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Annual Meeting Abstracts 2004 FEATURE Microsoft Access. Conclusions: NA 100—BRANDING PHARMACEUTICAL CARE SERVICES USING THE BRAND CLARITY PYRAMID. Abraham J, Bircea E, Stubbings J, University of Illinois at Chicago. E- mail: jabrah7@uic.edu Objective: (1) To alter the public image of pharmacy from the traditional dispensing role to the current patient-focused role, (2) to develop an image for pharmaceutical care using a proven professional tool used in the marketing and advertising industry, and (3) to help the public understand the role of pharmaceutical care in health care. Methods: To better represent the population, participants who interact with various types of pharmacy settings will be used. There will be multiple focus groups, each containing six to eight participants from a wide variety of backgrounds in each group. The brand clarity pyramid is the marketing tool chosen to create a new image of pharmaceutical care. Each session will last about 60 to 90 minutes and, with the permission of the participants, will be tape-recorded; the facilitator will ask the participants a series of questions to build a brand clarity pyramid for each session. After all the focus groups have done their brand clarity pyramids, a fifth focus group will be used to analyze the previous groups’ results and to develop a cohesive brand image. Results: Each brand pyramid from the focus groups will be presented. The results from the last focus groups will be used to determine if an effective image for pharmaceutical care has been developed; patient demographics from all focus groups will be included as well. Conclusions: This project is expected to promote an increased public understanding of pharmaceutical care. 101—DEVELOPMENT OF A HELICOBAC- TER PYLORI RAPID SCREENING PROGRAM IN THE COMMUNITY PHARMACY SET- TING. Kurpius M, University of Iowa, Sommers Hanson J, Dominick’s Pharmacy. E-mail: mollykurpius@uiowa.edu Objective: To implement a Helicobacter pylori screening program in the community pharmacy setting to (1) identify patients with untreated H. pylori infection, (2) initiate appropriate drug therapy for treatment of H. pylori infections, and (3) evaluate patient symptom improvement as the result of the interaction with the pharmacist. Methods: Patients for program participation were identified through patient prescription profile review for antisecretory medications and patient requests for nonprescription medication recommendations for the treatment of ulcer symptoms. Exclusion criteria included: patients younger than 18 years of age, pregnant, older than 50 years with new onset of symptoms, patients with gastroesophageal reflux disease-like symptoms, alarm symptoms, long-term use of nonsteroidal antiinflammatory medications, and previous infection or treatment of H. pylori. Those patients who did not meet the exclusion criteria were screened for H. pylori using a rapid whole blood test. Patients who tested negative were provided with drug therapy recommendations, suggestions for lifestyle modifications, and educational handouts. Patients who tested positive had a letter sent to the physician stating the patient’s symptoms, test results, and pharmacist’s recommendations for drug therapy. Follow-up with both groups of patients was made 1 month later via telephone call. Results: The pharmacist used a gastrointestinal symptom survey to assess the resolution of symptoms, outcomes of the pharmacist’s interventions, and implementation of recommendations made to the patient and the physician. Conclusions: This program is expected to benefit patient care as a result of pharmacist identification of patients requiring screening and treatment of H. pylori, and relieving symptoms associated with this infection. 102—NATIONAL PATTERNS OF ASPIRIN PROPHYLAXIS IN PATIENTS WITH DIA- BETES. Holness P, Lee E, Hogue V, Lombardo F, Howard University. E-mail: pholness@yahoo.com Objective: To describe the patterns of aspirin prescription in diabetic population using the 2000 National Ambulatory Medical Care Survey (NAMCS) and to evaluate the need for intervention by community pharmacists. Methods: Design: Cross-sectional descriptive study. Setting: Standalone office-based physician visits in ambulatory care settings. Participants: 22,224 NAMCS visit records made by patients 21 years of age and older. Results: Mean (± SD) age of the population was 54.3 (± 18) years. About 5% of the visits (1,046) were made by patients with diabetes. Mean age of patients making the diabetes visits (62.9 ± 13.8 years) was higher than that of the total population. Of the diabetes visits, 7.2% involved recommendations for aspirin were noted in the record. Visits made by diabetic patients were highly associated with aspirin record (odds ratio [OR], 3.6; 95% CI, 2.8–4.7). Although women patients were less likely to have aspirin records in the general population (OR, 0.4; 95% CI, 0.4–0.5), no gender difference was observed in the diabetic population (OR, 0.8; 95% CI, 0.5–1.3). Patients who were 65 years and older were approximately 4 times as likely to have aspirin record than patients who were younger than 65 years of age (OR, 3.7; 95% CI, 3.1–4.4). In addition, certain visit characteristics were associated with aspirin records among diabetic population. Cardiovascular specialists were more likely to be associated with aspirin records than were other physician specialties (OR, 5.2; 95% CI, 3.1–8.8). Physicians located in the Midwest were less likely to prescribe aspirin than were physicians in the Northeast (OR, 0.4; 95% CI, 0.2–0.9). No difference was observed by gender, race, metropolitan status, or counseling. Multivariate analyses will be conducted to describe factors predicting aspirin use. Conclusions: Status of aspirin use among patients with diabetes was suboptimal in 2000. More educational prevention programs focusing on aspirin prophylaxis are needed by community pharmacists. 