Information seeking during the COVID-19 pandemic: Application of the risk information seeking and processing model.

BACKGROUND: To limit the risk of contracting the coronavirus, it is crucial for individuals to attain accurate COVID-19 related information. Once equipped with such information, they can engage in risk preventive behaviors. OBJECTIVE: Applying the risk information seeking and processing (RISP) model, this study examined the sociopsychological factors predisposing individuals' information-seeking intentions. METHODS: This study employed a cross-sectional survey design. Using an online survey platform, study participants were recruited from US adults. A total of 510 valid responses were included in the analyses. Multivariate regression analyses were conducted in a hierarchical fashion while controlling for numerous covariates to determine the relationships between the sociopsychological variables and information-seeking intentions. RESULTS: Sociodemographic disparities were found in perceptions of COVID-19 risk. Perceived risk of coronavirus infection was higher among females, individuals with a history of COVID-19 symptoms, and those in a lower health status. Individuals' perceived risk provoked affective responses (e.g., worry and fear), which then increased self-perceived information insufficiency. This finding indicated individuals experienced worry and fear after perceiving the risk of coronavirus. Such affective responses made them realize that their current COVID-19 related knowledge was insufficient. Subjective norms were also found to increase information insufficiency. In other words, individuals who desired to comply with others' expectations to acquire knowledge about the risk recognized that their current knowledge about coronavirus was insufficient. Finally, individuals who acknowledged information insufficiency were motivated to seek information about the coronavirus. The relation between information insufficiency and information-seeking intentions was moderated by perceived information gathering capacity, but not by relevant channel beliefs. CONCLUSIONS: The findings suggest that policy makers and clinicians assist the public in obtaining accurate information from reliable sources.

Digital Health Interventions by Clinical Pharmacists: A Systematic Review.

Integrating digital interventions in healthcare has gained increasing popularity among clinical pharmacists (CPs) due to advances in technology. The purpose of this study was to systematically review CP-led digital interventions to improve patients' health-related clinical outcomes. PubMed and the Cochrane Database were searched to select studies that had conducted a randomized controlled trial to evaluate clinical outcomes in adults following a CP-led digital intervention for the period from January 2005 to August 2021. A total of 19 studies were included in our analysis. In these 19 studies, the most commonly used digital intervention by CPs was telephone use (n = 15), followed by a web-based tool (n = 2) and a mobile app (n = 2). These interventions were provided to serve a wide range of purposes in patients' outcomes: change in lab values (e.g., blood pressure, HbA1c) (n = 23), reduction in health service use (n = 8), enhancing adherence (n = 6), improvement in drug-related outcomes (n = 6), increase in survival (n = 3), and reduction in health-related risk (e.g., CVD risk) (n = 2). Although the impacts of telephone-based interventions on patients' outcomes were decidedly mixed, web-based interventions and mobile apps exerted generally positive influences. To date, little research has investigated the cost-effectiveness of digital interventions. Future studies are warranted.

Content Analysis of 2012-2019 FDA Warning Letters and Notices of Violations using the Economic, Clinical, and Humanistic Outcomes (ECHO) Model.

OBJECTIVE: The study purpose was to critically review FDA-issued warning letters (WLs) and notice of violation (NOV) letters against drug companies' from 2012-2019 for economic, clinical, and humanistic (ECHO) claims made in pharmaceutical promotional materials. Specific objectives were to assess the, (1) number of WLs and NOV issued; (2) frequency of WLs and NOV by therapeutic areas; (3) type of communication media cited in WLs or NOV; (4) intended audience for the claims in promotional materials for which the WLs and NOV were issued; and (5) number of WLs and NOV for ECHO claims. METHODS: The quantitative content analysis approach was employed to review WLs and NOVs, obtained from the FDA website, from January 2012-December 2019. A data abstraction form was created based on the published literature on this topic and assessment of the content of WLs and NOVs for 2010. This form was pilot tested on letters issued in 2011. The researchers discussed any unclear question or information presented in the letters. The letters were reviewed three researchers. If there was disagreement between the reviewers, either a fourth reviewer arbitrated on the disagreement or the letter(s) were discussed by the researchers to determine a final classification. ICD-10 codes were used for therapeutic categories in the data collected form. Descriptive statistics, Kappa statistics for interrater reliability, and Cochrane-Armitage test were performed using IBM SPSS Statistics version 24.0. RESULTS: A total of 102 letters were analyzed. Of these, 19 (19%) were WLs and 83 (81%) were NOVs. Majority of these letters were issued to manufacturers of therapeutic agents for diseases of the nervous system (n=15; 14.7%) and neoplasms (n=15; 14.7%). The most commonly cited media for violation was online website (n=29; 27.1%). Out of the 153 violations in 102 letters, 92 (60.1%) were clinical; 13 (8.5%) humanistic; 2 (1.3%) were economic; and 46 (30%) were categorized as 'Others'. CONCLUSION: The study found misleading claims of the clinical effectiveness and risk information included in the promotional materials targeted to consumers as well as healthcare providers. Promoting reliable, evidence-based information is important for the health of the public as inadequate information could lead to irrational decision making both on consumer as well as on prescriber side.

