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Annual Meeting Abstracts 2004 FEATURE Pharmacy (28%) on postsurvey. The career choice students were least likely to pursue was Military Pharmacy (30% pretest, 20% posttest). The most influential factor in pursuing a career was genuine interest in the field (72% pretest, 68% posttest). The least influential factor was family pressure (70% pretest, 66% posttest). Overall, 74% (N = 37) of students changed their career option choices, while 88% (N = 44) did not change the factors influencing their decision in a pharmacy career choice. Conclusions: The Career Explorers Program raised awareness about pharmacy career opportunities. This research helped to establish where students interests lies and what may influence their decision to pursue certain pharmacy-based careers. 13—POTENTIAL COST SAVINGS AT AN INDIGENT CARE CLINIC BY MAXIMIZING PATIENT ASSISTANCE PROGRAMS. Lindsey C, Sutherland J, University of Missouri–Kansas City. E-mail: lindseyca@umkc.edu Objective: To evaluate the cost of medications used in an indigent care clinic dispensary and determine the potential cost savings if patient assistance programs were optimized. Methods: This was a retrospective review of medication invoice purchases that took place at the Jackson County Free Health Clinic between August 2002 and August 2003. All purchases were recorded by medication, dose, drug class, date of purchase, and cost. Medication purchases were summated and evaluated based on the ability to access these products through assistance programs and therapeutic substitutions. Results: A total of $5,168.13 was spent to purchase 38 different medications for the dispensary over a 12-month time frame. Majority of medications were antihypertensives, antidepressants, and hypoglycemics. Of all of the maintenance medication purchases, 79.5% of our dispensary expenses could have been saved by ensuring the patient assistance program was optimized. Conclusions: Medication cost to the clinic could be potentially reduced by $4,107.93 annually by ensuring that each drug order is evaluated for its ability to be acquired through assistance programs. 14—THE DEFENSE SUPPLY CENTER: PHILADELPHIA’S COLD CHAIN MANAGE- MENT PROGRAM FOR THE INFLUENZA VIRUS VACCINE. Dallas D, Defense Supply Center Philadelphia. E-mail: dana.dallas@dla.mil Objective: To identify and improve problem areas associated with the distribution and storage of Influenza Virus Vaccine for Department of Defense (DoD) personnel and beneficiaries. Methods: The Pharmaceutical Commodity Business Unit of the Medical Directorate at the Defense Supply Center Philadelphia (DSCP) is responsible for the distribution of the Influenza Virus Vaccine for the Department of Defense. DSCP’s Cold Chain Management program was established to ensure product integrity following losses of hard to replace vaccine due to freezing during shipment. The program benchmarked off the United States Army Medical Materiel Agency’s Anthrax Cold Chain Management Program. It includes three packaging protocols: warm, moderate, and cold. These packaging protocols, using endothermic containers and temperature monitors, have been third party tested, and permit DSCP to ship and track Influenza Virus Vaccine in any ambient temperature to DoD medical facilities and deployed units worldwide. The temperature monitors enable DSCP to monitor the temperature of the vaccine during shipment by recording temperature readings every 15 minutes for up to 20 days. Results: Over the past 3 years, DSCP’s Cold Chain Management Program has dramatically improved the reliability of shipping temperature sensitive vaccines through training end users, increasing in transit visibility, established set shipping schedules with commercial carriers, and allowed DSCP to monitor 100% of the shipments from manufacturer to customer receipt. Conclusions: The Defense Supply Center Philadelphia’s Cold Chain Management program has been highly successful in ensuring more timely deliveries and most importantly, product integrity. 