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Annual Meeting Abstracts 2004 FEATURE was 58, 41, and 18 percent, respectively. Fluoxetine, trazodone, and nefazodone had higher switch rates. A limitation is that our database likely did not include solely those with depression since some of these medications were being used to treat insomnia, migraine headache prophylaxis, or anxiety. Conclusions: Medication adherence is the use of the right drug in the correct dose at the right interval. Brief questionnaires can help pharmacists target individual patients for additional counseling. START is a powerful statistical tool to examine pharmacy claims databases to determine rates of medication adherence. Assessment of adherence rates uncovers opportunities for improvement in pharmaceutical care. 53—AN EVALUATION OF THE IMPACT OF A PHARMACY BASED LATENT TUBER- CULOSIS INFECTION COMPLIANCE CLIN- IC ON COMPLETION RATES OF ISONIAZID IN A COLLEGE STUDENT POPULATION. Goad J, Johnson K, University of Southern California, Milani H, Longs Drug Stores. E-mail: goad@hsc.usc.edu Objective: To determine if a pharmacist-managed latent tuberculosis infection (LTBI) clinic in a university community pharmacy improves the completion rate of isoniazid (INH) therapy for students. Methods: Data were retrospectively collected from pharmacy and medical records at the campus pharmacy and student health center. Using pharmacy records, all students receiving INH between January 1999 and May 2003 were identified. Those patients on antituberculosis medications other than INH were excluded. The resulting set of patients was matched to student health center medical records. Students were excluded if they did not meet CDC guidelines for low INH toxicity risk. A community pharmacybased LTBI compliance clinic for INH therapy had been initiated in August 2000. The pre-LTBI pharmacy clinic group A (January 1999 to July 2000) was managed completely by student-health clinicians, and the pharmacy-managed group B (August 2000 to May 2003) was referred by student health for all follow-up care at the pharmacy. Before June 2000, LTBI in non-HIV patients was treated with a 6- month course of INH, while later patients received the currently recommended 9 months of therapy. Results: A total of 86 patients were included in group A, while 118 patients were in group B. The average age in both groups was 25 years, and the ethnicity of group B was primarily Asian. The completion rate in group A (6 months or 180 doses in 9 months) was 36%, compared with 65% in group B (9 months or 270 doses in 12 months). The rate of adverse drug reactions to INH in group A was 1.2%, while in group B it was 11%, most likely reflecting the infrequent visits with clinicians in group A. Conclusions: A community pharmacy-based compliance clinic may significantly increase the rate of INH completion for LTBI treatment. 54—BILINGUAL OVER-THE-COUNTER PRODUCT LABELS TO ENHANCE PROD- UCT USE. Sansgiry S, University of Houston. E-mail: ssansgiry@uh.edu Objective: The objective of this study was to develop and evaluate bilingual (Spanish and English) product information labels (PILs) for overthe-counter (OTC) medication products to enhance comprehension of product-use information. Methods: A randomized experimental study design was developed using three different label formats: new OTC labels, old OTC labels, and PILs. Data were collected from consumers in the process of selecting OTC medications from the pharmacy stores in the Houston area. Participants were classified into three groups—English monolinguals, Spanish monolinguals, and English/Spanish bilinguals. Each participant evaluated three label designs in random order after which they completed a questionnaire that measured dependent variables such as ease of use, product knowledge, attitude toward product label, product evaluation, and purchase intention. The questionnaire was provided in both English and Spanish languages. Demographic variables measured include age, gender, marital status, race, income, education, employment status, and prior medication use. Data were coded and analyzed to evaluate the effect of PILs as compared with other label designs. Results: A total of 336 subjects participated in the study. Participants had a mean age of 38.7 (± 12.2) years with a higher distribution of women (59.2%) and Hispanics (69%). The multivariate analysis of variance (MANOVA) test showed significant effect of label design on all dependent measures (P < .001). Scheffé post-hoc tests showed that PILs were significantly superior to the current OTC label formats, and the results were consistent across all dependent variables measured. Conclusions: This study highlights the need for better information sources for OTC medications, especially for the growing Hispanic population. PILs provide a valuable solution to the concerns of the Spanish-speaking communities who may have difficulty reading or understanding current OTC labels. 