Using the Theory of Planned Behavior to Understand Factors Influencing South Asian Consumers' Intention to Seek Pharmacist-Provided Medication Therapy Management Services.

The study purpose was to use the theory of planned behavior to understand factors influencing South Asian consumers' intention to seek pharmacist-provided medication therapy management services (MTMS). Specific objectives were to assess effects of attitude, subjective norm (SN), perceived behavioral control (PBC), and socio-demographics on South Asian consumers' intention to seek MTMS. Participants who were ≥18 years of age, of South Asian origin, with a previous visit to a pharmacy in the US for a health-related reason, and with ability to read and comprehend English were recruited from independent pharmacies in New York City. Responses were obtained through a self-administered survey. Descriptive statistics were performed, and multiple linear regression analysis was conducted to assess the study objective. SPSS was used for data analyses. Out of 140 responses, 133 were usable. Mean scores (standard deviation) were 4.04 (0.97) for attitude, 3.77 (0.91) for SN, 3.75 (0.93) for PBC, and 3.96 (0.94) for intention. The model explains 80.8% of variance and is a significant predictor of intention, F (14,118) = 35.488, p < 0.05. While attitude (ß = 0.723, p < 0.05) and PBC (ß = 0.148, p < 0.05) were significant predictors of intention, SN (ß = 0.064, p = 0.395) was not. None of the socio-demographics were significant predictors of intention. Strategies to make South Asians seek MTMS should focus on creating positive attitudes and removing barriers in seeking MTMS.

Fondaparinux Sodium Compared With Low-Molecular-Weight Heparins for Perioperative Surgical Thromboprophylaxis: A Systematic Review and Meta-analysis.

Background Fondaparinux sodium has been compared with low-molecular-weight heparins ( LMWH ) in randomized controlled trials for perioperative surgical thromboprophylaxis. However, the results from these studies are inconsistent in terms of efficacy and safety to reach a clinical decision. The objective of this study was to systematically review the randomized controlled trials comparing the efficacy and safety of fondaparinux and LMWH for perioperative surgical thromboprophylaxis. Methods and Results Systematic search in various databases was done to identify randomized controlled trials comparing fondaparinux and LMWH published during the years 2000 to 2017. Outcomes of interest in this study included venous thromboembolism up to day 15, all-cause mortality up to day 90, major bleeding, and minor bleeding during the treatment period. Analyses were performed with the relative odds based on a random-effects model using Mantel-Haenszel statistics. Results were presented as odds ratios with their 95% CIs. The assessment of study quality was performed as per Cochrane collaboration. After screening 10 644 articles, 12 randomized controlled trials including 14 906 patients were included in the final analyses. Pooled analyses showed the odds of venous thromboembolism in the fondaparinux group were 0.49 times the odds in LMWH group ( OR =0.49 [0.38-0.64]). However, the odds of major bleeding in the fondaparinux group were 1.48 times the odds in the LMWH group ( OR =1.48 [1.15-1.90]). Conclusions Fondaparinux was associated with a superior efficacy in terms of reduction of venous thromboembolism in this meta-analysis. However, it was also associated with increased odds of major bleeding.

Trends and Disparities in Quality of Diabetes Care in the US: The National Health and Nutrition Examination Survey, 1999-2016.