15—THE EVOLVING ROLE OF PATIENT ADVOCACY GROUPS IN IMPROVING HEALTH AND HEALTH CARE. Lee S, Amgen, Ascione F, McKercher P, University of Michigan. E- mail: run_so_run@yahoo.com Objective: The primary purpose of this study was to better understand the role of patient advocacy groups’ efforts to raise disease awareness and improve access to appropriate modern therapies. Methods: In-depth telephone interviews were commissioned by the University of Michigan’s Center for Medication Use, Policy & Economics and conducted by Market Strategies, Inc. Key representatives within selected patient advocacy organizations dedicated to serving patients in two different disease categories, kidney disease and breast cancer, were interviewed. In kidney disease advocacy groups, members at the National Kidney Foundation (NKF) and American Society of Nephrologists (ASN) were interviewed. In breast cancer, members at the American Cancer Society (ACS) and Susan G. Komen Foundation were interviewed. The targeted subjects for each organization were staff members at the national office as well as the state affiliates in California, Florida, Michigan, New Jersey, and Texas. Interviews lasted approximately 45–60 minutes and were conducted during April and May 2003. In total, 18 interviews (9 nephrology and 9 oncology) were conducted. Results: Differences were noted between the patient advocacy groups within each of two disease states. The NKF is focused on educating the general public and health care professionals, while ASN is heavily focused on nephrologists. Both organizations play a role in legislative issues. NKF tends to be more involved in areas of primary interest to patients, whereas ASN tends to be more involved in issues affecting the health care system as a whole. In terms of breast cancer, ACS is more involved in working with and educating health care professionals, whereas the Komen Foundation concentrates more of their efforts with the general public. Activities that appear to be the most effective are educational activities directed toward both consumers and health care professionals. Outreach activities are extremely successful in reaching the general public, especially the health fairs, and wellpublicized and -organized walks and runs. Conclusions: The role of patient advocacy groups has evolved from charitable public champions for disease victims to facilitating and enhancing early and progressive care. Our research suggests that patient advocacy groups play a growing and important role in dissemination of disease and treatment information and providing a forum for individuals seeking additional insight into their disease. 16—DRUG THERAPY FOR ALZHEIMER´S DISEASE: PERSISTENCE ON CHOLINESTERASE INHIBITORS MEA- SURED USING MEDICAID PHARMACY CLAIMS DATA. Dore D, Bunz T, Kogut S, University of Rhode Island. E-mail: dave@ daviddore.com Objective: To measure and compare persistence with the three commonly used cholinesterase inhibitors (ChEIs). Methods: A retrospective cohort analysis was completed using de-identified Rhode Island Medicaid pharmacy claims data between January 1, 2000 and August 31, 2003. Inclusion criteria were all Rhode Island Medicaid patients whom received newly initiated therapy on donepezil, rivastigmine, or galantamine between June 1, 2000 and August 31, 2002 and had at least 12 months of data for followup. Exclusion criteria were having received a dispensing for more than one ChEI product, having received any dispensing for a greater than 60-day supply, or having a greater than 90-day interval between any two dispensings. Persistence was defined as continuous therapy for at least 180 days. Patients were identified as not persistent if he or she did not receive a dispensing for a ChEI on days 180 through 365. The patient population included a total of 2,336 individuals; 1,802 supplied 12 months of follow-up data, and 1,612 did not switch between agents. Results: Persistence was measured in 888 individuals whom received any ChEI, 556 whom received donepezil, 193 whom received rivastigmine, and 139 whom received galantamine. Persistence at 6 months was estimated to be 75% overall and 76%, 74%, and 75% for donepezil, rivastigmine, and galantamine respectively. Conclusions: Approximately 1 in 4 patients did not persist to 6 months with ChEI therapy. In addition, persistence did not differ between ChEIs. Further research should be conducted to identify characteristics of individuals likely to fail therapy and to subsequently decrease prescribing in that population. Optimizing use of ChEIs may improve patient care and reduce expenditures on ineffective therapy. 2004 Abstracts of Contributed Papers Vol. 44, No. 2 March/April 2004 www.japha.org Journal of the American Pharmacists Association 229 Downloaded From: http://japha.org/ on 01/25/2014
