The pharmacist, the law, and self-testing products.
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Consumer Product Safety↗
Biomedical subjects
S J Coons
Publications and source records attributed to S J Coons.
Self-care practices of college students.
The literature indicates that the majority of symptoms of minor illness or injury experienced by individuals are handled routinely through some form of self-care. Less well described are the sources of information relied on in the self-care decision-making process. The purpose of this study was to assess the use of self-care measures by college students prior to visiting a student health service and, if self-care was undertaken, to determine the source(s) of self-care information. Results indicated that almost two thirds of the subjects had engaged in self-care for the symptoms that led to their visits. The most popular sources of self-care information included family members or friends, prior interaction with a health care provider, and nonprescription medication advertisements. This study did not address the appropriateness of the self-care information obtained; therefore, the quality of the information was not analyzed. Due to the prevalence of self-care among college students, attempts should be made to provide them with objective, high quality, and readily accessible self-care information. This information should be provided as part of an overall effort that encourages students to view health as a personal responsibility.
Adolescent↗
The effect of self-care information on health-related attitudes and beliefs of college students.
We conducted a study to determine whether an intervention using self-care information would change college students' attitudes and beliefs concerning personal responsibility and involvement in their own health care. Individuals entering a student health service were randomly assigned to a treatment or control group. Members of the treatment group (n = 187) received the intervention and completed the survey instrument. Members of the control group (n = 204) completed the survey instrument only. The intervention consisted of one page of general information about the benefits to individuals of taking responsibility for their own health and a booklet containing excerpts from a consumer-oriented health care book. The survey instrument was composed of a measure of attitudes toward information and behavioral involvement in health care and a measure of beliefs regarding control over one's health. Results indicated that the intervention was able to change the treatment group's attitudes regarding active participation in health care. The treatment group's responses also reflected less belief that health was outside of the individual's control. The study showed that a positive change in health-related attitudes and beliefs can result from a relatively uncomplicated informational intervention.
Adolescent↗
Promoting the appropriate use of medications by older adults; the pharmacist's role.
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Aged↗
A look at the purchase and use of home pregnancy-test kits.
A study was conducted to obtain information regarding the purchase and use of home pregnancy-test kits. Questionnaires were distributed to 438 women entering a family-planning clinic in the fall of 1987. A total of 153 questionnaires were completed and returned, providing a response rate of 34.9%. Results indicated that nearly 40% of the respondents had used a home pregnancy-test kit at least once. Of those who had used a home pregnancy-test kit, the majority did so because of "the speed of obtaining results" or "convenience." Although nearly 87% of the pregnancy-test kits had been purchased in a pharmacy, pharmacists played only a minor role in the decision-making process concerning purchase and use. Some three-fourths of the subjects listed "information on the side of the package," "price," or "advertisements" as the most important factor in the selection of a specific brand of test kit. Only about 7% of the subjects selected "recommendation of the pharmacist" as the most important factor. The results suggest that pharmacists could be doing more to promote the appropriate use of self-testing products, specifically home pregnancy-test kits.
Female↗
Continuing-education interests of hospital pharmacists in Kentucky.
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Education, Pharmacy, Continuing↗
Justification and implementation of a cancer center pharmacy satellite.
The justification, establishment, and evaluation of a full-service cancer center pharmacy satellite for a university hospital are described. Providing efficient and effective pharmaceutical services was difficult because (1) the cancer center is housed in a freestanding building adjacent to the hospital and (2) there are special considerations inherent in the ordering and preparation of antineoplastic medications. Data collected and presented by the pharmacy, along with letters of support from nursing and medical staff, provided justification of the need to establish an oncology satellite pharmacy. The satellite, open 8.0 hours per day Monday through Friday, is primarily responsible for preparing antineoplastic agents and dispensing first doses of other intravenous and oral medications for the cancer center. Satellite staffing consists of 1.2 full-time-equivalent (FTE) pharmacists and 2.0 FTE technicians. A technician works in the satellite the same number of hours as the pharmacist but is also available to prepare antineoplastic drugs in the central pharmacy on weekends. Pharmacist activities also include providing drug and dosing information to the medical and nursing staff, as well as handling investigational drugs. The satellite pharmacy has decreased medication turnaround time by one-half and has improved pharmaceutical services to the nursing staff.
Antineoplastic Agents↗
The need for evaluation of the ultimate impact of continuing pharmaceutical education.
Many governmental agencies and professional associations are using continuing education as the single, and relatively untested, means of ensuring that professionals maintain an acceptable level of knowledge and skills. The ultimate goal of continuing education in the health professions is improved professional performance leading to an improvement in the quality of health care provided. However, there is justifiable concern over the lack of a significant link between participation in continuing education activities and professional competence. This issue is explored and a conceptual framework for the evaluation of continuing pharmaceutical education is presented. The conceptual framework is an evaluation hierarchy which depicts the following four levels of a comprehensive evaluation process: participant satisfaction; changes in knowledge, attitudes, and skills; behavior change in practice setting; and improvement in patient care.
Education, Pharmacy, Continuing↗
Pharmacoeconomic research--facilitating collaboration among academic institutions, managed-care organizations, and the pharmaceutical industry: a conference report.
To provide a venue to allow for the exchange of information among parties interested in pharmacoeconomic research opportunities within managed-care organizations, an invitational conference was conducted by The University of Arizona's Center for Pharmaceutical Economics on January 20 and 21, 1994, in Tucson, Arizona. The purpose of the conference was to bring together representatives from managed-care organizations, academic institutions, and the pharmaceutical industry to discuss opportunities for collaboration, as well as consider the barriers to conducting pharmacoeconomic research in the managed-care setting. Challenges to collaboration include database development, the need for an integrated perspective, sensitivity to marketing matters, and a variety of technical and organizational barriers. To overcome these barriers, the interested groups must develop trust, recognize common ground, share risk, and communicate effectively. This article describes the emerging themes of the conference based on transcripts of formal presentations and participants' comments.
