Menstrual Products: Attitudes About Taxation and Safety.

Background: This study explored factors associated with the differences between women and men in attitudes, norms, and the support of taxation of menstrual products (MPs) and menstrual-adjacent products. It also investigated the use of these products in women. Methods: Young adults from 18 to 30 years of age were recruited via social media, listserve emails, and flyers placed throughout a university campus. Following cognitive interviewing, a survey investigated attitudes, beliefs, and behaviors associated with MPs. Results: Individuals self-identified as men or women. Women (n = 154) had more positive general attitudes, less positive safety attitudes, and less support for taxation of MPs than men (n = 43). Regression analyses indicated that factors, such as race, age, attitudes, norms, and taxation, were associated with product use. Conclusions: Attitudes about safety and taxation differ for men and women. Tax policies and attitude-shifting interventions need to be tailored to their audience, and our study can inform that effort.

Assessing the impact of the skin cancer awareness now (SCAN!) intervention several months following the intervention.

BACKGROUND: West Virginia (WV) is the third most rural state in the US and has a high incidence of skin cancer. Intervention efforts in WV are impeded by structural barriers, low health literacy, and lack of health care access. Community pharmacies and pharmacists are highly accessible and may be helpful in promoting skin cancer prevention. OBJECTIVE(S): The purpose of the study was to evaluate the impact of the Skin Cancer Awareness Now (SCAN!) pharmacy-based sun-safety intervention at follow-up. METHODS: Surveys assessed SCAN's effect on skin cancer prevention at preintervention and follow-up. The follow-up survey was administered between 8 and 12 months after our initial feasibility study. Questions included demographics, cancer history, cancer worry, knowledge, cancer communication, and skin cancer screening intentions. Multivariate repeated measures ANOVA assessed the change in worry, importance, knowledge, and intentions to be sun safe. RESULTS: Participants (n=56, response rate= 62.2%) had a mean age of 44.7 (standard deviation: 19.3) years. Most were females (87.5%), Whites (92.9%), and 48.2% lived in rural areas. Knowledge and intentions significantly improved over time. At follow-up, participants (41.1%) mentioned that they plan on discussing skin cancer prevention with their pharmacist in the future. CONCLUSION: The SCAN! intervention can be a useful resource for skin cancer prevention in community pharmacy settings. Community pharmacies have the potential to be change agents in skin cancer prevention by providing education on sun protection or detection and by promoting sun-safety behaviors.

Systematic review and meta-analysis of randomized controlled trials of interventions addressing caregiver distress and burden among cancer caregivers.

Objective: Informal caregivers (ICs) are vital to supportive cancer care and assisting cancer patients, but this caregiving burden is associated with significant distress. While addressing caregiving, it is important to explore if the caregivers are receiving care they need. Evaluating interventions that address burden and distress is integral to targeting ICs needs. This study evaluated interventions addressing IC burden and distress. Methods: Randomized control trials (RCT) assessing interventions for IC burden and distress and exploring supportive care as an adjunct to the intervention were included. Six electronic databases were searched in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines through October 2021. Effect sizes were estimated, and risk of bias was assessed. Results: Of 678 studies, 11 were included. Most ICs were spouses, females, and white. Interventions included educational programs, cognitive behavioral treatment, and a telephone support program. Five studies utilized behavioral theories and seven included supportive care. Pooled results showed no significant effect on reducing caregiver distress (ES, -0.26, p<0.001). Conclusions: Caring for the caregiver with interventions for reducing burden and distress are not efficacious. Innovative, well-designed, more pragmatic RCTs are needed. Innovation: This study exclusively focused on interventions and supportive care needs for reducing distress and burden among cancer ICs.

Prevalence and factors associated with diagnosed diabetes mellitus among Asian Indian adults in the United States.

