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Feeding Back Pharmacy Staff on their OTC Dispensing Performance: An Exploratory Study
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Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64
were low for TH (4.40.9) and ACC (5.41.0) as compared to the pMDI (8.10.9) (p!0.001, Independent Sample T test). Beside type of inhaler, higher inhaler technique scores were significantly associated with more recent diagnosis of asthma, older patient age (above 31), and lower reliever use (p¼0.019, one way ANOVA). Results showed no significant association between inhaler technique and ACT scores (meanSD), which were very low for all inhaler groups, with no significant differences between them (TH: 13.13.9, ACC: 13.33.9 and pMDI: 12.84.2, pO0.05). Conclusion: Patients in Jordan are using the pMDI inhalers more correctly than the newer DPIs. Significant association between higher inhaler technique scores and lower reliever use was found, but no significant association with ACT scores was detected.
Conclusions: Our vision is to better understand and improve statin adherence via promotion or prevention tailored messages and interventions, according to each patient’s regulatory focus. We envision pharmacists and other healthcare professionals being trained to communicate with their patients using specific tailored messages that match the patients’ regulatory focus. This communication may then strengthen the patient-provider relationship, enhance patient adherence to medications, and ultimately improve health outcomes.
Factors Influencing Statin Medication Adherence: Regulatory Focus and Fit A.I. Iaconi1, K.B. Farris1, R. Bagozzi1, S. Erickson1, J. Piette2, M. Dorsch2, 1Social and Administrative Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan 48109, USA, 2University of Michigan School of Public Health University of Michigan, Ann Arbor, Michigan 48109, USA
Feeding Back Pharmacy Staff on their OTC Dispensing Performance: An Exploratory Study P. Veiga1, L.V. Lapa˜o2, A.M. Cavaco1,3, M.P. Guerreiro4, 1Instituto de Investigac¸a˜o do Medicamento (iMed.ULisboa), Faculdade de Farma´cia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal, 2WHO Collaborating Center for Health workforce policy and planning, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal, 3Faculdade Farma´cia Universidade de Lisboa (FFUL), Lisbon, Portugal, 4Instituto Superior de Cieˆncias da Sau´de Egas Moniz (ISCSEM), Monte da Caparica, Portugal j Escola Superior de Enfermagem de Lisboa (ESEL), Lisbon, Portugal
Statin medication non-adherence is as low as 25 to 40% and few theory-based approaches have been examined to improve it. Regulatory focus and fit have been used to explain health behaviors, but not medication-taking. Health communication regarding statin medications may be improved by understanding these concepts and their relationship to medication adherence. The objective of the proposed study is to examine how a person’s regulatory focus and fit affect statin medication adherence by testing the conditional indirect relationships with behavioral intentions and motivational intensity serving as mediators and self-efficacy, outcome expectancies, and optimism serving as moderators. Methods: We will use a psychological field experiment with a randomized design that consists of two manipulations and two QualtricsÒ internet surveys. A letter describing the study will be mailed to 3,000 qualified University of Michigan Health System participants. Survey one participants will randomly receive either promotion or prevention manipulations for both regulatory focus and implementation intentions. Participants will provide self-reported medication adherence 7 days later in the second survey. Pre-paid and promised incentives will be offered for completing both surveys. The relationship between regulatory focus/fit on statin medication adherence will be determined via the conditional process modeling analysis. Results: We expect that a person’s self-efficacy, outcome expectancies and optimism will moderate the mediated relationship by behavioral intentions/motivational intensity between regulatory focus/fit and statin medication adherence.