103—PHARMACY STUDENTS’ EXPEC- TATIONS OF COLLABORATIVE WORKING RELATIONSHIPS (CWRS) AMONG PHAR- MACISTS, PHYSICIANS, AND PATIENTS. Stehling D, Gaebelein C, St. Louis College of Pharmacy. E-mail: d_stehlin@yahoo.com Objective: A major trend in pharmacy education is the promotion of a collaborative role for pharmacists in patient care. This effort involves the establishment of CWRs among pharmacists, physicians, and patients. Currently, however, little research is available on the dynamics of these relationships. The objective of this study was to adapt an existing survey tool, the Health Role Expectations Index (HREI), to study pharmacist–physician–patient interactions. The success was measured in terms of the statistical reliability and sensitivity of the resulting survey, the HREI-Pharmacist. Methods: The HREI, originally developed to study role expectations among nurses, physicians, and patients, was modified by substituting the term “pharmacist” for “nurse” in the 16-item questionnaire. The resulting items reflected the degree of collaboration expected among physicians, pharmacists, and patients in the health care setting. The survey also provided a general index of egalitarianism. The statistical reliability and sensitivity of the HREI–Pharmacist were assessed with a convenience sample of 55 students in their second year of professional studies at St. Louis College of Pharmacy. Survey data were analyzed using the Statistical Package for the Social Sciences (SPSS), release 10.0, and Microsoft Excel. An alpha level of .05 was used for all statistical decisions. Effect size estimations were calculated according to Cohen. Results: The statistical reliability of HREI–Pharmacist was determined by calculating a Generalizability Coefficient according to the principles of Generalizability Theory. A value of 0.68 was obtained, indicating that the HREI displayed adequate statistical reliability. The sensitivity of the HREI–Pharmacist was assessed by dividing respondents into two groups based upon the median egalitarianism score, and then comparing responses on the three collaborative dimensions. Students with high CWR scores expected much collaboration with physicians, while those with low CWR scores did not. However, both groups expected much collaboration with patients. Based on effect size estimations, the group difference in collaboration among physicians was large, and that among pharmacists was moderate. Conclusions: The HREI–Pharmacist is a reliable and sensitive tool for the study of the health role expectations of pharmacists, physicians, and patients. Current work with the tool involves benchmarking the CWR attitudes of pharmacy students and rural pharmacists. 2004 Abstracts of Contributed Papers Vol. 44, No. 2 March/April 2004 www.japha.org Journal of the American Pharmacists Association 251 Downloaded From: http://japha.org/ on 01/25/2014
FEATURE Annual Meeting Abstracts 2004 104—PROVIDING MEDICATIONS TO UNDERSERVED POPULATIONS UTILIZING 340B. Reid C, Jackson T, Langridge S, Midwestern University. E-mail: aleeza77@aol.com Objective: To increase awareness of the 340B program by educating pharmacist and other health care professionals in a community health care (CHC) setting. Methods: This is a two-hour continuing education (CE) program that is designed to educate health care professionals about 340B pricing. The main speaker of the program, a consultant for the Office of Pharmacy Affairs, will discuss barriers of access to pharmaceutical care in the working poor, 340B pricing, benefits of implementing the program, entities eligible for 340B pricing and who to contact for assistance when starting 340B. The group demographics will differ in gender, age, health care background, employment experience and education level. Each health care provider that attends the CE program will be asked to respond to a retrospective pre/post test. The survey is designed to assess participants’ knowledge of 340B pricing and the intent to implement the 340B pricing program. Results: The retrospective before–after test answers will be analyzed using the Wilcoxon Singed Rank analysis to measure the difference in the participant’s pretest and posttest knowledge of the 340B pricing program. Rasch analysis will determine the probability of answering a question correctly and measure the difference between the participant’s intent to implement the program before and after the retrospective pre/post test. Demographic variables will be analyzed using descriptive statistics. Conclusions: This CE program is expected to increase knowledge of 340B pricing among participants and gauge the intent to implement the program. 105—THE UNAVAILABILITY OF PRE- SCRIBED MEDICATIONS IN THE COMMU- NITY PHARMACY SETTING. Rodriguez I, NOVA Southeastern University, Lai L, Nova Southeastern University. E-mail: risis@nova.edu Objective: To evaluate if there is a relationship between the unavailability of prescribed medications and patients’ deserting the pharmacy. Methods: A convenience sampling method was used to recruit the study subjects at three community pharmacies in the Pembroke Pines and Miami area in Florida. The unavailability of a prescription is defined as a medication not available until next day. “patients’ deserting the pharmacy” was defined as a patient not returning to pick up the medication within the next 7 days. The patients who were not permanent residents of Florida or who did not agree to interchange the medication for one that is available were excluded from the study. Data will be obtained from the pharmacy computer database including: age, gender, race, type of medication prescribed, if the