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1.
Medicine (Baltimore) ; 98(40): e17375, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577741

RESUMO

Achieving abstinence in schizophrenic smokers using a combination of medications and cognitive behavioral therapy is feasible; however, abstinence rates are significantly lower compared to the general population and studies are scanty. Additionally, maintaining sustained abstinence and preventing relapse is a major limiting factor and represents key tasks in managing tobacco dependence in schizophrenic patients. Several theories have been postulated to explain the higher tendency of tobacco use among schizophrenic individuals. Schizophrenic patients may use nicotine as a "self-medication" strategy to improve negative symptoms of schizophrenia. However, studies suggest that although nicotine may act as an anxiolytic acutely, chronic use of nicotine may lead to increased anxiety with the possibility of increased catecholamines, which is confirmed with the prevalence of tachycardia and hypertension in smokers in general. On this basis, the main objective of our present study was to assess anxiety in schizophrenic smoking and nonsmoking patients by comparing the number of anxiety and agitation episodes and evaluating the amount of antianxiety/antiagitation medication used by each group. A separate objective was to document the unmet needs of smoking cessation programs in treating schizophrenic patients. Consequently, in the present retrospective cohort study, it was observed that schizophrenic smokers tend to have higher anxiety episodes and utilize as-needed medications at a higher frequency compared to nonsmokers for the relief of anxiety and agitation symptoms. Further research is warranted to examine these results on a larger scale.


Assuntos
Ansiedade/epidemiologia , Fumar Cigarros/epidemiologia , Esquizofrenia/epidemiologia , Ansiolíticos/uso terapêutico , Antipsicóticos/uso terapêutico , Ansiedade/tratamento farmacológico , Feminino , Humanos , Masculino , Estudos Retrospectivos , Esquizofrenia/tratamento farmacológico , Fumantes , Abandono do Hábito de Fumar/métodos
2.
Thromb Res ; 182: 110-115, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31476484

RESUMO

INTRODUCTION: Cancer patients are prone to higher risk of venous thromboembolism (VTE) compared to the general population. However, the estimated incidence of cancer-associated VTE varied among the studies. The primary objective of this study was to determine the national annual incidence and examine the trend of cancer-associated VTE in the US over the years from 2005 to 2014. METHODS: A retrospective population based study was conducted using data from the Medical Expenditure Panel Survey. The study included all noninstitutionalized US adults aged ≥18 years who had a final person-weight > 0 to be representative of the national population. Simple linear regression (SLR) and Mann-Kendall (MK) tests were used to examine the trend of cancer-associated VTE over the years. RESULTS: On average, there were 15,570,000 adult persons living with a cancer condition every year. Female represented 53.8% of the study population, and the mean of age was 63.5 years. The overall annual incidence of cancer-associated VTE varied between 1.80 and 0.72% over the years, with an overall average of 1.18%. The study found a non-significant downward trend in the incidence of cancer-associated VTE over the years. Patients who had cancer-associated VTE were significantly older than patients without VTE (mean 68.64 vs. 62.68 years, p < .0001). CONCLUSION: The study found cancer patients continued to have the risk of VTE over the years. The non-significant downward trend in cancer-associated VTE suggests that health care practitioners are heading in the right direction, but enhanced preventative care is needed to avoid further incidents of cancer-associated VTE.

3.
Am J Pharm Educ ; 83(4): 7215, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31223162

RESUMO

Schools and colleges of pharmacy in the United States increasingly interact with those in Asian countries for various purposes such as education and research. For both those visiting and those hosting, it is important to understand and respect the culture of the other's country to enrich these interactions. This paper, the second of two manuscripts on Asian countries, focuses on India, Indonesia, Malaysia, Philippines, and Vietnam. For each country, the following information is provided: general introduction, health care system, pharmacy practice, and pharmacy education, stereotypes and misconceptions, recommendations for US-based health care professionals, faculty members, and students who visit these Asian countries, and recommendations for them to host visitors from these Asian countries. The aim of this paper is to assist US health care professionals, faculty members, and students in initiating and promoting a culturally sensitive engagement.

