bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unit-of-Use Versus Traditional Bulk Packaging
Authors: So Tiffany , Wertheimer Albert 
Published: January 2018

Background: The choice between unit-of-use versus traditional bulk packaging in the US has long been a continuous debate for drug manufacturers and pharmacies in order to have the most efficient and safest practices. Understanding the benefits of using unit-of-use packaging over bulk packaging by US drug manufacturers in terms of workflow efficiency, economical costs and medication safety in the pharmacy is sometimes challenging.
Methods: A time-saving study comparing the time saved using unit-of-use packaging versus bulk packaging, was examined. Prices between unit-of-use versus bulk packages were compared by using the Red Book: Pharmacy's Fundamental Reference. Other articles were reviewed on the topics of counterfeiting, safe labeling, and implementation of unit-of-use packaging. Lastly, a cost-saving study was reviewed showing how medication adherence, due to improved packaging, could be cost-effective for patients.
Results: When examining time, costs, medication adherence, and counterfeiting arguments, unit-of-use packaging proved to be beneficial for patients in all these terms.

Type: Student Project
Excluding Orphan Drugs from the 340B Drug Discount Program: the Impact on 18 Critical Access Hospitals
Authors: Wallack Madeline Carpinelli , Sorensen Todd 
Published: January 2018

Purpose: The 340B Drug Pricing Program is a federal program designed to reduce the amount that safety net providers spend on outpatient drugs. The Patient Protection and Affordable Health Care Act of 2010 extended eligibility for 340B to critical access hospitals (CAHs) for all drugs except those designated as "orphan." Because this policy is unprecedented, this study quantifies the gross financial impact that this exemption has on a group of CAHs.
Methods: Drug spending for 2010 from 18 CAHs in Minnesota and Wisconsin are reviewed to identify the prevalence of orphan drug purchases and to calculate the price differentials between the 340B price and the hospitals' current cost.
Results: The 18 CAHs' purchases of orphan drugs comprise an average of 44% of the total annual drug budgets, but only 5% of units purchased, thus representing a very high proportion of their expenditures. In the aggregate, the 18 hospitals would have saved $3.1 million ($171,000 average per hospital) had purchases of drugs with orphan designations been made at the 340B price. Because CAH claims for Medicare are reimbursed on a cost-basis, the Federal government is losing an opportunity for savings.
Conclusion: The high prevalence of orphan drug use and considerable potential for cost reduction through the 340B program demonstrate the loss of benefit to the hospitals, Federal government and the states.

Type: Original Research
Evaluation of Patient Assistance Program Eligibility and Availability for Top 200 Brand Name and Generic Drugs in the United States
Authors: Chu Chin-Fun , Lal Lincy S , Felder Tisha M , Rosenau Pauline 
Published: January 2018

One strategy to encourage uninsured and underinsured patients' compliance with medication regimen is to refer them to pharmaceutical industry-sponsored patient assistance programs (PAPs). In order to receive the requested medications, patients should be qualified based on the program eligibility requirements. The purpose of this study was to examine PAP eligibility criteria for the most commonly dispensed prescriptions in the United States. We identified 136 unique chemical entities in the Top 200 drug list and 111 (82%) of these pharmaceutical products were offered by PAPs. Among the available medications, 69 (62%) were brand name; 29 (26%) were generic, and 13 (12%) had both brand name/generic forms. In terms of the availability of types of drugs (brand name vs. generic) provided by PAPs, differences in PAP eligibility requirements were found for citizenship (p < 0.001), permanent residency (p < 0.001), and prescription drug coverage (p< 0.001), but not for income limits (p= 0.051). Overall, PAPs could help low-income patients to obtain necessary medications; however, U.S. citizenship/permanent residency and restriction on prescription coverage are more likely to be required for brand name drugs rather than for generics. PAPs also provide some options for the underinsured and those with private insurance or Medicare Part D plan that offers inadequate prescription coverage.