To explore pharmacy staff’s perspectives on OTC visits. Methods: A purposively selected community pharmacy was subjected to mystery shopper visits, using four symptom-based (SbS) and three product-based scenarios (PbS). Ethical approval was granted and participants signed an informed consent. Performance data were collected by means of a previously tested checklist containing both interpersonal and technical criteria, completed by trained mystery shoppers immediately after each visit. Data were converted into two composite scores (technical and interpersonal performance), and analyzed with SPSSÒ v.18. The perspectives of pharmacy staff (one pharmacist, one pharmacy-technician and three counter-assistants) on their performance were collected using audiotaped semi-structured interviews. During the interviews participants received general feedback on standards met and scores. Analysis of verbatim transcripts followed the framework approach based on an attitudinal model (i.e. cognitive, affective and behavioral components). Results: Ten mystery shopper visits were considered for analysis. Overall, the mean technical performance score was 50.4% and the mean interpersonal performance score was 77.7%; the former was higher for SbS (63.2%) than for PbS (31.3%). Cognitive and behavioral dimensions were predominant. Inadequate patient evaluation and counselling (written instructions) were found. Most participants expressed disappointment about unmet standards and provided justifications for their suboptimal performance. Reasons included perceiving some questions as irrelevant, believing the person was already informed, considering counselling for cold medicines unnecessary (as they are commonly used),
Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64 believing written instructions are unnecessary if the consumer had been informed orally, and discomfort in questioning and counselling consumers seeking emergency contraception. Data indicate that staff centered their behaviors on beliefs, perceptions and past experiences rather than factual knowledge. Conclusions: Our study suggests that pharmacy staff needs to be encouraged to engage in effective communication with consumers, to ascertain their needs and wishes pertaining to OTC medicines. Fostering Interprofessional Communication with Pharmacy and Nursing Students A.M.H. Chen1, M.E. Kiersma2, C.N. Keib3, S. Cailor1, 1 School of Pharmacy, Cedarville University, Cedarville, OH, 2College of Pharmacy, Manchester University, Manchester, OH, 3School of Nursing, Cedarville University, Cedarville, OH To evaluate pharmacy and nursing student self-perceptions of confidence in interprofessional communication skills (IPC) as well as faculty member perceptions of actual skills. Methods: A prospective, longitudinal interprofessional experience was implemented with first professional year pharmacy and third-year bachelors’ nursing students enrolled in semester-long, required research courses. Students participated in two large group sessions, which included IPC pre-readings, icebreakers, an active-learning lecture to address discipline-specific stereotypes and IPC, and role-playing case scenarios to incorporate IPC skills. In the discipline-specific courses, nursing faculty discussed nursing research with pharmacy students, and vice-versa. Finally, students participated in a poster session, presenting their semester-long course projects to small groups of nursing and pharmacy students and faculty. An instrument was developed using peer-reviewed literature and expert opinion to assess IPC skills (4 questions, Likert-type), with the student version assessing self-confidence in IPC (1¼Not at all, 5¼Extremely confident) and the faculty version assessing actual IPC (1¼Strongly disagree, 5¼Strongly agree). Instruments were completed at the end of the poster session, and faculty had previously been trained on IPC and instrument utilization. Descriptive and non-parametric (Mann-Whitney U test) analyses were performed, with an a priori a¼0.05. Results: Students (N¼47 pharmacy, 110 nursing) and faculty (N¼10 pharmacy, 10 nursing) participated in the poster session. Most students were very or extremely confident regarding their IPC skills (4 questions, R86%), with no significant differences between pharmacy and nursing students (pO0.05). Most faculty agreed or strongly agreed that students presented well to an interprofessional audience (4 questions, R93% faculty), with no significant differences by student major or faculty discipline (pO0.05). Conclusions: After graduation, health professionals are often involved in interdisciplinary teams; however, many
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are not educated in a collaborative learning environment. Integrating structured activities offers opportunities to improve communication between healthcare practitioners and modify attitudes and perceptions. Health Literacy Tests for Iraqi Patients A.A. Al-Jumaili1, M.D. Al-Rekaby2, B. Sorofman1, 1The University of Iowa College of Pharmacy, Iowa City, IA, USA, 2University of Kufa College of Pharmacy, Al-Najaf, Iraq The aims were to measure for the first time the health literacy level of Iraqis, to explore the use of standardized health literacy tests for Iraqis and to investigate whether there is relationship between the participant characteristics and the health literacy level. Methods: A convenience sample of 97 Iraqis was studied in five community pharmacies in Al-Najaf and Babylon governorates, Iraq from September 2013 to February 2014. Health literacy tests were translated and printed in the Arabic language. These were S-TOFHLA, NVS and SILS. Basic demographic information was collected. Results: Ninety seven subjects participated in this study, 42 females and 55 males. The average age was 27.2(9.67) years, range (14-60) years old. The participants were divided into three groups, (14-24), (25-35) and (36-60) years accounting for 46.39, 37.11 and 16.49 % of study sample, respectively. They were categorized by education, less than middle school (13.79 %), completed middle school (31.03 %), completed high school (31.03 %), and some college (24.14 %). SILS indicated that 76% of participants had limited reading ability (chose sometimes, often or always). The NVS test results showed that 17.05% of participants had probably inadequate, 46.59% had possibly inadequate and 36.36% had adequate health literacy. According to S-TOFHLA test, 8.42, 7.37 and 84.21 % of participants had inadequate, marginal and adequate health literacy respectively. Conclusions: In this sample, there was no statistically significant correlation between age, gender and educational and health literacy level. SILS could not reflect the accurate level of literacy because it has only one subjective, possibly culturally biased question. Since Iraqis are not use to read product labels, eight out of 97 participants refused to answer the NVS test. S-TOFHLA was the most comprehensive test because it measures both reading and calculation abilities besides almost all ( 95) participants answered this test completely.
