Evaluating Curriculum Differences in US PharmD Programs: A Peer Evaluation.

OBJECTIVE: To evaluate the differences in curriculum structure and content and observe commonalities across various Doctor of Pharmacy (PharmD) programs in the United States. METHODS: This research involves the collection of course content and credit hour data from the curricula and course descriptions, course catalogs, and student handbooks of all the PharmD programs available on their websites and categorization based on the content areas outlined in the Accreditation Council of Pharmacy Education. The core courses, elective offerings, and experiential education (eg, Introductory and Advanced Pharmacy Practice Experience) were evaluated using Excel® for credit hours, integration, non-integration, program duration (3-year vs 4-year), and online offerings. RESULTS: Of 142 accredited schools/colleges, 135 were included in the study, which met the inclusion criteria. In total, 85 of these schools have an integrated curriculum, 19 have a 3-year curriculum, and 15 offer a distance learning pathway for a PharmD degree. Fourteen of the 37 required content areas from the Accreditation Council of Pharmacy Education Appendix 1 were identified, with more than 50% of schools listing no credit hours allocated. Only 9 areas had 90% or more of pharmacy schools allocating credit hours. On average, biomedical, pharmaceutical, social/administrative/behavioral, clinical sciences, experiential education, and electives allocate 10.6, 25.3, 17.1, 40.5, 45.5, and 7.0 credit hours, respectively. CONCLUSION: Each school's curriculum has a significant variation in credit hours, and there is an opportunity to simplify the curricular structure and content by reducing redundancy and increasing flexibility based on health care needs.

The Status of Students, Faculty, and Leadership Diversities in US Pharmacy Schools/Colleges.

OBJECTIVE: The purpose of this research is to address knowledge gaps on diversity in the United States (US) population, pharmacy students, faculty, and school/college leadership. METHOD: The population data were collected from the US Census Bureau. The pharmacy student and faculty data were collected from the American Association of Colleges of Pharmacy enrollment and faculty profiles to compute Diversity Indices (DIs). To delve further into observed DI values, different ratios were calculated by dividing the total number of people in a racial/ethnic group of a particular category (eg, students) by the total number of people in the same racial/ethnic group in a different category (eg, faculty). Two factors (ratios among racial groups and changes in ratios over time) ANOVA without replication was conducted using Excel. RESULTS: The students are the most diverse category (average DI = 69%), followed by the US population (average DI = 58%), faculty diversity (average DI = 54%), assistant/associate dean (average DI = 42%) and dean (average DI = 31%). The ratio analyses among student, faculty, and leadership categories reveal a disproportionately high representation of White individuals in faculty and leadership roles when compared to other racial groups, resulting in low DI values in these categories. CONCLUSION: A significant ratio difference was found among various racial groups each year. However, there was no significant change observed in ratios over time. The academic community must develop hiring practices that increase the DI values among faculty and leadership categories to reduce the gap and promote student success.

The Representation of Causality and Causation with Ontologies: A Systematic Literature Review.

Objective: To explore how disease-related causality is formally represented in current ontologies and identify their potential limitations. Methods: We conducted a systematic literature search on eight databases (PubMed, Institute of Electrical and Electronic Engendering (IEEE Xplore), Association for Computing Machinery (ACM), Scopus, Web of Science databases, Ontobee, OBO Foundry, and Bioportal. We included studies published between January 1, 1970, and December 9, 2020, that formally represent the notions of causality and causation in the medical domain using ontology as a representational tool. Further inclusion criteria were publication in English and peer-reviewed journals or conference proceedings. Two authors (SS, RM) independently assessed study quality and performed content analysis using a modified validated extraction grid with pre-established categorization. Results: The search strategy led to a total of 8,501 potentially relevant papers, of which 50 met the inclusion criteria. Only 14 out of 50 (28%) specified the nature of causation, and only 7 (14%) included clear and non-circular natural language definitions. Although several theories of causality were mentioned, none of the articles offers a widely accepted conceptualization of how causation and causality can be formally represented. Conclusion: No current ontology captures the wealth of available concepts of causality. This provides an opportunity for the development of a formal ontology of causation/causality.

Patient characteristics associated with the use of pharmacist-administered vaccination services and predictors of service utilization.