FEATURE Annual Meeting Abstracts 2004 17—EVALUATION OF CARDIOPUL- MONARY RESUSCITATION CERTIFICA- TION AMONG PHARMACY STUDENTS. Patel S, Eap N, Blodgett B, Onamade A, University of Illinois at Chicago. E-mail: opatel1@uic.edu Objective: The morbidity and mortality of cardiac arrest are costly in the United States. Research has demonstrated that immediate cardiopulmonary resuscitation (CPR) improves survivability in patients who experience cardiac arrest and respiratory failure. Even though they are future health professionals, pharmacy students are often minimally trained in CPR. Because patients at increased risk of cardiovascular and pulmonary events regularly visit health care settings, pharmacy students should have adequate CPR training before entering the workforce. The purpose of this study is to assess the knowledge and attitude regarding CPR certification among pharmacy students and to evaluate the effectiveness of their training. Developing confidence through repetition enhances students’ ability to perform these skills. Currently, CPR training is offered to students during the fourth (experiential) year. This study will investigate whether students perceive a benefit to CPR being offered earlier in the curriculum. Specifically, the investigators will assess student knowledge and confidence regarding their ability to perform CPR as a health care professional. Methods: Students in their fourth year at a college of pharmacy who have completed CPR training will be asked to complete a self-assessment instrument. The instrument will measure students’ perceived knowledge and attitudes about their ability to use CPR in immediate response situations. Additionally, first- through third-year students will be surveyed about their perceived need for obtaining CPR training earlier in the curriculum and their willingness to participate in these programs if offered. Results: Data will be analyzed using Rasch rating scale model to measure hierarchically responses provided by the two instruments. Conclusions: Students are expected to perceive value in having CPR offered earlier in the curriculum and in repeated participation in these training sessions that allow students to demonstrate their ability, willingness to initiate immediate response, and develop confidence in performing CPR. 18—PHARMACY STUDENTS’ ATTI- TUDES ABOUT MEDICALLY UNDER- SERVED POPULATIONS. Langridge S, Jackson T, Lurvey P, Midwestern University. E-mail: Sarah.Langridge@mwumail.midwestern.edu Objective: To determine the extent to which experience and knowledge gained regarding medically underserved populations affects pharmacy students’ attitudes about community health centers (CHCs), clinicians, and patients. BACKGROUND: Approximately 40 million Americans are medically uninsured or underinsured. Poor health outcomes occur more frequently in these patients when compared with insured populations. Clinicians in collaboration with pharmacists in CHCs have been successful in improving patient health outcomes. However, many are unaware of these resources. To introduce these resources to fourth professional year pharmacy students, an elective class was developed, “Bringing Pharmaceutical Care to Underserved Populations.” Methods: A retrospective pre–post attitudinal survey, comprising three different sections, was developed and administered to students in the course. Section 1 used a four-point Likert-type scale to assess students’ perceived knowledge of CHCs, services they offer, patients who use these services, and characteristics of clinicians who provide them. Section 2 evaluated responses about the perceived frequencies of services provided, barriers encountered, and duties of CHC pharmacists. Section 3 assessed students’ intentions to provide pharmaceutical care services in a CHC environment and their confidence level regarding their ability to develop a pharmaceutical care services plan for a CHC. Results: Students who completed the class participated in the pilot study (N = 2). Students believed this elective class increased their awareness of the services CHCs provide and that these services are not exclusive to indigent populations. Students viewed pharmaceutical care in a CHC as a viable career option and indicated their confidence level in their ability to implement these services increased. The effectiveness of this elective will be evaluated with the same instrument in winter 2003, and the final poster will reflect these data. Conclusions: Overall, the perceptions about services provided in CHC environments and the patients who use these services improved after taking this elective. 