55—BLOOD PRESSURE CONTROL OF ELDERLY HYPERTENSIVE PATIENTS WITH PHARMACEUTICAL CARE INTER- VENTION AND HOME BLOOD PRESSURE MONITORING. Christian M, Johnson & Johnson. E-mail: mchris2785@aol.com Objective: To assess the effectiveness of pharmaceutical care intervention, medication-use review, and home blood pressure monitoring for blood pressure control in elderly hypertensive patients. Methods: Eligible patients were entered into this prospective, controlled 4-month, two-phase study. Blood pressure was recorded and quality of life (QOL) assessments made using the 36-item short form (SF-36). During the initial (control) phase, blood pressure was monitored monthly by a trained health care professional without pharmaceutical care interventions. Weight and pulse were measured monthly. Patients were maintained on their medication regimen, adjustments only made as per standard of care. At the start of the second (intervention) phase of the trial, patients were administered the QOL survey. Monthly, patients received medication counseling, disease education, lifestyle modification counseling, and instruction on using a home blood pressure monitor. Monthly, patients had blood pressure monitored by a health care professional. Weight and pulse were measured monthly. At the conclusion of the trial, the QOL assessment was administered once again. Results: During the control phase, patients exhibited a mean elevation in both systolic and diastolic blood pressure from baseline. Heart rate remained virtually unchanged, and weight was reduced an average of 2 pounds, corresponding to a mean reduction of BMI. QOL assessment, using SF-36, showed an improvement in six of eight categories in the intervention group over the control group. General health category scores were improved 31.7% over baseline in the intervention group, compared with a 17.8% decline in general health score for the control group. During the intervention phase, systolic and diastolic blood pressures were reduced by an average of 3.25 and 0.4 mm Hg, respectively. Heart rate remained stable, and weight loss was observed in 7 of 12 patients for a mean reduction of 3 pounds (a mean reduction in BMI of 3.8%). Conclusions: Data presented demonstrate that active, monthly pharmaceutical care intervention along with home blood pressure monitoring was effective in blood pressure control of elderly hypertensive patients. Patient QOL can be significantly improved after pharmaceutical care intervention. Weight reduction was also enhanced with active pharmaceutical care intervention. 56—CHANGING BEHAVIOR TOWARDS OSTEOPOROSIS PREVENTION: DOES SCREENING LOCATION MATTER? Scolaro K, Stamm P, Lloyd K, Auburn University. E-mail: scolakl@mail.auburn.edu Objective: To determine if adherence to pharmacist recommendations for osteoporosis prevention differs by screening setting. Methods: Nonrandomized prospective analysis conducted in two chain community pharmacies (CP) and one nondispensing pharmaceutical care center (PCC) in suburban Alabama. The sample consists of 200 adult men and women. CP recruitment efforts include flyers, pharmacy staff referrals, and patient self-referrals. PCC patients are recruited during routine visits. Eligible patients complete an intake form collecting demographic data, basic medical information, osteoporosis risk factors, and current preventative behaviors (calcium and vitamin D use and exercise). Patients are then screened using the Achilles Express Ultrasound, educated about their results, and given recommendations to reduce osteoporosis risk. Follow-up surveys are mailed to each patient screened. Surveys are used to determine patient adherence to recommendations and patient satisfaction. Results will be compared to see if adherence or satisfaction differs according to screening setting. Nominal data (e.g., gender) will be analyzed using descriptive statistics. Differences in nominal data 2004 Abstracts of Contributed Papers Vol. 44, No. 2 March/April 2004 www.japha.org Journal of the American Pharmacists Association 239 Downloaded From: http://japha.org/ on 01/25/2014