4.
Am J Pharm Educ ; 83(4): 7220, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31223165

RESUMO

Objective. To provide a resource for schools and colleges of pharmacy in different regions of the world that are considering sending their students and faculty members to the United States for training. Methods. A literature review (2000-2018) was conducted that involved database and Internet searches using specific keywords and terms. Information was also solicited from authors in different regions of the United States who have hosted international students and faculty members. Recommendations for pharmacists and other health care practitioners on culturally sensitive engagement were formulated. Results. Global engagement between schools and colleges of pharmacy from different regions of the world and the United States is increasing. In addition to various cultural aspects, general information about the US health care system, pharmacy education programs, and pharmacy practice were found to be available to individuals who are charged with organizing and facilitating these exchanges. Common stereotypes and misconceptions about the United States were also identified. Conclusion. For international learners to have an enriching and fruitful engagement while in the United States, an understanding of American culture in general as well as the unique cultural aspects of different regions of the country as provided in this paper is critical.

5.
Am J Pharm Educ ; 83(4): 7228, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31223168

RESUMO

Objective. To create a resource on cultural sensitivity for schools and colleges of pharmacy that are currently engaged or considering future outreach opportunities in the Arab world. Methods. A literature review (2000-2018) of databases and Internet searches with specific keywords and terms were conducted. Authors who had experience in travelling to and hosting students and professionals from the Arab world and authors with local work experience in the Arab world were solicited. Results. General information about the Arab world, including unique aspects of individual countries, is presented. Stereotypes and misconceptions regarding the region and the people are discussed. Specific information about the government and infrastructure of each country, including their health care system is provided, with emphasis given to pharmacy education and practice in the region. In addition, recommendations for culturally sensitive engagement for pharmacy and other health care practitioners are discussed. Finally, recommendations for culturally sensitive engagement when hosting students and/or faculty members from the Arab world are also addressed. Conclusion. Global engagement between schools and colleges of pharmacy in the United States and those in the Arab world is increasing. For an enriching and fruitful engagement, sensitivity toward the cultural and clinical needs of the people, and in particular, the professionals of that region is critical.

6.
Curr Pharm Teach Learn ; 11(5): 476-484, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31171249

RESUMO

INTRODUCTION: This study was designed to assess the depth, breadth, and perception of pharmacogenomics education in pharmacy curricula in the United States (US). METHODS: A modified, online questionnaire from previous studies was sent to all accredited US schools and colleges of pharmacy. The survey covered three distinct areas related to the schools' educational environments, the depth and the extent of pharmacogenomics core competencies and topics taught, and the institutions' perceptions of the importance of pharmacogenomics in the curriculum and future plans for expanded pharmacogenomics education. Multiple approaches were used to increase the response rate, and results were analyzed using descriptive statistics. RESULTS: Of the 133 eligible programs, 32 participated in the survey. Six invalid surveys were excluded from our study, resulting in a 19.6% response rate. Results revealed that all responding schools included pharmacogenomics in the curriculum. Interestingly, 76.9% of the respondents believed pharmacists do not have the appropriate knowledge of pharmacogenomics. However, only 30.7% indicated that their programs planned to expand pharmacogenomics in their curriculum. CONCLUSIONS: The responding schools all included some pharmacogenomics in their curriculum. However, the depth and the extent of pharmacogenomics topics covered varied. Respondents perceived that pharmacists today do not possess the appropriate level of pharmacogenomics knowledge. Despite this, there is limited emphasis on expanding pharmacogenomics instruction in the responding schools' curriculums.

7.
J Interprof Care ; 32(1): 118-122, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28972421

RESUMO

The American Diabetes Association announced in 2012 that 86 million Americans were diagnosed with prediabetes compared to 79 million in 2010. Prediabetes + Me (PreDiaMe) is an innovative educational programme developed by pharmacy students at Nova Southeastern University College of Pharmacy, which provides collaborative interprofessional care for patients with prediabetes. A literature review using EBSCOhost, EMBASE, and MEDLINE databases searching the terms education, health services, interprofessional team, and prediabetes was conducted. Human studies published in English between 2006 and 2016 were included. Investigators interviewed a community pharmacist and a consultant pharmacist certified in diabetes education. Based on these interviews and the literature found, PreDiaMe was created to unite healthcare professionals through a three-step community outreach programme. The goal of PreDiaMe is to identify patients at risk of prediabetes, to decrease the prevalence of type 2 diabetes mellitus (T2DM), to reduce healthcare costs, and to improve the quality of life for patients with prediabetes. PreDiaMe benefits patients with prediabetes, the healthcare system, and pedagogy as it aims to decrease in the prevalence and economic burden and increase health outcomes of patients with prediabetes while being used as a tool to provide integrative education in health professional programmes.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/terapia , Educação de Pacientes como Assunto/organização & administração , Estudantes de Farmácia , Idoso , Comportamento Cooperativo , Feminino , Humanos , Relações Interprofissionais , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Projetos Piloto , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/terapia , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida
8.
J Pain Palliat Care Pharmacother ; 32(4): 216-225, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31070496