How Challenging Are Branded Medicines in Portugal? A Linguistic Evaluation of Brand Names A. Cavaco, C. Pires, M. Viga´rio Medicine names must be not only easily memorized, but also not confusing to patients. The main aim of this study was to evaluate in a set of Portuguese medicines’
Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64
were low for TH (4.40.9) and ACC (5.41.0) as compared to the pMDI (8.10.9) (p!0.001, Independent Sample T test). Beside type of inhaler, higher inhaler technique scores were significantly associated with more recent diagnosis of asthma, older patient age (above 31), and lower reliever use (p¼0.019, one way ANOVA). Results showed no significant association between inhaler technique and ACT scores (meanSD), which were very low for all inhaler groups, with no significant differences between them (TH: 13.13.9, ACC: 13.33.9 and pMDI: 12.84.2, pO0.05). Conclusion: Patients in Jordan are using the pMDI inhalers more correctly than the newer DPIs. Significant association between higher inhaler technique scores and lower reliever use was found, but no significant association with ACT scores was detected.
Conclusions: Our vision is to better understand and improve statin adherence via promotion or prevention tailored messages and interventions, according to each patient’s regulatory focus. We envision pharmacists and other healthcare professionals being trained to communicate with their patients using specific tailored messages that match the patients’ regulatory focus. This communication may then strengthen the patient-provider relationship, enhance patient adherence to medications, and ultimately improve health outcomes.
Factors Influencing Statin Medication Adherence: Regulatory Focus and Fit A.I. Iaconi1, K.B. Farris1, R. Bagozzi1, S. Erickson1, J. Piette2, M. Dorsch2, 1Social and Administrative Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Michigan 48109, USA, 2University of Michigan School of Public Health University of Michigan, Ann Arbor, Michigan 48109, USA
Feeding Back Pharmacy Staff on their OTC Dispensing Performance: An Exploratory Study P. Veiga1, L.V. Lapa˜o2, A.M. Cavaco1,3, M.P. Guerreiro4, 1Instituto de Investigac¸a˜o do Medicamento (iMed.ULisboa), Faculdade de Farma´cia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal, 2WHO Collaborating Center for Health workforce policy and planning, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal, 3Faculdade Farma´cia Universidade de Lisboa (FFUL), Lisbon, Portugal, 4Instituto Superior de Cieˆncias da Sau´de Egas Moniz (ISCSEM), Monte da Caparica, Portugal j Escola Superior de Enfermagem de Lisboa (ESEL), Lisbon, Portugal
Statin medication non-adherence is as low as 25 to 40% and few theory-based approaches have been examined to improve it. Regulatory focus and fit have been used to explain health behaviors, but not medication-taking. Health communication regarding statin medications may be improved by understanding these concepts and their relationship to medication adherence. The objective of the proposed study is to examine how a person’s regulatory focus and fit affect statin medication adherence by testing the conditional indirect relationships with behavioral intentions and motivational intensity serving as mediators and self-efficacy, outcome expectancies, and optimism serving as moderators. Methods: We will use a psychological field experiment with a randomized design that consists of two manipulations and two QualtricsÒ internet surveys. A letter describing the study will be mailed to 3,000 qualified University of Michigan Health System participants. Survey one participants will randomly receive either promotion or prevention manipulations for both regulatory focus and implementation intentions. Participants will provide self-reported medication adherence 7 days later in the second survey. Pre-paid and promised incentives will be offered for completing both surveys. The relationship between regulatory focus/fit on statin medication adherence will be determined via the conditional process modeling analysis. Results: We expect that a person’s self-efficacy, outcome expectancies and optimism will moderate the mediated relationship by behavioral intentions/motivational intensity between regulatory focus/fit and statin medication adherence.