BACKGROUND: Data on the impact of pharmacists as vaccinators are available; however, research on understanding the characteristics of users of pharmacist-administered vaccinations is scarce. OBJECTIVES: This study aimed to identify the characteristics of the users of pharmacist-administered vaccinations and recognize predictors of utilizing these services. METHODS: Data were obtained from a cross-sectional online survey, and the sample size was 26,173 respondents from all over the United States. The outcome measure was the previous use of pharmacist-administered vaccination. Independent variables were demographic factors, health-related factors, and previous utilization of pharmacy products and services. Chi-square test and multivariable logistic regression analyses were conducted to examine the factors associated with the use of this service. P values, odds ratios (ORs), and 95% CIs were computed and reported. RESULTS: About 31% of respondents reported previous use of pharmacist-administered vaccination. The gender of respondents was mainly female (71.2%), and the race was mainly white (80.7%). Chi-square analysis showed a statistically significant association of service use with age, education, geographic region, use of other pharmacy services and products, type of pharmacy, and the number of chronic diseases (P < 0.05). Logistic regression analysis showed a statistically significant association with the number of chronic diseases (OR 1.085 [95% CI 1.049-1.122]), level of education (1.352 [1.35-1.28]), race (0.901 [0.840-0.969]), and proximity to pharmacy (0.995 [0.992-0.997]). Age, type of pharmacy, and previous use of other pharmacist-provided services and products also showed statistically significant associations (P < 0.05). CONCLUSION: The use of pharmacist-administered vaccination has been increasing over the past years. The service has many advantages compared with other vaccination service providers and associated with higher vaccination rates among people with older age, higher education, and a higher number of chronic diseases. With proper training and education, pharmacists are unique in improving vaccination services and public health in general.

Predisposing, Enabling, and Need Factors Associated with the Choice of Pharmacy Type in the US: Findings from the 2015/2016 National Consumer Survey on the Medication Experience and Pharmacists' Roles.

BACKGROUND: Knowing the type of pharmacy used by the patient is meaningful to the pharmacist. Previous studies have assessed different factors predicting the kind of pharmacy selection and reached inconsistent findings. OBJECTIVES: To identify patient and health-related factors associated with pharmacy type selection. METHODS: The Andersen Behavioral Model of Health Service Use was used to organize the selection of patient characteristics and categorize them as predisposing, enabling, and need factors. The dependent variable was the type of pharmacy used. Logistic regression was used to predict the association between patient-related characteristics and the type of pharmacy used. RESULTS: Older age respondents were less likely to use independent pharmacies (OR = 0.992) and more likely to use mail pharmacy services (OR = 1.026). Highly educated people showed higher use of chain and mail pharmacies (OR = 1.272, 1.185, respectively) and less tendency to use the independent, supermarket, and prescription-only pharmacy types. Men were less likely to use chain pharmacies (OR = 0.932) and more likely to use supermarket pharmacies than women. Patients who use Medication Therapy Management (MTM) services had higher odds of using independent and supermarket pharmacies (OR = 2.808, 1.689, respectively). Patients with a higher number of chronic diseases and experienced side effects of medications were more likely to use independent pharmacies (OR for number of disease = 1.097 and for side effects = 1.095). CONCLUSIONS: This study's findings identify characteristics associated with selecting certain pharmacy settings and direct future research to include other predictors encompassing beliefs, attitudes, and other social factors.

Herbal medicines: a cross-sectional study to evaluate the prevalence and predictors of use among Jordanian adults.

INTRODUCTION: Understanding why adults resort to herbal medicine can help in planning interventions aimed at increasing awareness regarding herbal use. This study sought to investigate the prevalence and to determine factors for predicting the use of herbal medicine among Jordanian adults. METHODS: A cross-sectional study was conducted involving 378 older adults who were randomly selected from two different areas of Jordan. A questionnaire was used to gather data and validation criteria for validity and reliability of the content were tested by content and face validity in a panel of experts. RESULTS: From a total of 500 invited participants, 378 completed the questionnaire. The prevalence of the use of of herbal products in this study was high at 80.2%. Herbal medicines use was not associated with any demographic factors other than age (p < 0.05). Moreover, the only associated health-related characteristic was the patient's disease state including, notably, hypertension (p < 0.05). Reasons for not using herbal medicines as reported by nonusers included mainly a lack of belief in their efficacy (52.2%). Another two important reasons were that the individuals believed themselves to healthy and have no need for their use (31.3%) and the unavailability of enough information about the herbal medicines (29.7%). Finally, the most common side effects as reported by patients in this study were nausea and vomiting (9.3%), and, to a lesser extent, skin rash (2.1%). CONCLUSION: There is a high rate of use of herbal medicines in Jordan, especially among hypertensive patients. Therefore, there is a need to establish effective herbal medicine policies and health education programs to discuss the benefits and risks of herbal medicine use, with the aim of maximizing patient-desired therapeutic outcomes.

Anemia and Dietary Behaviors among Young Adults in Riyadh, Saudi Arabia.