Type: Original Research
Development of a Risk Assessment Tool for Falls Prevention in Hospital Inpatients Based on the Medication Appropriateness Index (MAI) and Modified Beer's Criteria
Authors: Rumore Martha M. , Vaidean Georgeta 
Published: January 2018

Medication review is an essential component of comprehensive falls assessment. A medication review by pharmacists can assist to identify and notify prescribers of medications that require adjustment or discontinuation. Beers Criteria and the Medication Assessment Index (MAI) are explicit and implicit inappropriate prescribing (IP) tools, respectively. While the Beers Criteria has been applied to falls prevention, the MAI has not. Developing alternative falls prevention tools has been spurned by both the desire to overcome limitations of the Beers Criteria, coupled with the need for implicit criteria which includes consideration for patient äóñspecific clinical judgement. A literature search and review of the Beers Criteria and MAI tools revealed advantages and disadvantages of each. Using combined explicit/implicit falls assessment criteria using both the Beers Criteria and MAI as a framework, a falls specific inappropriate prescribing (FASPIP) tool for use in elderly hospitalized patients was developed. Validation of the FASPIP in the clinical setting is needed.

Type: Review
The use of the health belief model to assess predictors of intent to receive the novel (2009) H1N1 influenza vaccine
Authors: Coe Antoinette B. , Gatewood Sharon B.S. , Moczygemba Leticia R. , Goode Jean-Venable "Kelly" R. 
Published: January 2018

Objectives: 1) Assess participants' perceptions of severity, risk, and susceptibility to the novel H1N1 influenza virus and/or vaccine, vaccine benefits and barriers, and cues to action and 2) Identify predictors of participants' intention to receive the novel H1N1 vaccine.
Design: Cross-sectional, descriptive study
Setting: Local grocery store chain and university in the central Virginia area
Participants: Convenience sample of adult college students and grocery store patrons
Intervention: Participants filled out an anonymous, self-administered questionnaire based upon the Health Belief Model.
Main Outcome Measures: Participants' predictors of intention to receive the novel H1N1 vaccine
Results: A total of 664 participants completed a questionnaire. The majority of participants were aged 25-64 years old (66.9%). The majority were female (69.1%), Caucasian (73.7%), and felt at risk for getting sick from the virus (70.3%). Most disagreed that they would die from the virus (68.0%). Participants received novel H1N1 vaccine recommendations from their physicians (28.2%), pharmacists (20.7%), and nurses (16.1%). The majority intended to receive the H1N1 vaccine (58.1%). Participants were significantly more likely to intend to receive the H1N1 vaccine if they had lower scores on the perceived vaccine barriers domain (OR= 0.57, CI: 0.35-0.93). Physicians' recommendations (OR=0.26, CI: 0.11-0.62) and 2008 seasonal flu vaccination (OR=0.45, CI: 0.24-0.83) were significant predictors of intention to receive the H1N1 vaccine.
Conclusions: Most participants felt at risk for getting the novel H1N1 virus and intended to receive the novel H1N1 vaccine. Educating patients about vaccine benefits and increasing healthcare professionals' vaccine recommendations may increase vaccination rates in future pandemics.

Type: Original Research
Lifestyle Medicine-Related Cardiovascular Risk Factor Changes in Employees Participating in a Pharmacist-Run Risk Reduction Program
Authors: Lenz Thomas L. , Gillespie Nicole D. , Faulkner Michele A. , Skrabal Maryann Z. , Skradski Jessica J. , Qi Yongyue , Larson Jessica C. 
Published: January 2018

Cardiovascular disease (CVD) remains the leading cause of death among American adults accounting for approximately one-third of all deaths. It has been shown, however, that the actual causes of death are related to lifestyle behaviors such as tobacco use, poor diet and physical activity and alcohol consumption. A pharmacist-run employee health program, started in 2008, sought to lower CVD risk through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participants were shown to significantly increase exercise quantity (p < 0.001), fruit and vegetable consumption (p < 0.001), and decrease self-reported stress level (p = 0.006). The percentage of program participants simultaneously adherent to the recommended levels of exercise, combined fruit and vegetable intake and tobacco abstinence at one-year was 34.5% vs. 5.5% at baseline. This compares with only 5.1% of the U.S. population adherent to the same three behaviors. Pharmacists can positively impact healthy lifestyle behaviors when working in an employee health setting.