FEATURE Annual Meeting Abstracts 2004 will be assessed using chi square analysis. Interval data will be analyzed using means, standard deviations, and Student’s t test for paired data. Results: Screenings are ongoing; the following data are aggregate. A comparison by setting will be presented. A total of 92 patients (81 CP, 11 PCC) have been screened, including 88 (96%) women. Mean (± SD) age is 48 ± 18 years. Patients average 2.7 ± 1.6 risk factors for osteoporosis, and the mean (± SD) T score is –0.2 ± 1. A total of 221 osteoporosis-specific recommendations have been made: 67 to increase calcium, 53 to increase vitamin D, 50 to initiate or increase weight-bearing exercise, 25 to obtain a diagnostic scan, 6 to reduce modifiable risk factors, and 20 miscellaneous. Some 54 (59%) patients returned evaluable surveys, and 16 of 37 (43%) responders had followed calcium recommendations, and 14 of 30 (47%) responders followed the exercise recommendations. On a scale of 1 to 10 (1 = very dissatisfied; 10 = very satisfied), patients rated the screening service at 8.9 ± 2.5, and all reported that they would recommend the service to a friend. Conclusions: Preliminary results indicate patients do change behavior, are highly satisfied with osteoporosis screenings conducted by pharmacists in the community setting and in nondispensing pharmaceutical care centers, and would recommend the service to others. 57—COMPARING THE RISK FOR OSTEO- POROSIS IN HISPANIC AND CAUCASIAN WOMEN BASED UPON BONE DENSITY MEASUREMENTS OBTAINED FROM COM- MUNITY HEALTH SCREENINGS. Alvarez G, Nova-Southeastern University, Marsh W, Hunter T, Droege M, Nova Southeastern University. E-mail: galvarez@nova.edu Objective: The objective of this study was to determine whether Caucasian–Hispanics are at a significantly lower risk than are non-Hispanic Caucasians for development of osteoporosis. Osteoporosis, a debilitating bone disease defined by decreased mass and altered bone micro-architecture, results in increased bone fragility and increased risk of fracture. The World Health Organization defines osteoporosis as a T score 2.5 standard deviations below the mean for young adult controls. All women, regardless of race, are at risk of developing osteoporosis; however, Caucasian or Asian women are commonly considered being at higher risk. Hispanics in the United States are of Mexican, Puerto Rican, Cuban, Dominican Republic, Central American, or South American descent; many Hispanics in South Florida are of Caucasian heritage. Whether osteoporosis risk differs based upon heritage within the Hispanic population is unknown. If health care providers mistakenly believe that some are not at risk for this disease, opportunities for appropriate prevention may be forfeited. Methods: Bone density measurements were used to assess the osteoporosis risk in 627 men and women in South Florida. Each subject self-reported gender, age, and race. Bone density measurements were obtained using a Hologic Sahara Bone Sonometer and T scores were calculated. Data are presented for 353 (209 Hispanic and 144 Caucasian) women over the age of 55. Results: The overall mean T score for the group was –1.229 with a standard deviation of 1.0385. The mean T score obtained for Hispanic women was –1.194, compared with –1.280 for Caucasian women. An independent Student’s t test for paired data confirmed that there was no statistically significant difference between the groups (t = 0.76, P = .47). As expected, the correlation between the obtained T score and age was negative (r = –.36), reflecting bone loss with increasing age. Conclusions: This study indicates that Hispanic women of Caucasian heritage are at equal risk of developing osteoporosis as Caucasian women. 58—CONSUMER ATTITUDES TOWARD THE OVERALL VALUE OF THE PHARMA- CIST AS A DRUG INFORMATION SOURCE. Rollins B, Sullivan D, Ohio Northern University. E- mail: b-rollins@onu.edu Objective: Consumers consistently view the pharmacist as one of the most trusted and respected professionals, but do they truly view the pharmacist as a valuable source of drug and medical information? The pharmacist, especially in the community setting, is the one of the most accessible and reliable sources of drug information for the consumer. However, are there barriers preventing consumers from seeking the pharmacist’s advice? The purpose of the study is to assess consumer attitudes toward the overall value of the pharmacist as a drug information source. The researchers will attempt to answer the following research questions: (1) Consumer