OBJECTIVE: The study sought to assess the prevalence and the risk factors associated with anemia among male and female young adults in (Riyadh city, Saudi Arabia). METHODS: A cross-sectional study was conducted at King Saud University and Alfaisal University in September 2016 among young adults aged 18 to 28 years old. Data were collected using an interview questionnaire. Additionally, the respondents were evaluated clinically and via laboratory testing for anemia. RESULTS: Our study population showed a higher percentage of men as compared to women participants. About half of our study sample had a lightly active lifestyle, and more than one-third of the study participants were overweight (34.7%). The average age of the respondents was 22.08 ± 1.98 years. The only factor significantly associated with anemia was gender, in that female gender showed a positive association with anemia. CONCLUSION: The most explicit risk factor for anemia among Saudi individuals of college and young professional ages was the female gender. Dietary lifestyle, heavy menstruation, pregnancy, and intake of non-steroidal anti-inflammatory drugs were additional important risk factors among these individuals, but they were statistically not significant.

Prevalence and Predictors of Herbal Medicine Use Among Adults in the United States.

OBJECTIVE: To describe the prevalence of herbal medicine use among US adults and to assess factors associated with and predictors of herbal use. DESIGN: The data for herbal products use were collected from the 2015 National Consumer Survey on the Medication Experience and Pharmacists' Roles. Chi-square test was used to analyz factors associated with herbal use, and predictors of herbal use were assessed with logistic regression analysis. RESULTS: Factors associated with herbal supplement use include age older than 70, having a higher than high school education, using prescription medications or over-the-counter (OTC) medications, and using a mail-order pharmacy." All Disease state associated significantly with herbal use. Approximately thirty-eight percent of those who used herbals used prescription medications and 42% of those who used herbals also used an OTC medication. The most frequent conditions associated with herbal supplement use were a stroke (48.7%), cancer (43.1%), and arthritis (43.0%). Among herbal product users, factors that predicted use included having higher than school education, using OTC medications, using mail-order pharmacy, stroke, obesity, arthritis, and breathing problems. CONCLUSIONS: More than one-third of respondents reported using herbal supplements. Older age and higher education were associated with a higher use of herbal supplements. People with chronic diseases are more likely to use herbal medicines than others. OTC drug users and patients with stroke are more likely to use herbal medicines than others.

The certainty in consumers' willingness to accept pharmacist-provided medication therapy management services.

OBJECTIVES: To describe consumers' willingness to accept medication therapy management (MTM) services provided by a pharmacist. DESIGN: Cross-sectional Internet survey included questions about willingness to use 11 components of MTM services. PARTICIPANTS: The data of 8352 United States' adults who were on 3 or more medications were obtained from the 2015 National Consumer Survey on the Medication Experience and Pharmacists' Roles, which included 26,173 respondents. MAIN OUTCOME MEASURES: Respondents used a scale that ranged from "definitely would not accept" to "definitely would accept" to specify their willingness to use each of the MTM components. RESULTS: The mean age was 53.1 years, with an average of 1.9 health problems and 5.4 prescription medications. About 50% of respondents definitely would accept 6 or more MTM components. The services with the highest rates of "definitely would accept" were "Recommend the use of a generic drug to help save money" and "Provide advice in administering medications as prescribed" (65.4% and 64.2%, respectively). The next highest were "Performing a review of all medications to make sure they are effective, safe, and affordable" and "Recommendation of nonprescription medications to take care of mild ailments or discomforts" (57.0% and 56.4%, respectively). Those who definitely would accept MTM services, compared with those who would not, differed in terms of gender, education level, income, medication insurance coverage, ever having been a pharmacist, and number of health problems. CONCLUSION: The majority of United States' adults expressed a certain willingness to accept most of the components of MTM services. More research needs to be done to understand why certain groups were less willing to accept MTM services.

Predictors of hepatitis C testing intention among African American Baby Boomers.

Baby Boomers (BBs) are responsible for three-quarters of hepatitis C virus (HCV) infections in the United States; however, HCV testing is distinctly underused by them. A cross-sectional study was conducted to assess the prevalence of HCV testing and to evaluate predictors of HCV testing intention among African-American BBs. The study was guided by the Health Belief Model and theory of reasoned action frameworks. Of the 137 participants included in the study, 44.8% had at least a college education; 13.9% received prior to 1992 blood transfusion. Findings related to HCV testing showed that 32.1% of the participants intended to test for HCV within 6months and 43.8% had received a previous HCV test. Significant predictors of HCV testing intention within 6months included having a blood transfusion prior to 1992 [odds ratio (OR)=8.25, 95% confidence interval (CI): 2.02-33.61], perceptions of benefits (OR=1.57, 95% CI: 1.13-2.18), severity (OR=1.39, 95% CI: 1.17-1.65), and subjective norms (OR=1.42, 95% CI: 1.12-1.79). These predictors of HCV testing intention can be used to develop future HCV testing initiatives for African-American BBs.

Consumers' characteristics associated with the use of mail pharmacy services in the United States: Findings from the 2015 National Consumer Survey on the Medication Experience.