RESUMO

The use of cannabis medications has grown in recent years for the symptomatic relief of chemotherapy-induced nausea/vomiting (CINV) and chronic pain (cancer-related and non-cancer-related). As states legalize the use of cannabis, it is important for pharmacists and other health care professionals to be aware of how to counsel patients receiving prescriptions for cannabis medications. The aim of this study was to develop patient counseling guidelines for the use of cannabis products in treatment of CINV and chronic pain. A literature search was performed using Medline/PubMed resources and Google Scholar between July 2015 and August 2018 using broad search terms, e.g., cannabinoids adverse effects, cannabis, natural cannabinoids, and tetrahydrocannabinol. Using the American Society of Health-System Pharmacists patient counseling guidelines and medical information on cannabis medications gathered from drug databases, a comprehensive counseling guideline was developed. Medical evidence of the use of natural cannabis medications that are smoked or orally ingested have not been studied as extensively as oral therapeutic agents currently available. Cannabis medications have become more prevalent by approval of legislators in several states. Hence, pharmacists and health care professionals should counsel patients effectively on its use. This guideline needs to be tested to assess its utility in patients.


Assuntos
Antineoplásicos/efeitos adversos , Dor Crônica/tratamento farmacológico , Aconselhamento/normas , Maconha Medicinal/uso terapêutico , Náusea/tratamento farmacológico , Educação de Pacientes como Assunto/normas , Vômito/tratamento farmacológico , Antineoplásicos/administração & dosagem , Aconselhamento/métodos , Humanos , Maconha Medicinal/efeitos adversos , Maconha Medicinal/farmacocinética , Maconha Medicinal/farmacologia , Neoplasias/tratamento farmacológico , Educação de Pacientes como Assunto/métodos
9.
Health Mark Q ; 32(4): 382-93, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26569378

RESUMO

CVS Health has taken a strategic marketing move by banning tobacco sales. They risk losing customers who buy medications and cigarettes at their drugstores. They estimate they will lose 2 billion dollars by banning cigarette sales. CVS Health believes they will benefit from being regarded as health care partner by insurers and banning cigarette sales is an important step in being recognized as such. The Affordable Care Act expanded access to pharmacy-based medical clinics, increased affordability of medications, and expanded the clinical role of pharmacists. CVS Health is positioning itself to take advantage of these changes.


Assuntos
Comércio/economia , Marketing/economia , Farmácias/economia , Tabaco , Pessoal de Saúde/psicologia , Promoção da Saúde , Humanos , Marketing/métodos , Prevenção do Hábito de Fumar , Estados Unidos
10.
J Pharm Pract ; 26(4): 442-7, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23184409

RESUMO

The white coat has symbolized professionalism, while representing provider-patient fiduciary relationship. Although well described in the literature for physicians, few studies examine the impact of pharmacist attire on patients' opinions regarding professionalism and trust. Therefore, understanding patient perceptions regarding pharmacist's attire and its influence on comfort, confidence, trust, and professionalism may provide guidance on ways to enhance the quality of the provider-patient relationship. A 43-item Likert-type questionnaire was administered to 347 adults in a community pharmacy setting to determine preferences about the pharmacist's attire, accessories, and body art incorporating 8 photographs depicting a male pharmacist in various degrees of dress formality (ie, casual to professional). Descriptive and inferential statistics were used to summarize and analyze the data. Survey respondents reported it was desirable/strongly desirable that pharmacists be dressed in a shirt and tie, dress shoes, white coat, and name tag (mean 4.21-4.72), whereas they should not be dressed in jeans, casual shoes, or have visible body art (mean 2.17-2.78). Over 86% of the respondents felt that a pharmacist with a white coat instilled feelings of comfort, confidence, trust, and professionalism. In a community pharmacy setting, a pharmacist wearing a white coat appears to be the mainstay in displaying professionalism and inspiring trust in adult patients.