Objectives: To examine trends and disparities in the quality of diabetes care among US adults with diabetes. Methods: Individuals aged 20 years or older with diabetes from NHANES (1999-2016) were included in the study. Quality indicators for diabetes care included Hemoglobin A1c (HbA1c) < 8%, Blood Pressure (BP) < 130/80 mm Hg, Low-Density Lipoprotein (LDL-C) < 100 mg/dL, triglycerides < 150 mg/dL, receiving eye and foot examinations in the past year, and meeting with a diabetes educator in the past year. Results: A total of 7,521 adults with diabetes were identified. During the 18-year study period, significant improvements in diabetes care were observed in the overall study sample. Adjusted regression analyses showed that compared with their White counterparts, Blacks were more likely to have received eye (OR=1.37; P=0.01) and foot (OR=1.42;P=0.01) examinations and met a diabetes educator (OR=1.40;P<0.01) over the past year. However, Blacks were significantly less likely to achieve treatment goals for HbA1c (OR=0.77, P=0.02), BP (OR=0.75, P<0.01), LDL-C (OR=0.68, P<0.01). Hispanics in general had suboptimal healthcare utilization for diabetes but the Hispanic-white disparities in diabetes care outcomes were attenuated after controlling for patient sociodemographic, clinical and utilization characteristics. Overall, suboptimal quality of diabetes care were particularly prominent among adults without health insurance and those with lower educational attainment. Conclusions: In the United States, despite persistent efforts, racial disparities in quality of diabetes care still persist. Lack of health insurance and lower socioeconomic status are among the strongest predictors of poor quality of diabetes care. These findings provide valuable information in developing policies and practices to promote racial equity in diabetes care.

Use of a Comic Book to Assist Pharmacy Student Learning of the Affordable Care Act (ACA).

PURPOSE: To assess the pedagogical effectiveness of a comic book in pharmacy student learning of the Affordable Care Act (ACA). METHODS: Comparative-group, matched pre-posttest survey design was used to measure pharmacy students' comprehension of ACA. PharmD students (P-1year) from two sections of a Pharmacy and US Healthcare course participated in this study. Treatment group students received a comic book on ACA. The comparison group received the textual information, without pictures, from the book in a typed document. A posttest survey was administered later in the semester, before the instructor discussed ACA in class. Fourteen questions, developed from the information in the book and document, assessed pharmacy students' comprehension of ACA. Response options included a visual analogue scale. Independent sample t-test was used to assess the differences in the mean pre-posttest scores between the two groups. RESULTS: A total of 103 (n = 49 comparison vs. n = 54 treatment group) students completed the survey. No statistically significant differences were found in the pre-test mean scores between the groups. Differences in the pre-post test mean scores of treatment group were significantly higher than the differences in the mean scores of the comparison group. Students agreed that the comic book format gave them a better understanding of ACA and increased their interest in learning more about the Act. CONCLUSION: Comic books were found to be effective in student learning of the ACA. The positive response from students highlight the point that pharmacy faculty could use comic books as supplemental reading in pharmacy courses.

Comics as a Medium for Providing Information on Adult Immunizations.

This study compared the following effects of two vaccine information flyers-one developed by the Centers for Disease Control and Prevention (CDC) versus one adapted from this information to a comic medium (comic)-on adults: (a) attitude toward the flyer; (b) perceived informativeness of the flyer; (c) intention to seek more information about adult immunizations after viewing the flyer; and (d) intention to get immunized after viewing the flyer. A between-group, randomized trial was used to randomly assign adults (age 18 years or older) at an ambulatory care center to review the CDC or comic flyer. Participants were asked to complete a survey to measure several outcome variables. Items were measured using a 7-point semantic differential scale. Independent-samples t-test was used for comparisons. A total of 265 surveys (CDC n = 132 vs comic n = 133) were analyzed. The comic flyer had a statistically significant effect on participants' attitudes and their perception of the flyer's informativeness compared to the CDC flyer. Flyer type did not have a statistically significant effect on intention-related variables. The study findings showed that the comic flyer was positively evaluated compared to the CDC flyer. These findings could provide a new direction for developing adult educational materials.

