Downloaded - Journal of American Pharmacists Association

More documents

Recommendations

Info

Annual Meeting Abstracts 2004 FEATURE Identification of risk factors such as health status, health care utilization, and age may be helpful to clinicians targeting interventions of women using resorptive medications. 263—RESPONSE QUALITY OF INFOR- MATION FROM “ASK THE PHARMACIST” SERVICES ON INTERNET PHARMACY SITES. Nath D, Duquesne University, Holmes E, University of Mississippi, Markuss J, Desselle S, Duquesne University. E-mail: nath405@duq.edu Objective: There is concern over the veracity and comprehensiveness of information provided by Internet pharmacy sites. Some sites offer an “Ask the Pharmacist” service whereby consumers E-mail questions to a pharmacist who subsequently returns a response. The objectives of this study are to (1) compare the quality of responses from questions submitted to “Ask the Pharmacist” services among Verified Internet Pharmacy Practice Sites (VIPPS) and non-VIPPS pharmacy practice sites and among standalone, brick-and-mortar chain community, and brick-and-mortar independent community practice sites; and (2) determine if the quality of responses services differ among the sources providing the drug information (i.e., drug information specialist versus community pharmacist). Methods: Design: Content Analysis. VIPPS sites were acquired through the NABP’s current listing of sites provided on www.nabp.org. Other sites are obtained though in a WebFerret 5.0 metasearch engine query. Professional pharmacy students are submitting five drug information questions to each of the pharmacy practice sites sampled using fictitious Internet E-mail accounts. The drug information questions and scoring schemata for each question were developed by a focus group panel comprising pharmacists and academicians who were guided by information from resources typically available to practicing pharmacists. Trained professional pharmacy student judges will score the responses obtained from the sites. Each response will be scored by three judges working independently. Interrater reliability among the judged will be determined from the calculation of intraclass correlation coefficients. Student t tests and analyses of variance with Tukey’s HSD posthoc tests will be used to determine differences in response quality. Results: A panel of five pharmacists and academicians have developed questions and constructed scoring templates for standard items to assure these met predetermined criteria. Submission of questions has been initiated. Conclusions: All responses will have been evaluated and the analysis completed by the time of presentation. 264—SURVEY OF PHARMACY STUDENT WORK EXPERIENCE. Siracuse M, Creighton University, Schondelmeyer S, Hadsall R, Schommer J, University of Minnesota. E-mail: msiracuse@creighton.edu Objective: The objective of this study was to survey pharmacy students to determine the type of pharmacy work environments they have experienced and their attitudes towards these experiences. Methods: A total of 533 third-year (in a four-year program) PharmD students from eight colleges and schools of pharmacy in the Midwest volunteered to participate in this study using a written survey. The students were surveyed as a group at their respective institutions. Data collection included demographics, workplace descriptive information, and Likert scales to determine student attitudes toward their work environment. Data cleansing resulted in 509 usable surveys. Statistical analysis included determination of frequencies and means for descriptive data and Likert scale mean item scores for the attitudinal data. Results: Overall, 496 (97.4%) students reported at least one pharmacy work experience. Of these students, the most frequently reported work sites for their most recent or current positions were: 331 (65.0%) in chain pharmacies; 74 (14.5%) in hospital pharmacies; 58 (11.4%) in independent community pharmacies; and 12 (2.4%) in long-term care pharmacies. Overall, students spent most of their time (69.0%) in dispensing, distribution, and compounding activities. Students spent considerably less time in direct patient care/pharmaceutical care (10.5%) activities and providing drug information to patients (11.6%), but not in the same depth that would be expected from a pharmaceutical care consultation. Students spent the least amount of time (4.2%) providing consultative services to other health care professionals. Other activities such as cashiering and clerical duties took up 4.7% of student time. A 5-point Likert scale