Assuntos
Atitude , Vestuário , Serviços Comunitários de Farmácia , Farmacêuticos , Adulto , Humanos , Confiança
11.
Health Mark Q ; 28(3): 270-85, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21815743

RESUMO

Since their founding in 2000, retail-based health care clinics, also called convenient care clinics, have flourished but continue to generate controversy. This article examines the literature with respect to the industry's background, establishment of industry standards, types of services offered, marketing of retail health clinics, industry growth with new target markets, and patient demographics. It also examines the growing relationship with insurers and third-party payers, quality-of-care concerns by medical associations, and legal regulations and their potential impact on industry growth nationwide.


Assuntos
Instituições de Assistência Ambulatorial , Instituições de Assistência Ambulatorial/legislação & jurisprudência , Instituições de Assistência Ambulatorial/organização & administração , Instituições de Assistência Ambulatorial/normas , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Comércio/organização & administração , Acesso aos Serviços de Saúde , Humanos , Licenciamento/legislação & jurisprudência , Marketing de Serviços de Saúde , Satisfação do Paciente , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Qualidade da Assistência à Saúde , Estados Unidos
12.
Int J Electron Healthc ; 6(1): 34-46, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21406350

RESUMO

E-prescribing may help reduce medical errors. Study objectives were to determine use, perceptions, and a model of adoption regarding e-prescribing. A questionnaire was developed and sent to pharmacists in Puerto Rico. Multiple regression analyses were used to test a model of influences on adoption. 438 pharmacists responded. The overall adoption model was significant. Perceived advantages had a positive influence on adoption. Pharmacist groups demonstrating higher adoption included: male > female, chain > independent, younger > older (all p < 0.05). Barriers had a negative influence (p = 0.01). The model employed here can help explain pharmacist adoption and integration of e-prescribing.


Assuntos
Atitude do Pessoal de Saúde , Serviços Comunitários de Farmácia , Prescrição Eletrônica , Farmacêuticos/psicologia , Adulto , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Porto Rico , Papel (figurativo) , Inquéritos e Questionários
13.
J Health Commun ; 14(5): 451-60, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19657925

RESUMO

A 68-question Internet survey was used to determine the impact of televised direct-to-consumer advertising (DTCA) on consumer-initiated medication changes for the treatment of gastroesophageal reflux disease (GERD) and social anxiety disorder (SAD). Of the 427 respondents, 10% that viewed DTCA for GERD and 6% that viewed DTCA for SAD reported that they subsequently initiated a conversation with their physician. Nearly half of respondents, 47.4% for GERD and 40% for SAD, reported that a change in therapy occurred as a direct result of these discussions. Televised DTCA for these two drug classes can have a significant impact on patient-initiated prescription requests.


Assuntos
Ansiolíticos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Refluxo Gastroesofágico/tratamento farmacológico , Satisfação do Paciente/estatística & dados numéricos , Inibidores da Bomba de Prótons/uso terapêutico , Adolescente , Adulto , Idoso , Antiulcerosos/uso terapêutico , Feminino , Florida , Comportamentos Relacionados com a Saúde , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Inquéritos e Questionários , Televisão/estatística & dados numéricos , Estados Unidos , Adulto Jovem
14.
Health Mark Q ; 26(2): 98-116, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19408179

RESUMO

Electronic detailing (e-detailing) has been introduced in the last few years by the pharmaceutical industry as a new communication channel through which to promote pharmaceutical products to physicians. E-detailing involves using digital technology, such as Internet, video conferencing, and interactive voice response, by which drug companies target their marketing efforts toward specific physicians with pinpoint accuracy. A mail survey of 671 Iowa physicians was used to gather information about the physician characteristics and practice setting characteristics of those who are usually targeted by pharmaceutical companies to participate in e-detailing. A model is developed and tested to explain firms' targeting strategy for targeting physicians for e-detailing.