Economics, Pharmaceutical↗
A review of health-related quality-of-life measures used in end-stage renal disease.
Health-related quality of life (HRQOL) is a critical issue in the treatment of end-stage renal disease (ESRD) patients. The variety of symptoms, comorbidities, and treatments of ESRD over the course of its chronic disease trajectory necessitate comprehensive assessment of the impact of interventions on HRQOL. A literature review of ESRD HRQOL studies was performed to provide an overview of the instruments used and to provide recommendations for HRQOL assessment in future studies. Instruments were classified based on the health domains they assess and whether they are generic or disease targeted. The instruments were judged in terms of their comprehensiveness, reliability, and validity.
Affect↗
Disease management--separating fact from fantasy.
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Costs and Cost Analysis↗
Disease management: definitions and exploration of issues.
Disease management (DM) appears to be sweeping the health care industry. Its supporters claim that it can produce optimal health care outcomes through enhancements in the quality of care provided to patients and effective control of costs. This paper examines the primary reasons for the recent popularity of DM, discusses several thematic components common to various definitions of DM, and compares the often overly optimistic claims made for DM with the realities of how such programs are actually implemented. Finally, it examines critical issues and controversies that participants in DM must consider as this approach to managing patient care evolves.
Cost-Benefit Analysis↗
Pharmaceuticals and medicare managed care: pharmacoeconomic considerations.
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Drug Therapy↗
Sexual behavior, communication, and chlamydial infections among college women.
The sexual practices, partner communication patterns, and prevalence of chlamydial infection were determined in a sample of college women. Specific inclusion criteria were used to screen 146 participants. The presence of a mucopurulent cervical discharge was the only criterion significantly associated with infection. Only 12% of the sample used condoms alone or in combination with another birth control method, and only 31% of the women discussed with their partner their own or their partner's sexual history. Thirty-eight percent of the sample reported a history of one to four episodes of a sexually transmitted disease, and 21% of the women stated they had had two or more sexual partners within the past 6 months. Health providers, counselors, and women themselves must address this health issue with more assertive behavior and communication skills.
Adolescent↗
Comparison of Finnish and U.S.-based visual analog scale valuations of the EQ-5D measure.
The EQ-5D is a multiattribute health status measure that can be used to derive preference-based index scores for health-related quality-of-life (HRQOL) assessment. Valuations for EQ-5D health states using different techniques have been obtained in a number of countries. It is not clear how valuations from different countries compare. Using an ordinary least-squares regression, visual analog scale valuations for EQ-5D health states obtained in postal surveys in Finland and the United States were compared. The regression model estimates indicated that Finnish and U.S. respondents did provide different preference valuations for different levels of health. However, the country-specific differences were not large and depended on the dimension and the level of problem on that dimension. Differences in health-state valuations are unlikely to have important implications when using the EQ-5D in international studies.
Adolescent↗
Construct validities of the Quality of Well-Being Scale and the MOS-HIV-34 Health Survey for HIV-infected patients.
This research assessed the construct validities of two health-related quality-of-life instruments: the Quality of Well-Being Scale (QWB) and the Medical Outcomes Study 34-item HIV Health Survey (MOS-HIV-34). A sample of 100 adult male, HIV-infected patients, across six HIV disease classifications, was used as subjects. Four convergent validity measures of health-related quality of life were used: CD4 cell counts, beta-2 microglobulin levels, disease classification, and age. All convergent validity measures were significant for the QWB. Forty percent of the convergent validity comparisons with the MOS-HIV-34 were statistically significant. Because the two measures provide different perspectives on health-related quality of life, both instruments appear to be useful in measuring health-related quality of life in this patient population.
Adult↗
Assessing health-related quality of life: application to drug therapy.
There is growing awareness among the principal stakeholders in health care that health outcomes data should be used in the evaluation of medical care interventions. Health-related quality of life is a patient-reported health outcome that is gaining increasing attention. In fact, in certain diseases, quality of life may be the most important health outcome to consider in assessing treatment efficacy. Quality of life is a construct commonly viewed as having several dimensions or domains. Although the terminology may differ depending on the author, the basic dimensions of health-related quality of life are physical status and functioning, emotional/psychological status, social functioning, and disease- or treatment-related symptomatology. There are a number of methodologic issues in the measurement of quality of life that must be carefully considered when designing a study or evaluating existing research. These issues include general or disease-specific measures, index or profile outcome measures, dimensions measured, relative importance of dimensions, reliability of the measure, and validity of the measure. This paper provides a brief overview of health-related quality of life and its measurement in the context of drug therapy.
Decision Making↗
Relative importance of dimensions in the assessment of health-related quality of life for patients with hypertension.
There are many different approaches to quality of life measurement. Most of these methods consider several dimensions of health status. However, few of the current methods evaluate the relative importance of the various dimensions. We suggest that the relative importance dimension is of central importance in the development of a general theoretical conceptualization of health outcome. Further, we offer a General Health Policy Model that can be used to evaluate outcomes in cardiovascular care and to compare the cost/utility of cardiovascular interventions to investments in other aspects of health care. Employing the relative importance concept requires several important assumptions and methodological challenges. For example, we must select between competing measurement methodologies and we must decide whose values to use in the models. As new research addresses these questions, we expect greater use of the models in patient decision making and in health policy research.
Humans↗