medication is used for acute or chronic conditions, type of insurance, and if the medication was picked up or not. A total of 154 study subjects was estimated to be the minimum sample size to provide results with a confidence interval of 95% and a power of .70. Results: This study is expected to identify that patients with new prescriptions for acute conditions will be less willing to wait or come back for the medication. Elderly patients and customers with insurance are expected to be less willing to order the medication for next day. Conclusions: NA. APhA–APPM Hospital & Institutional Practice 106—APPROPRIATE TREATMENT OF SYSTOLIC HEART FAILURE IN THE PRI- MARY CARE CLINICS. Worrall T, Ralph H. Johnson Veterans Affairs Medical Center, Simpson K, Medical University of South Carolina, Jenrette D, Ralph H. Johnson Veterans Affairs Medical Center. E-mail: tomcathyw@msn.com Objective: Heart failure is a common medical condition affecting more than five million people in the United States. Many experts believe that suboptimal pharmacological treatment contributes significantly to hospitalizations and deaths. This study was designed to quantify the percentage of patients in the primary care clinics receiving appropriate therapy for systolic heart failure (SHF) and to potentially improve prescribing practices in this patient population. Methods: Male veterans with SHF from three primary care teams were evaluated. Patients with SHF were randomly selected from the fourth quarter of 2001. The primary end points evaluated were the percentage of patients on ACE inhibitors, betablockers, or combination therapy. The secondary end point evaluated was the percentage of patients on spironolactone. Following an initial retrospective chart review, two educational interventions were performed to increase compliance with the SHF treatment guidelines. The effectiveness of this education was assessed through a review of SHF patient charts using the same methods described in the initial retrospective evaluation. Logistic regression modeling was used to assess the effect of the educational interventions. The Likelihood Ratio was used to assess overall model significance, and each variable was assessed using the chi-square test. The Wald Confidence Interval (CI) for the odds ratio estimates was also calculated. Results: A total of 148 patients were evaluated (75 before and 73 after education). The mean (± SD) age of the patients was 65 ± 11.3 years, the mean ejection fraction was 29 ± 9.5%, and the mean number of drugs prescribed per patient (other than study drugs) was 9.5 ± 4.8. The New York Heart Association (NYHA) functional class distribution was similar between groups. The percentages of patients prescribed ACE inhibitor in the before and after education groups were 90.7% and 89%, respectively. After education, beta-blocker and spironolactone prescribing increased by 12,8% and 6.2%, respectively. Spironolactone prescribing increased 10% in NYHA class III and IV heart failure patients. These patients were also 3.7 times more likely to receive appropriate therapy (95% CI, 1.16–11.63, P = .026). Conclusions: These results indicate that pharmacists’ educational interventions significantly improved the appropriate pharmacological treatment of SHF in primary care clinics. Original Citation: American College of Clinical Pharmacy 2003 Annual Meeting. November 5, 2003. Atlanta, Georgia. 107—COUNSELING MONOAMINE OXI- DASE INHIBITOR PATIENTS. Wenzel R, Diamond Headache Clinic Inpatient Unit, Schommer J, U. of Minnesota, Diamond S, Diamond Headache Clinic. E-mail: rwenz@ hotmail.com Objective: Assess whether a classroom-based pharmacy education service for hospitalized patients newly prescribed a monoamine oxidase inhibitor (MAOI) results in (1) higher self-perceived medication knowledge or (2) lower perceived risk of using MAOIs. Methods: Quasi-experimental self-administered patient survey given before the education service and repeated 24–72 hours after the service. Results: A total of 78 individuals completed the study. Paired-sample t tests showed that for each of the four items related to self-perceived medication knowledge, the scores reflected higher knowledge after the MAOI class compared with before the class (P < .05). For three of four items related to perceived risk of using MAOIs, the scores reflected a lower level of perceived risk after the MAOI class, compared with before the class (P < .05). One item did not significantly change: “The MAOI prescribed for me is just as good as other products available for treating headache.” Conclusions: Our results demonstrate a classroom-based teaching structure for newly prescribed MAOI patients can result in higher self-perceived medication knowledge and lower perceived risk of using MAOIs. The utility of this personnel-efficient method of counseling hospitalized patients prescribed other medications warrants further investigation. 108—DEVELOPMENT OF A CLINICAL PATHWAY TO OPTIMIZE EPOETIN THER- APY IN THE TREATMENT OF ANEMIA IN CHRONIC RENAL FAILURE PATIENTS. Canney T, Kindred Hospital. E-mail: dantissa@yahoo.com Objective: The objective of the project was to increase the utilization of iron supplementation and of the subcutaneous administration of epoetin in chronic renal failure patients through the design and implementation of a clinical pathway. Methods: Protocol developed based on literature and practice guidelines from the National Kidney Foundation (approved by renal specialists and the Medical Executive Committee of the hospital). Data were collected for 30 inpatients in an acute respiratory-care hospital who were prescribed epoetin. Dialysis and nondialysis patients were included and 252 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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