access to prescription drugs and coping strategies when households cannot afford prescription drugs. About half of the households could not always afford needed prescriptions, and ability to pay was related positively to Medicaid coverage. Households that could not afford prescriptions employed five strategies: (1) prioritizing, (2) financing, (3) rationing, (4) substituting, and (5) postponing. Financing, postponing, and rationing were cited most frequently. The impact of culture and areas for future research are discussed.

Mebhydrolin napadisylate. A possible cause of reversible agranulocytosis and neutropenia.

Mebhydrolin napadisylate is an antihistamine marketed in Australia as Fabahistin, and as an ingredient of Fabahistin Plus. Since June, 1973, 11 Australian reports associating this drug with either agranulocytosis or neutropenia have been received by the Adverse Drug Reactions Advisory Committee. In seven of these reports, mebhydrolin napadisylate was the only suspected drug. These reactions are probably uncommon, but the association should be borne in mind if evidence of agranulocytosis or neutropenia is found in patients taking the drug.