Type: Original Research
Design and Evaluation of Health Literacy Instructional Video for Pharmacy Students
Authors: Butler Lakesha M , Devraj Radhika , Santanello Catherine 
Published: January 2018

Objectives: 1) To describe the development of a health literacy video tailored for pharmacy students. 2) To compare the use of a health literacy video as an instructional method to a previously used health literacy instructional strategy by using both and: a) assessing pharmacy students' perceptions of their ability to communicate with low health literacy patients and b) assessing pharmacy students' perceptions of their overall understanding of the role of health literacy in a pharmacy setting.
Case Study: A novel pharmacy health literacy instructional video was created providing patient-pharmacist scenarios involving low literacy patients. A previously used role-play activity was performed in a required "Health Promotion and Literacy" course followed by the viewing of the newly designed health literacy instructional video. Two separate paper-based survey instruments were developed and administered to individually assess both active learning strategies and for comparison of the strategies. Statistically significant differences were noted on all five survey questions with the instructional video rating higher than the role play activity in the overall enhancement of students' understanding of health literacy.
Conclusions: A pharmacy health literacy instructional video was well received by students. It significantly improved students' perception of their ability to communicate with low health literacy patients in a pharmacy setting and their overall understanding of health literacy.

Type: Case Study
Psychometric Assessment of the PPDG: Utilizing Cronbach's Alpha as a Means of Reliability
Authors: Marr-Lyon Lisa R , Gupchup Gireesh V , Anderson Joe R 
Published: January 2018

Introduction: Since the development of the 10 item Purdue Pharmacist Directive Guidance (PPDG) Scale several studies of the psychometric properties of the PPDG have been conducted. Although Cronbach's alpha was calculated as a means of internal consistency reliability, a demonstration of the mean centering of the individual items from the instrument were not explored.
Objectives: This study focused on investigating the mean stabilization of items within the PPDG as they pertain to Cronbach's reliability coefficient calculation.
Methods: Using item analysis procedures in SPSS, the mean stability of items within the general factor of directive guidance and subscales of instruction and feedback and goal setting were examined for the PPDG.
Results: Mean stability scores for entire PPDG scale and the subscales of instruction and feedback and goal setting were strong. Also, corrected item-total correlations and Cronbach's alphas following item deletion were good for the overall PPDG scale and the subscales.
Conclusions: The results provide evidence to enhance understanding of the psychometric stability of the PPDG scale and its subscales.

Type: Original Research
Affordable Care Act: A review and discussion of its impact on healthcare today, and a primer for pharmacists
Authors: Lui Leo Lai Ho , Wertheimer Albert 
Published: January 2018

In the midst of countless healthcare debates, the Patient Protection and Affordable Care Act is written into legislation as a possible solution to the United States's rising healthcare costs. Individualized into nine titles, the act sought to provide additional coverage to millions of Americans while cutting down healthcare costs through numerous provisions effective into 2020. While the act has been challenged publicly and privately by the states, many healthcare professionals today, let alone the average American, are unaware and uneducated of what comprises the act, as well as the impact in which it has on the future of healthcare in the United States. With an increasing role of patient care placed upon pharmacists today, an understanding of the PPACA allows us to provide extensive answers to questions in which our patients may have.

Type: Student Project
Social Media and Unprofessional Pharmacist Conduct: A Cross-Sectional Survey of Boards of Pharmacy
Authors: Skelley Jessica , Hughes Peter , Elmore Lindsey 
Published: January 2018