Higher prevalence of diabetes mellitus (DM) has been documented among South Asians living in the United States. However, combining the south Asian subgroups into one category masks the heterogeneity in the diagnosed DM, after controlling for known protective and risk factors. We assessed the association of Asian Indian ethnicity to diagnosed DM using a nationally representative sample of 1,986 Asian Indian adults in the US compared to 109,072 Non-Hispanic Whites (NHWs) using disaggregated data from the National Health Interview Survey (2012-2016) (NHIS). 2010 US census figures were used for age-sex standardization. Age-sex adjusted prevalence of DM was 8.3% in Asian Indians as compared to 5.8% in NHW. In adjusted multivariable logistic regression models, Asian Indians had higher odds ratios of reporting diagnosed DM compared to NHWs (AOR = 1.39, 95% CI: 1.12, 1.71). This association remained strong and significant even after controlling for other risk factors in the model (AOR = 1.47, 95% CI: 1.16, 1.85). Results suggest a favorable socio-economic profile of Asian Indians was not protective on diagnosed DM. In addition, they were more likely to have diagnosed DM due to higher prevalence of obesity despite healthier behaviors of smoking and exercise.

Cost impact of different treatment regimens of brolucizumab in neovascular age-related macular degeneration: A budget impact analysis.

BACKGROUND: Brolucizumab is a new anti-vascular endothelial growth factor (anti-VEGF) approved for treating neovascular age-related macular degeneration (nAMD). Multiple treatment regimens are available for treating nAMD. These regimens include manufacturer-recommended regimens, pro re nata (PRN) regimens, and treat-and-extend (T&E) regimens, which are based on clinical practice guidelines and data observed in the real-world clinical setting, classified as real-world evidence (RWE). Most budget impact models predict the financial consequences of adding a new drug to the formulary based on the manufacturer-recommended regimen. With different anti-VEGF treatment regimens being used in nAMD by ophthalmologists, it is OBJECTIVE: To estimate the budget impact of different treatment regimens of brolucizumab in nAMD from a US payer perspective. METHODS: A Microsoft Excel-based budget impact model was developed for different treatment regimens of brolucizumab over a 1-year time frame from a US payer perspective. A separate analysis was performed to estimate the budget impact from a US patient population perspective. Model inputs included drug costs, administration costs, physician visit costs, and disease monitoring costs. Outcomes in the budget impact model included the cost per member per month, annual health plan cost, and the US patient population-based annual cost. Based on the prevalence of nAMD in public and commercial health plans, a scenario analysis was conducted on the US population to account for the differences in the drug cost to the public and commercial payers. Further, 1-way sensitivity analyses were conducted to test model assumptions and uncertainty in model inputs. RESULTS: The addition of brolucizumab to the formulary increased the net budgetary impact under PRN and T&E regimens. The maximum increase in expenditure for a hypothetical health plan with 1 million enrollees was associated with the PRN regimen ($824,696), followed by the T&E regimen ($163,101). In contrast, using the manufacturer-recommended and RWE regimens led to an annual saving of $93,068 and $94,170 for the health plan, respectively. In the US patient population model, the introduction of brolucizumab resulted in savings in the manufacturer-recommended ($30.99 million) and RWE regimens ($31.35 million) but led to an increase in annual expenditures for the PRN ($274.58 million) and T&E ($54.30 million) regimens. CONCLUSIONS: Payers need to evaluate the cost impact of different treatment regimens of existing and new anti-VEGFs when making formulary decisions in nAMD management. DISCLOSURES: Mr Siddiqui, Ms Dhumal, Dr Patel, and Dr LeMasters have nothing to disclose. Dr Kamal has received research funding from Cerevel Therapeutics, served as a consultant to Pfizer/Cytel Inc, and received honoraria from Pharmacy Times Continuing Education. Dr Almony has served as a consultant to Cardinal Health and received honoraria from Pharmacy Times Continuing Education and Prime Education.

Patient Satisfaction with Substance Use Disorder Rehabilitation Services: a Qualitative Study.