used to analyze student attitude toward resulted in: 390 (78.6%) students either agreed or strongly agreed their current work experience was favorable; 290 (58.6%) students either agreed or strongly agreed they would have a fulfilling career working in a pharmacy that is similar to their current work experience. Conclusions: NA. 265—TALKING TO PHARMACISTS ABOUT DIABETES: HOW TO ASK ABOUT MONITORING CLINICAL TARGETS. Guirguis L, Chewning B, University of Wisconsin–Madison. E-mail: lmguirguis@ pharmacy.wisc.edu Objective: To (1) discuss the development of an interview instrument to assess community pharmacists’ use and beliefs about clinical targets such as blood glucose, cholesterol levels, and blood pressure, for their patients with diabetes and (2) present pharmacist perceptions of outcome monitoring in response to pilot questions. Methods: Twelve pharmacists were asked to participate in one of four stages of the development of a paper instrument for face-to-face interviews: (1) developmental interview, (2) behavioral item pretesting, (3) subjective item pretesting, and (4) cognitive testing. Results: In the developmental interview, pharmacists used medications rather than patients to recall routine interactions with patients, talked about clinical targets primarily when changes occurred, and had differing reasons for asking about blood sugars. In the development of behavioral items, pharmacists found it easier to describe a recent interaction with a patient when they named the product involved. They asked routine questions about whether patients had any concerns instead of asking about clinical targets and used estimation to report how often they asked about clinical targets. Because so few pharmacists monitored clinical outcomes, it became important to structure the interview to minimize respondent embarrassment by allowing them to comment on the busyness of their practice and their usual questions to patients prior to questions regarding rates and importance of asking about clinical targets. Conclusions: The combination of a developmental interview, pretesting, and cognitive testing helped create a detailed interview to understand how and why pharmacists do or do not talk to patients with diabetes about clinical targets. 266—THE SPREAD AS A SOURCE OF PBM REVENUE. Clark B, Creighton University, Garis R, Creighton University School of Pharmacy & Health Professions. E-mail: bclark@creighton.edu Objective: To conduct a pilot study that develops valid methodology for documenting the spread in drug ingredient cost between what PBMs charge employers and what PBMs pay dispensing pharmacies for the drug ingredient portion of prescription transactions. Spread is defined as the difference between the drug ingredient cost billed to an employer by a PBM and the drug ingredient cost that is paid to the dispensing pharmacy by the PBM on behalf of the employer. Methods: Researchers conducted a retrospective review of two sets of financial records issued by each of two PBMs. These financial records were: (1) line-item prescription transactions billed to employers and (2) line-item transaction data accompanying PBM payment to dispensing pharmacies. Drug ingredient cost amounts billed to employers were compared with the amounts paid to pharmacies for 129 prescription transactions. Nonparametric analyses were used for comparisons of these non–normally distributed outcome variables. Results: Taking both PBMs together, the average spread of $12.29 per prescription ranged from –$1.67 to $201.65. Considering all 129 transactions together, there was a significant difference between brand-name drugs and generics with mean spreads of $4.65 and $23.45 per prescription, respectively. The spread difference between PBMs on generic drugs was suggestive (P < .09). A significant difference between PBMs was found only in the spread percentage charged on brandname drugs (P < .02). Conclusions: For the PBMs and prescriptions analyzed, results indicate dramatic differences in spread and spread percent when comparing generic and brand-name drugs, but essentially no difference between PBMs. Wider ranges in spread opportunities available with generic drugs are, in part, explained by the disparity between generic drug 2004 Abstracts of Contributed Papers Vol. 44, No. 2 March/April 2004 www.japha.org Journal of the American Pharmacists Association 293 Downloaded From: http://japha.org/ on 01/25/2014