Purpose: To determine how often boards of pharmacy (BOPs) receive complaints related to licensee's online behavior, and what types online behaviors may prompt an investigation of a licensee.
Methods: A survey (consisting of questions related to BOP's management of complaints against licensee online behavior and 10 case vignettes) was adapted from a previous survey of United States medical boards. Vignettes encompassed themes such as patient confidentiality, derogatory language, alcohol use, false or misleading product claims, and others. Following institutional review board approval, survey materials were distributed via email by the National Association of Boards of Pharmacy to 63 domestic and international boards of pharmacy. Completed surveys were analyzed using descriptive statistics. The proportion of respondents who indicated that the vignette would "very likely" or "likely" result in an investigation was used to determine consensus. Proportions of >75%, 50%-75% and <50% were classified as high, moderate and low consensus, respectively.
Results: Fourteen completed surveys (22.2%) were received. Sixty percent of respondents stated that their board has been involved in managing a complaint regarding the online behavior of a licensee, and that disciplinary actions including revocation or suspension of license, letter of reprimand, and monetary fines have been enacted. While 79% of responding BOPs have a policy regarding Internet usage, 36% are unsure whether the policies are sufficient to cover online professionalism. One vignette, where a pharmacist made misleading claims regarding a compounded product, achieved high consensus for likelihood to prompt an investigation. Moderate consensus was achieved for a breach of patient confidentiality, inappropriate alcohol use, and misrepresentation of professional credentials.
Conclusion: Boards of pharmacy are widely varied in what types of online behaviors may prompt an investigation. Additional dialogue is needed among pharmacy leaders to determine best practices.

Type: Original Research
Project ImPACT: Hypertension Outcomes of a Pharmacist-Provided Hypertension Service
Authors: Nemerovski Carrie Wentz , Young Maria , Mariani Nicholas , Bugdalski-Stutrud Carol , Moser Lynette R. 
Published: January 2018

Objective: To evaluate the impact of pharmacists, working collaboratively with patients, on blood pressure control, lifestyle goal setting, adherence to antihypertensive therapy, patient knowledge and satisfaction, and modification of cardiovascular risk factors.
Methods: Self-declared hypertensive patients met with the pharmacist for blood pressure monitoring, lifestyle goal setting, and education about medications and disease state on four occasions over a 6-month period.
Practice innovation: A community pharmacy partnered with an employer wellness plan to provide education and monitoring for patients with hypertension based on home blood pressure readings obtained using monitors that wirelessly transmit information to the pharmacist.
Main outcome measure(s): Percentage of patients at blood pressure goal, mean blood pressure, percentage of patients with lifestyle goals, medication adherence, patient knowledge and satisfaction, and modification of cardiovascular risk factors.
Results: Patients not at their goal blood pressure at baseline had a significant decrease in blood pressure and a significant increase in achievement of their blood pressure goals. Across the population, no significant changes were seen in the primary outcome, lifestyle goals, medication adherence or modification of cardiovascular risk factors. Patient knowledge increased from baseline and satisfaction with the service was high.
Conclusion: Blood pressure control improved in patients not at their treatment goal. All patients increased their knowledge about hypertension and reported high satisfaction with the pharmacy service. Pharmacy services should be offered to patients who are more likely to reap a benefit. Home blood pressure readings are useful to inform clinical decision making and supplement patient consultation within the pharmacy setting.

Type: Original Research
Student Self-Ratings of Skill Acquisition from a Clinical Controversy Debate in a Third Year Pharmaceutical Care Lab
Authors: McNamara Anusha , Janke Kristin , Conway Jeannine , Schweiss Sarah 
Published: January 2018

Objectives: To evaluate student perspectives of a clinical controversy debate activity designed to improve their skills to effectively approach and communicate complex therapeutic dilemmas.
Design: A clinical controversy debate activity was implemented in the fall semester of the third year pharmaceutical care laboratory curriculum. Topics were chosen based on controversies encountered in practice. Students were assigned to groups of 5-6 and subdivided to the pro or con of the topic. Each debate lasted 25 minutes. Students completed a self-assessment asking them to rate eight skills (e.g. selecting appropriate references, analysis of literature, defending and predicting arguments, composing and delivering the presentation, and persuading the audience) before and after the debate as: novice, developing, skilled, facilitating/leading, or educating. Results were analyzed descriptively and the pre-post ratings were compared using a Wilcoxon Signed Rank Test.
Results: 140 (84.8%) students responded to the self-assessment survey. The skill that students rated most highly prior to the debate was selecting appropriate resources and primary literature, with only 7.1% rating themselves as novice. After completing the debate, the skill rated with the greatest improvement was predicting opposing arguments with 47.1% rating as developing and 40% rating as skilled. All eight skills had statistically significant improvements pre- and post- assignment (p < 0.001).
Implications: Preparing arguments for and against treatment options is an important clinical skill, used regularly by pharmacists. A clinical controversy debate activity resulted in reports of improvement on eight measures of evidence based medicine-related skills.