attitudes toward the availability and approachability of the pharmacist; (2) is the pharmacist seen as a true patient advocate; (3) who do consumers seek to answer their drug information questions; and (4) do consumers prefer written drug information or pharmacist counseling? The fourth research question is based on the results of a previous study in which consumers slightly to moderately agreed they would rather have a voluntary package insert versus personal instruction from the pharmacist regarding the use of a corticosteroid nasal spray (mean = 4.49 ± 1.268; scale: 1 = strongly disagree to 6 = strongly agree). Methods: Consumers were selected for inclusion in the study from a database of Ohio residents between the ages of 18 and 70. A sample size of approximately 140 consumers was calculated based on a priori alpha of .05, beta of .20, and power of .80. Based on an estimated response rate of 35%, 400 consumers will be randomly selected through simple random sampling from this database. The survey instrument is a self-administered mailed questionnaire. The questionnaire uses approximately 35 questions to assess the four research questions. Data will be analyzed using descriptive statistics and Student’s t test for paired data. Demographic differences (gender, age, education level) will also be analyzed. Results: Data collection ongoing. Conclusions: Data collection ongoing. 59—CREATING THE CAPACITY FOR CASE MANAGEMENT IN A COMMUNITY PHARMACY. McDonough R, Doucette W, Musick J, Klepser D, McCarthy R, University of Iowa. E-mail: randal-mcdonough@uiowa.edu Objective: Main at Locust Pharmacy Clinic developed and implemented a process to provide case management services for the Iowa Medicaid Pharmaceutical Case Management (PCM) Program. The objective of this report is to describe the patient care processes and forms that were developed to provide case management services for eligible patients. Methods: Design: A descriptive overview of the patient care processes developed and implemented at the pharmacy to provide efficient and effective care to eligible Medicaid patients. Setting: An independent community pharmacy Patients: Medicaid recipients who were taking four or more long-term oral medications and had one or more of the 12 disease states that are costly to Iowa Medicaid (heart failure, coronary artery disease, diabetes mellitus, hypertension, hyperlipidemia, asthma, depression, atrial fibrillation, osteoarthritis, gastroesophageal reflux disease, peptic ulcer disease, and chronic obstructive pulmonary disease) Data Collection: A description of the patient care process that evolved over the 2- year period is provided. Patient care forms and physician communication tools that were developed to improve the efficiencies of the patient care process are discussed and shared. The number of patients enrolled, the number of drug therapy problems found, and the physician response to pharmacists’ recommendations is described. Analysis Plan: Description of the patient care process Results: Over a 2-year period, 259 patients met eligibility criteria. The clinic enrolled 153 patients into the program. Patient care processes were developed and patient care forms created. Communication forms were developed that improved the physician response rate to the pharmacists’ recommendations. Pharmacists found 901 drug therapy problems over the 2-year period. Physicians responded to pharmacists’ recommendations approximately 60% of the time. In 48% of the cases, pharmacists’ recommendations led to a documented change in patients’ medications. Conclusions: Pharmacists at Main at Locust Pharmacy Clinic were successful in developing and implementing case management services in a patient population considered at high risk for drug therapy problems. 60—DETERMINING THE EFFECT OF MEDIA RELATIONS ON PHARMACISTS. Ferreri S, University of North Carolina at Chapel Hill, Coffey C, Mercer University Southern School of Pharmacy. E-mail: ferreri@E-mail.unc.edu Objective: (1) To address if pharmacists have interacted with media. (2) Report if pharmacists receive communication or media training. (3) Identify how pharmacists could improve their interaction with the media. Methods: The members of the OTC Media Advisors network were chosen based on the criteria of knowledge of OTC medications, availability to 240 Journal of the American Pharmacists Association www.japha.org March/April 2004 Vol. 44, No. 2 Downloaded From: http://japha.org/ on 01/25/2014
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