FEATURE Annual Meeting Abstracts 2004 acquisition cost and the published generic AWP. Results presented, and their statistical significance in this small sample, have severe limitations clearly associated with the extremely limited number of prescription transactions and PBMs studied. 267—THE ECONOMIC BURDEN OF HYPERPHOSPHATEMIA-RELATED END- STAGE RENAL DISEASE IN FLORIDA MED- ICAID PATIENTS. White A, University of Florida, Odedina F, Florida A&M University. E- mail: whiteann@ufl.edu Objective: The purpose of this study was to determine whether end-stage renal disease (ESRD) associated with hyperphosphatemia had a significant impact on health care costs from a third party payers’ perspective. Study objectives were to: (1) describe the characteristics of these patients in terms of demographics, comorbidities, and utilization, (2) evaluate the primary cost drivers in the treatment of these patients, and (3) assess the economic burden associated with treating hyperphosphatemia-related ESRD patients. Methods: Retrospective study using secondary data from the Florida Medicaid database provided by the Agency for Health Care Administration. Patient inclusion criteria consisted of recipients taking either Renagel or Phoslo, verification of continuous eligibility, time period of July 1, 1999 to December 31, 2002 (July 1 through December 31, 1999, was a washout period). Patient exclusion criteria consisted of diagonosis of with HIV or hemophilia. Data frequencies were examined using regression and quarterly trend analyses. Results: Results of the cost analysis showed that patients with hyperphosphatemia-related ESRD impose an economic burden of $228 million. Facility claims expenditures represented the largest proportion of increase in total direct costs, increasing from $56 million in 2000 to $78 million in 2002. Results showed that the major cost driver for 2000–2002 in the treatment of hyperphosphatemiarelated ESRD among Medicaid patients was dialysis center visits with a total cost of $95 million, followed by general hospital visits with a total cost of $92 million, and prescription medication with a total cost of $11 million. Health care for the study population was most often used through facility visits (78.1%), followed by pharmacy-related services (17.2%), and then medical services (4.7%). Based on medical claims utilization patterns, ambulance service contributed the most to health care utilization by patients with hyperphosphatemia-related ESRD (8.7%), followed by recipient home visits (3.3%) and inpatient visits (2.1%). Facility claim utilization was dominated by dialysis center visits (48.5%), followed by general hospital visits (43.3%) and lastly nursing home visits (7.4%). Conclusions: This study has shown that health care costs for this population of patients had a substantial impact on the Florida Medicaid budget. Additional efforts should be undertaken to further enhance the diagnosis, treatment, and recovery of these patients. 268—THE EFFECT OF DIRECT-TO-CON- SUMER ADVERTISING ON PRESCRIPTION DRUG USE AMONG THE INSURED. Hansen R, University of North Carolina at Chapel Hill, Schommer J, Cline R, University of Minnesota. E- mail: rahansen@unc.edu Objective: Direct-to-consumer advertising (DTCA) has become a common promotional technique among the pharmaceutical industry. The relative effect of DTCA on prescription drug utilization and spending is unknown, in part because of the effect of insurance on consumers’ marginal cost. The objective of this study was to determine if the effect of DTCA is moderated by cost-sharing incentives among insured individuals. Methods: Design: retrospective cohort study. Study population: 396,500 employees and dependents with employer-sponsored health insurance continuously enrolled in a contributing plan during July 1997 through December 1998. Data: Personlevel enrollment and claims data were provided by MEDSTAT MarketScan. DTCA data were provided by Competitive Media Reporting (CMR) and linked to the MEDSTAT enrollment files by metropolitan statistical area. Analysis plan: Localized DTCA levels for one class of medication were evaluated and matched with prescription claims for MEDSTAT contributors residing in one of 47 defined advertising markets. Product use within the advertised medication class was evaluated by the intensity of the advertising campaign for various types and levels of cost-sharing incentives, controlling for health status and other covariates. Results: The effectiveness of DTCA was modified by the type and amount of beneficiary out-ofpocket payments for provider visits and prescription drugs. Significant relationships were observed for use of the advertised product as well as its competitor. When high levels of DTCA were present, increased product use of the advertised product was observed for those with high provider out-of-pocket costs, and decreased use was observed among those with high prescription costs. Conclusions: Insured individuals may respond differently to DTCA, depending on the type and level of cost-sharing incentives employed by their insurance plan. More research is needed in this area to verify the findings of this study and explore the interactive effects of insurance coverage and pharmaceutical promotion. 