Type: Case Study
A Description of Medication Decision-Making, Dispensing, and Utilization for Hypertensive Patients in Nishtar Hospital Multan, Pakistan
Authors: Saeed Hafiz Muhammad Khawar , Nasar Naveera , Batool Sonia , Ghauri Rabia , Rauf Aquula 
Published: January 2018

Hypertension is a worldwide health problem affecting developed and developing countries, and Pakistan is no exception. Nishtar Hospital Multan is categorized as one of the biggest hospitals in South Asia. The objective for this study was to describe medication decision-making, dispensing, and utilization for patients diagnosed with hypertension at this patient care facility. The study was conducted by 5 trained pharmacists working in collaboration with prescribers who met with study participants when they visited the hospital. All interview questions were asked in Urdu during the hospital visit. Data were summarized using descriptive statistics. A total of 301 patients who visited the hospital agreed to participate in the study. The findings showed that prescribers spend little time with patients and rarely follow guidelines for decision-making. Regarding the dispensing of medications for the treatment of hypertension, none of the dispensing was completed by a pharmacist and none of the patients received counseling about medications at the time of dispensing. Most patients reportedly do not take their medication as prescribed. Regarding outcomes, 20% of the patients had pre-hypertension, 47% stage 1 hypertension, and 33% stage 2 hypertension. Great improvements are possible in the treatment of hypertension at the hospital we studied through application of standard treatment guidelines, patient education, and adjustments to work system processes so that alignment of provider's skills with opportunities in improving the patient care process can be achieved.

Type: Case Study
The impact of a community pharmacist conducted comprehensive medication review (CMR) on 30-day re-admission rates and increased patient satisfaction scores: A pilot study
Authors: Snodgrass Brittany , Babcock Charles K. , Teichman Anne 
Published: January 2018

Objective: To determine the impact of pharmacist conducted Comprehensive Medication Review (CMR) follow-up within seven days after discharge on (1) readmission rates, (2) detection of drug related problems, (3) and changes in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores.
Design: Rates of re-admission for pneumonia, congestive heart failure (CHF), or myocardial infarction (MI), within 30 days of discharge are compared between patients receiving a CMR from the pharmacist to a historical control group not receiving the service. The CMR documentation is reviewed to classify any detected drug related problems. Overall HCAHPS scores for the hospital are compared for the three months prior to instituting this service and the three months during the service.
Setting: Patients were discharged from a 101-bed acute care hospital located in rural West Virginia. The community pharmacist worked with the hospital to contact patients after discharge to demonstrate a partnership between inpatient and outpatient care.
Patients: Patients were included if they had a discharge diagnosis of pneumonia, congestive heart failure (CHF), or myocardial infarction (MI), and were returning to self-care or family-care. If discharged between 10/12/2012 and 12/11/2012 they were included in the historical control group. If discharged between 12/12/2012 and 2/12/2012 they were offered the CMR service and included in the intervention group.
Intervention: Patients received a telephone call two to seven days following discharge from a pharmacist who conducted the Comprehensive Medication Review (CMR)
Results: Patients who participated in a CMR via the telephone had decreased 30-day readmission rates compared to the historical control group (16% v 33%). Overall 22 significant drug therapy problems were identified among patients. HCAHPS scores for the questions "Did you receive communication regarding your medications" increased during the study time period (65% vs 72%).
Conclusion: The mixed results of available data from previous studies on pharmacist inclusion in the discharge process focuses heavily on counseling before the patient is discharged. Results of this study show community pharmacist partnership in discharge follow-up can also assist in decreasing readmissions, detecting drug related problems, and increasing patient satisfaction.

Type: Original Research