Despite its recognized value, there is a gap in the assessment of patient satisfaction among patients with substance use disorder (SUD) in rehabilitation. The study objective was to determine patient satisfaction dimensions relevant to individuals receiving residential rehabilitation for SUD. Semi-structured interviews were conducted with the following: (1) adult males enrolled in the program and (2) counseling staff involved in the care of these individuals. A literature review formed the basis for interviews, which were audio recorded and transcribed. Text data was analyzed using directed content analysis to identify dimensions relevant to patient satisfaction. Eighteen individuals participated, including 14 men with SUD and four staff. Content analysis of the interview transcripts resulted in five themes: (1) counselor (skill), (2) programmatic structure (adhering), (3) skill development (personal responsibility), (4) comparison to other programs, and (5) case management facilitation. These dimensions will be utilized to create a patient satisfaction tool specific to SUD rehabilitation.

SCAN! A pharmacy-based, sun safety feasibility study.

OBJECTIVES: Skin cancer is the most common form of cancer, and individuals from the medically underserved Appalachian region are at elevated risks for cancer morbidity and mortality. Skin cancer can be prevented by decreasing ultraviolet light exposure (sunscreen sun protection factor 30, shade, clothing, sunglasses, hats) and can be caught at an early treatable stage through a routine skin examination. The Skin Cancer Awareness Now! (SCAN!) pilot project promoted skin cancer prevention and screening in community pharmacies, using a dynamic communication model. The objectives of the study were to understand (1) the feasibility of the SCAN! and (2) the preliminary impact of the SCAN! METHODS: We conducted pre- and postintervention surveys of the SCAN!, a student pharmacist-led or pharmacy resident-led intervention in community pharmacies (n = 3). RESULTS: Participants (n = 90) had a mean age of 43.8 (SD= 18.4) years, were predominantly white (92.1%), without a college degree (65.6%), and had an average family income in the range of $25,000-$49,999, with approximately 16% falling below the poverty level. To begin, the SCAN! scored highly in attention (mean = 5.8), liking (mean = 6.1), comprehension (mean = 6.7), and intentions to be sun safe (mean = 6.0). Most improved in their knowledge of the amount of sunscreen needed per application for sun safety (66%, P < 0.01) and of melanoma features from pre- and postintervention (39%, P < 0.01). A multivariate analysis of variance indicated that knowledge and intentions improved (all P's < 0.01). Interaction effects indicated that improvements in knowledge were greater for those in the rural pharmacy (P = 0.03), and improvements in perceived importance were greater for those in urban pharmacies (P = 0.01). CONCLUSION: The SCAN! intervention was well received by the population. Our study provides evidence that community pharmacy is a novel venue for skin cancer prevention interventions, particularly for rural, medically underserved populations.

Barriers and facilitators to shared decision-making in oncology: a systematic review of the literature.

PURPOSE: Shared decision-making (SDM) is a strategy to facilitate patient-centered care and is increasingly important in oncology, where patients are faced with complicated treatment decisions that require them to weigh efficacy and safety, quality of life, and cost. Understanding the contributors to the use of SDM may provide insight to its further implementation. Therefore, the objective of the study was to examine the patient-related barriers/facilitators to SDM in oncology care. METHODS: A systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was executed. A search strategy composed of cancer, decision-making, and patient-centered terms was conducted utilizing PubMed, EBSCO MEDLINE, Scopus, CINAHL, and the Cochrane Library databases between January 2007 and November 2017. Full-text, US-based, English language articles describing the patient perspective of SDM in oncology care were included. Relevant data from articles were reviewed in a qualitative synthesis. RESULTS: From 3435 potential citations, a total of 35 articles were included. The most common cancers studied were breast (n = 22; 62.9%) and prostate (n = 9; 25.7%). The identified themes for barriers to SDM were uncertainty in the treatment decision, concern regarding adverse effects, and poor physician communication. Themes for facilitators for SDM included physician consideration of patient preferences, positive physician actions and behaviors, and use or encouragement of support systems. CONCLUSION: As SDM gains use within oncology practice, understanding key influences will allow for more effective implementation of strategies to increase patient engagement and improve care and value in the treatment process.