To explore pharmacy staff’s perspectives on OTC visits. Methods: A purposively selected community pharmacy was subjected to mystery shopper visits, using four symptom-based (SbS) and three product-based scenarios (PbS). Ethical approval was granted and participants signed an informed consent. Performance data were collected by means of a previously tested checklist containing both interpersonal and technical criteria, completed by trained mystery shoppers immediately after each visit. Data were converted into two composite scores (technical and interpersonal performance), and analyzed with SPSSÒ v.18. The perspectives of pharmacy staff (one pharmacist, one pharmacy-technician and three counter-assistants) on their performance were collected using audiotaped semi-structured interviews. During the interviews participants received general feedback on standards met and scores. Analysis of verbatim transcripts followed the framework approach based on an attitudinal model (i.e. cognitive, affective and behavioral components). Results: Ten mystery shopper visits were considered for analysis. Overall, the mean technical performance score was 50.4% and the mean interpersonal performance score was 77.7%; the former was higher for SbS (63.2%) than for PbS (31.3%). Cognitive and behavioral dimensions were predominant. Inadequate patient evaluation and counselling (written instructions) were found. Most participants expressed disappointment about unmet standards and provided justifications for their suboptimal performance. Reasons included perceiving some questions as irrelevant, believing the person was already informed, considering counselling for cold medicines unnecessary (as they are commonly used),
Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64 believing written instructions are unnecessary if the consumer had been informed orally, and discomfort in questioning and counselling consumers seeking emergency contraception. Data indicate that staff centered their behaviors on beliefs, perceptions and past experiences rather than factual knowledge. Conclusions: Our study suggests that pharmacy staff needs to be encouraged to engage in effective communication with consumers, to ascertain their needs and wishes pertaining to OTC medicines. Fostering Interprofessional Communication with Pharmacy and Nursing Students A.M.H. Chen1, M.E. Kiersma2, C.N. Keib3, S. Cailor1, 1 School of Pharmacy, Cedarville University, Cedarville, OH, 2College of Pharmacy, Manchester University, Manchester, OH, 3School of Nursing, Cedarville University, Cedarville, OH To evaluate pharmacy and nursing student self-perceptions of confidence in interprofessional communication skills (IPC) as well as faculty member perceptions of actual skills. Methods: A prospective, longitudinal interprofessional experience was implemented with first professional year pharmacy and third-year bachelors’ nursing students enrolled in semester-long, required research courses. Students participated in two large group sessions, which included IPC pre-readings, icebreakers, an active-learning lecture to address discipline-specific stereotypes and IPC, and role-playing case scenarios to incorporate IPC skills. In the discipline-specific courses, nursing faculty discussed nursing research with pharmacy students, and vice-versa. Finally, students participated in a poster session, presenting their semester-long course projects to small groups of nursing and pharmacy students and faculty. An instrument was developed using peer-reviewed literature and expert opinion to assess IPC skills (4 questions, Likert-type), with the student version assessing self-confidence in IPC (1¼Not at all, 5¼Extremely confident) and the faculty version assessing actual IPC (1¼Strongly disagree, 5¼Strongly agree). Instruments were completed at the end of the poster session, and faculty had previously been trained on IPC and instrument utilization. Descriptive and non-parametric (Mann-Whitney U test) analyses were performed, with an a priori a¼0.05. Results: Students (N¼47 pharmacy, 110 nursing) and faculty (N¼10 pharmacy, 10 nursing) participated in the poster session. Most students were very or extremely confident regarding their IPC skills (4 questions, R86%), with no significant differences between pharmacy and nursing students (pO0.05). Most faculty agreed or strongly agreed that students presented well to an interprofessional audience (4 questions, R93% faculty), with no significant differences by student major or faculty discipline (pO0.05). Conclusions: After graduation, health professionals are often involved in interdisciplinary teams; however, many
e25
are not educated in a collaborative learning environment. Integrating structured activities offers opportunities to improve communication between healthcare practitioners and modify attitudes and perceptions. Health Literacy Tests for Iraqi Patients A.A. Al-Jumaili1, M.D. Al-Rekaby2, B. Sorofman1, 1The University of Iowa College of Pharmacy, Iowa City, IA, USA, 2University of Kufa College of Pharmacy, Al-Najaf, Iraq The aims were to measure for the first time the health literacy level of Iraqis, to explore the use of standardized health literacy tests for Iraqis and to investigate whether there is relationship between the participant characteristics and the health literacy level. Methods: A convenience sample of 97 Iraqis was studied in five community pharmacies in Al-Najaf and Babylon governorates, Iraq from September 2013 to February 2014. Health literacy tests were translated and printed in the Arabic language. These were S-TOFHLA, NVS and SILS. Basic demographic information was collected. Results: Ninety seven subjects participated in this study, 42 females and 55 males. The average age was 27.2(9.67) years, range (14-60) years old. The participants were divided into three groups, (14-24), (25-35) and (36-60) years accounting for 46.39, 37.11 and 16.49 % of study sample, respectively. They were categorized by education, less than middle school (13.79 %), completed middle school (31.03 %), completed high school (31.03 %), and some college (24.14 %). SILS indicated that 76% of participants had limited reading ability (chose sometimes, often or always). The NVS test results showed that 17.05% of participants had probably inadequate, 46.59% had possibly inadequate and 36.36% had adequate health literacy. According to S-TOFHLA test, 8.42, 7.37 and 84.21 % of participants had inadequate, marginal and adequate health literacy respectively. Conclusions: In this sample, there was no statistically significant correlation between age, gender and educational and health literacy level. SILS could not reflect the accurate level of literacy because it has only one subjective, possibly culturally biased question. Since Iraqis are not use to read product labels, eight out of 97 participants refused to answer the NVS test. S-TOFHLA was the most comprehensive test because it measures both reading and calculation abilities besides almost all ( 95) participants answered this test completely.
How Challenging Are Branded Medicines in Portugal? A Linguistic Evaluation of Brand Names A. Cavaco, C. Pires, M. Viga´rio Medicine names must be not only easily memorized, but also not confusing to patients. The main aim of this study was to evaluate in a set of Portuguese medicines’