19—RETURN ON INVESTMENT ANALY- SIS FOR BONE MINERAL DENSITY (BMD) SCREENING. Patel H, Shenandoah University, Skelton J, US Wellness, Inc., Ahrens R, Stolte S, Shenandoah University. E-mail: Hpate3@su.edu Objective: To estimate the number of new antiosteoporosis prescriptions generated for patients with low BMD upon screening, and to estimate the potential return on investment (ROI) in terms of new antiosteoporosis prescriptions for a pharmaceutical manufacturer–sponsor of BMD screenings. Methods: A total of 262 patients were screened for osteoporosis using the Hologic Sahara Clinical Bone Sonometer. Screenings were conducted at four physician offices and six employer groups. All patients were 40 years or older and were not currently taking any antiosteoporosis prescription medications. Patients were placed into either a low-, moderate-, or high-risk fracture group based on their T scores from the BMD screening. A follow-up survey was performed within 60 days after initial screening to determine whether the patient scheduled a followup appointment with their physician. Patients were also asked whether an antiosteoporosis medication was prescribed. Results: A total of 98 patients were identified as low risk were excluded from the follow-up and ROI analysis, and 2 other patients were lost to follow-up. Among the remaining 162 patients, the fracture risk at initial screening was 76% for physician office patients and 58% from employer group patients. A total of 78% of patients initiated a follow-up appointment with their physicians, and 69% of patients in the high-risk category received a prescription antiosteoporosis medication. The return on investment for the BMD screenings was 256%, assuming the patients’ average medication adherence was 6 months. Conclusions: The BMD screening program demonstrated that 9.8% of patients screened received an antiosteoporosis prescription. Screenings appear to be beneficial to both patients and a pharmaceutical manufacturer–sponsor. APhA–APPM Clinical & Pharmacotherapeutic Practice 20—A RANDOMIZED, DOUBLE-BLIND TRIAL OF LOW-DOSE OXYMORPHONE IMMEDIATE RELEASE (5 MG) FOR MILD TO MODERATE PAIN IN AMBULATORY PATIENTS. Walker D, Granger Medical Clinic, Inc. Gimbel J, Arizona Research Center, Ma T, Zagorski A, Ahdieh H, Endo Pharmaceuticals, Inc. E-mail: livinginpa135@aol.com Objective: To assess the safety and efficacy of low-dose (5 mg) oxymorphone immediate release (IR) in patients with mild to moderate pain following outpatient knee arthroscopy. Methods: A double-blind, randomized, placebocontrolled study will include patients 18 years of age and older following ambulatory arthroscopic knee surgery. To enter the study, patients must have initial postsurgical pain between 30 and 70 mm on a 100- mm visual analog scale (VAS) and a pain rating of mild or moderate on a categorical scale. Patients will be instructed to take the study medication (5 mg oxymorphone IR or placebo) as needed for pain for up to 8 hours, and not more frequently than 1 dose per hour. Pain will be assessed at 30 minutes after the first dose and every hour thereafter. Patients requiring rescue medication will be discontinued from the study. Patients will record in diaries pain intensity, relief, and use of study medication and rescue medication. Efficacy measures are hourly pain intensity scores (VAS), pain intensity and relief scores (Brief Pain Inventory), frequency of remedication, time to rescue medication or discontinuation, and patient global assessment of pain relief. Records of adverse events will measure safety. Results: Data will be presented for approximately 100 patients (50 patients per group). Conclusions: Conclusions will be presented based on the trial results, and the implications for pharmacists will be discussed. 21—ANALGESIC EFFICACY OF OXY- MORPHONE IMMEDIATE RELEASE IN POSTSURGICAL ORTHOPEDIC PAIN: RESULTS OF A RANDOMIZED, DOUBLE- BLIND, PLACEBO-CONTROLLED, DOSE- RANGING COMPARISON WITH OXY- CODONE. Gimbel J, Lee W, Arizona Research Center, Ma T, Zagorski A, Ahdieh H, Endo Pharmaceuticals, Inc. E-mail: vrisman@hotmail.com 230 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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