Effects of anthropomorphic images and narration styles in promotional messages for generic prescription drugs.

BACKGROUND: Anthropomorphism is attribution of human characteristics to nonhuman objects or events. Marketers have used anthropomorphized characters to promote products and services. To promote use of generic drugs to save on prescription drug costs, health systems are in the process of developing informational materials to influence consumer's perceptions about generic prescription drugs. OBJECTIVES: To evaluate the effects of anthropomorphic images (control vs caring vs authoritative) and information narration styles (first person vs third person) on (1) social presence, (2) attitude toward the overall promotional message, (3) perceived informativeness of the message content, (4) attitude toward specific message, (5) intent to seek information, and (6) intention to switch to a generic prescription drug. METHODS: A 3×2 between-subject factorial design was used. Student participants were administered a mock promotional message regarding generic prescription drugs. Following the promotional message, they were asked to respond to items developed to measure the effects of the promotional message. Manipulation checks were conducted to test the desired effects of the independent variables. Pilot testing, exploratory factor analysis, and reliability testing of the item measures were conducted before their use in the study. Analysis of variance was used to analyze the data and test the proposed effects of the independent variables. RESULTS: Anthropomorphic images showed a positive effect on social presence and attitude toward the specific message. Narration styles had a positive effect on attitude toward the overall promotional message. Neither anthropomorphic images nor narration styles had a significant effect on perceived informativeness, intent to seek information, and intention to switch to a generic prescription drug. CONCLUSIONS: This research reveals that anthropomorphism of medications and narration styles could play a significant role in promotional messages for generic prescription drugs. These findings provide a new direction in developing educational materials for information about generic prescription drugs.

Cultural competence knowledge and confidence after classroom activities.

OBJECTIVES: To determine change in cultural competency knowledge and perceived confidence of second-year pharmacy students to deliver culturally competent care after completing a required cultural competency curriculum. DESIGN: Cultural competence material was covered in the second-year PharmD curriculum through lectures, laboratories, and an experiential/out-of-class assignment. ASSESSMENT: Eighty-five second-year (P2) pharmacy students completed a survey which assessed influence of classroom activities related to cultural competence. Mean values for knowledge and perceived confidence were significantly higher for posttest compared to pretest (p < 0.01), after cultural competency activities. Focus groups were used to solicit students' opinions on instructional effectiveness, relevance of activities, and areas for enhancement. CONCLUSION: The cultural competency curriculum increased pharmacy students' awareness of and confidence in addressing cultural diversity issues that affect pharmaceutical care delivery.

Vaccine supply, demand, and policy: a primer.

OBJECTIVE: To provide an overview of supply and demand issues in the vaccine industry and the policy options that have been implemented to resolve these issues. DATA SOURCES: Medline, Policy File, and International Pharmaceutical Abstracts were searched to locate academic journal articles. Other sources reviewed included texts on the topics of vaccine history and policy, government agency reports, and reports from independent think tanks. Keywords included vaccines, immunizations, supply, demand, and policy. STUDY SELECTION: Search criteria were limited to English language and human studies. Articles pertaining to vaccine demand, supply, and public policy were selected and reviewed for inclusion. DATA EXTRACTION: By the authors. DATA SYNTHESIS: Vaccines are biologic medications, therefore making their development and production more difficult and costly compared with "small-molecule" drugs. Research and development costs for vaccines can exceed $800 million, and development may require 10 years or more. Strict manufacturing regulations and facility upgrades add to these costs. Policy options to increase and stabilize the supply of vaccines include those aimed at increasing supply, such as government subsidies for basic vaccine research, liability protection for manufacturers, and fast-track approval for new vaccines. Options to increase vaccine demand include advance purchase commitments, government stockpiles, and government financing for select populations. CONCLUSION: High development costs and multiple barriers to entry have led to a decline in the number of vaccine manufacturers. Although a number of vaccine policies have met with mixed success in increasing the supply of and demand for vaccines, a variety of concerns remain, including developing vaccines for complex pathogens and increasing immunization rates with available vaccines. New policy innovations such as advance market commitments and Medicare Part D vaccine coverage have been implemented and may aid in resolving some of the problems in the vaccine industry.