269—THE EFFECT OF DIRECT-TO-CON- SUMER AD CONTENT ON BELIEF TENACI- TY: A STUDY OF APPEALS, ARGUMENT TYPES, AND JUDGMENTS. Jalnawala N, University of Mississippi, Wilkin N, University of Mississippi Medical Center. E-mail: nekshanj@ olemiss.edu Objective: This study was conducted to evaluate the usefulness of inoculation theory (sidedness of appeals) and theory of belief formation (argument types and judgments) in understanding belief tenacity. Direct-to-consumer advertisements (DTCAs) and negative experiences were used to study these theories. Methods: A 2 (one-sided versus two-sided) × 2 (causal versus authoritative) factorial study design was employed. A total of 263 undergraduate students were nonsystematically assigned to view one of the four mock influenza medication advertisements and complete a questionnaire. Subjects were then presented with a negative scenario and were asked to fill out a questionnaire based on the information in the ad and in the negative scenario. The dependent measures included belief change, change in purchase intent and standardized price change. Data were analyzed using two-way analysis of variance. Results: Subjects exposed to two-sided appeals showed lower belief change, standardized price change, and change in purchase intent following a negative experience than subjects exposed to onesided appeals (P < .05). No significant difference was found between subjects who received causal and authoritative arguments. A significant interaction effect was observed between sidedness of appeal and argument type on initial belief and initial purchase intent. Belief change was correlated with the change in information reliability (r = .525, P = .01) and the change in information relevance (r = .583, P = .01). Changes in relevance and reliability also were significantly greater in those subject exposed to one-sided appeals (P < .05). Conclusions: Some support for aspects of inoculation theory and theory of belief formation was found. The findings suggest that complying with the “fair-balance” requirement may be beneficial to pharmaceutical marketers as two-sided appeals increase the tenacity of consumers’ beliefs. Higher initial belief and purchase intent when causal arguments are used in two-sided promotional messages suggest that evidence-based advertising may result in enhanced beliefs about the merits of advertised products (P < .05). 270—THE EFFECTS OF PHARMACISTS’ POSITIONS ON EMPOWERMENT AND ORGANIZATIONAL BEHAVIORS. Kahaleh A, Ohio Northern University, Gaither C, University of Michigan. E-mail: a-kahaleh@onu.edu Objective: To assess the impact of pharmacists’ position on antecedents and consequences of psychological and structural empowerment. Methods: The study has a cross-sectional design. Self-administered questionnaires were mailed to a national random sample of 1,200 licensed pharmacists. Descriptive statistics, reliability and validity tests, analyses of variance, and path analyses using structural equation techniques (SEM) were used to analyze the data. The theoretical model examines the effects of need for achievement and power factors on psychological and structural empowerment that in turn affect loyalty, organizational commitment, identification, and job turnover intention. Power factors are structural elements that enhance empowerment. Psychological empowerment is defined as the affective state that individuals must experience for managerial interventions to be successful. It has four dimensions: meaning, competence, self-determination, and impact. Structural empowerment is defined as having access to knowl- 294 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
Page 1 and 2:
FEATURE APhA2004 Abstracts of Contr
Page 3 and 4:
FEATURE Annual Meeting Abstracts 20
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18: FEATURE Annual Meeting Abstracts 20
Page 67: FEATURE Annual Meeting Abstracts 20
Page 77: FEATURE Annual Meeting Abstracts 20
show all

Downloaded - Journal of American Pharmacists Association

Create successful ePaper yourself

Delete template?

Save as template?