OBJECTIVES: The purpose of this study was to describe current users of mail pharmacy services and to evaluate factors associated with the use of mail pharmacy services. DESIGN: Cross-sectional online survey-based study. SETTING AND PARTICIPANTS: The data were obtained from the 2015 National Consumer Survey on the Medication Experience, which included 26,173 adults from throughout the United States. OUTCOME MEASURES: Mail pharmacy utilization was based on participant self-report. Demographic variables included age, education, race, gender, insurance status, distance to nearest pharmacy, number of disease states, and income. Chi-square and t test analyses were conducted to assess the factors associated with mail pharmacy use. Multivariable logistic regressions were used to compute the odds ratios (ORs) and 95% confidence intervals for the predictors of mail pharmacy usage. RESULTS: Overall, 17% of respondents reported the use of mail pharmacy services. Based on chi-square analysis, use of mail pharmacy services was significantly associated with age, education, race, and region. In addition, distance to nearest pharmacy and the report of the presence of certain disease states were significantly associated with mail pharmacy use (P <0.001). Based on the results of logistic regression analysis, there was a significant association of mail pharmacy use by age, having chronic diseases, level of education, distance to nearest pharmacy, and other included variables (P <0.05). CONCLUSION: Mail pharmacy service users accounted for 17% of the respondents of this study. Advancing age, presence of chronic diseases, increasing level of education, and increasing distance to the nearest pharmacy were positively associated with the use of mail pharmacies. Further research is needed to better understand patient-specific reasons for choosing mail pharmacies or community pharmacies.

The Impact of Information Technology on Patient Engagement and Health Behavior Change: A Systematic Review of the Literature.

BACKGROUND: Advancements in information technology (IT) and its increasingly ubiquitous nature expand the ability to engage patients in the health care process and motivate health behavior change. OBJECTIVE: Our aim was to systematically review the (1) impact of IT platforms used to promote patients' engagement and to effect change in health behaviors and health outcomes, (2) behavior theories or models applied as bases for developing these interventions and their impact on health outcomes, (3) different ways of measuring health outcomes, (4) usability, feasibility, and acceptability of these technologies among patients, and (5) challenges and research directions for implementing IT platforms to meaningfully impact patient engagement and health outcomes. METHODS: PubMed, Web of Science, PsycINFO, and Google Scholar were searched for studies published from 2000 to December 2014. Two reviewers assessed the quality of the included papers, and potentially relevant studies were retrieved and assessed for eligibility based on predetermined inclusion criteria. RESULTS: A total of 170 articles met the inclusion criteria and were reviewed in detail. Overall, 88.8% (151/170) of studies showed positive impact on patient behavior and 82.9% (141/170) reported high levels of improvement in patient engagement. Only 47.1% (80/170) referenced specific behavior theories and only 33.5% (57/170) assessed the usability of IT platforms. The majority of studies used indirect ways to measure health outcomes (65.9%, 112/170). CONCLUSIONS: In general, the review has shown that IT platforms can enhance patient engagement and improve health outcomes. Few studies addressed usability of these interventions, and the reason for not using specific behavior theories remains unclear. Further research is needed to clarify these important questions. In addition, an assessment of these types of interventions should be conducted based on a common framework using a large variety of measurements; these measurements should include those related to motivation for health behavior change, long-standing adherence, expenditure, satisfaction, and health outcomes.

An evaluation of hepatitis C knowledge and correlations with health belief model constructs among African American "baby boomers".

BACKGROUND: Baby boomers (people born between 1945 and 1965) are responsible for three-quarters of Hepatitis C (HCV) infections in the US; however, HCV testing is distinctly underused by them. AIM: To assess the status, predictors, and correlates of HCV knowledge among African-American baby boomers (AABBs) in Washington, DC. METHODS: A cross-sectional survey among persons aged 46-69 was conducted using audio computer-assisted self-interviewing (ACASI). Data on HCV knowledge, socio-demographics, prior history of HCV testing, health-related characteristics, HCV vulnerability and HCV treatment perceptions were collected. Descriptive statistics was used to describe the study population. Pearson correlations were used to examine linear associations between HCV knowledge and Health Belief Model constructs related to HCV. Linear regression analysis was conducted to assess the predictors of knowledge. RESULTS: Out of the 137 participants, about sixty percent (60.6%) were females, mean age 59±6.40; 44.8% had at least a college education. The average knowledge score was low (48.7%). HCV knowledge was significantly correlated with constructs of perceived severity and perceived benefits. Age (ß=-0.10; p=0.003), and level of education (ß=0.93, p=0.027) were significant predictors. CONCLUSIONS: Overall, respondents have a low level of knowledge. The lower level of education and older age were significant predictors of inadequate HCV knowledge. Thus, HCV education among these people may be a vital component in reducing the gaps in HCV knowledge.