Assuntos
Indústria Farmacêutica , Internet , Marketing/métodos , Médicos , Coleta de Dados , Feminino , Metas , Humanos , Iowa , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Estados Unidos
15.
Health Mark Q ; 26(1): 42-55, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19197587

RESUMO

The pharmaceutical industry spends billions of dollars annually on direct-to-consumer advertising (DTCA). Patient perspectives on the impact of televised DTCA on health-related behaviors and issues were assessed by means of a 68-question survey. 58.6% of respondents believed that DTCA allowed consumers to have a more active role in managing their health. However, 27.6% felt DTCA caused confusion, and an alarming 17.8% of respondents stopped taking their medication because of concerns about serious side effects mentioned in DTCA. Overall, participants believed DTCA plays a useful role in health self-management; however, a considerable percentage thought that the cost outweighs the benefits.


Assuntos
/métodos , Participação da Comunidade , Comportamentos Relacionados com a Saúde , Adolescente , Adulto , Indústria Farmacêutica , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Autocuidado , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
16.
J Hosp Mark Public Relations ; 19(1): 2-14, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19197653

RESUMO

Pharmaceutical sales representatives (PSRs) can impact physician prescribing. The objective of this study was to test a model of physician and practice setting characteristics as influences on decisions by physicians to see PSRs. A survey was sent to a random sample of 2000 physicians. Multiple linear regression analyses were used to test models for predicting influences on decisions to see PSRs frequently, defined as at least monthly. Independent variables included: presence of restrictive policy for pharmaceutical detailing, volume of prescriptions, gender, age, type of specialty, academic affiliation, practice setting size, and urban versus rural. The dependent variable was frequency of PSRs visits to physicians. Six hundred seventy-one responses were received yielding a response rate of 34.7%. Four hundred thirty-two physicians (79.5%) reported seeing PSRs at least monthly. The decision influence model was found to be significant. Primary care physicians and high-volume prescribers showed increased likelihood to see PSRs. Physicians practicing in settings that were small, urban, without restrictive policies for pharmaceutical detailing, and not academically affiliated were more likely to see PSRs frequently. This model of physician and practice characteristics is useful in explaining the variations in physicians' characteristics who see PSRs frequently. These characteristics could be used to guide the development of future academic or counter-detailing initiatives to improve evidence-based prescribing.


Assuntos
Comércio , Indústria Farmacêutica , Relações Interinstitucionais , Médicos , Coleta de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
J Clin Nurs ; 18(2): 228-33, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19120751

RESUMO

AIMS AND OBJECTIVES: The aim of our study was to investigate the perceptions of pharmaceutical sales representatives by nurse prescribers. BACKGROUND: Nurses with advanced training have earned prescriptive authority in North America, Europe and other parts of the world. These nurses are being increasingly targeted by pharmaceutical sales representatives. There is a paucity of data regarding nurses' perceptions of pharmaceutical sales representatives. DESIGN: Survey. METHODS: A convenience sample of nurse prescribers was recruited to complete an Internet questionnaire about their interactions with and perceptions of sales representatives. The data were collected over one month ending in January 2007. There were 39 survey items ranging from perception-based items assessed by Likert-type scale to open-ended queries. Descriptive statistics were used to summarise the results. RESULTS: Ninety-two nurses completed this survey, which demonstrated good internal consistency yielding a Cronbach's alpha coefficient of 0.83. Positive perceptions of pharmaceutical representatives included: explaining their products clearly (80.4%) and knowledge about their medications (88.0%). Negative aspects included: lack of consideration of nurses' time (50%) and failure to equally discuss medication strengths and weaknesses (21.8%). Perhaps the most alarming finding was that 35.9% of respondents indicated that sales representatives suggested paybacks for promoting their drugs. CONCLUSIONS: Nurses with prescriptive authority generally perceive interactions with pharmaceutical sales representatives as positive. However, they also have concerns about the nature and methods of some of their activities. Nations that have nurses with prescribing authority can benefit from observing both the mis-steps and the positive inroads that have already been made by the profession in the USA and other countries. RELEVANCE TO CLINICAL PRACTICE: Appropriate use of pharmaceutical sales representatives' services may enhance the ability of nurse prescribers to deliver optimal nursing care. Methods, such as counter-detailing may be necessary to maintain an evidence-based approach as the controlling factor.


Assuntos
Indústria Farmacêutica , Prescrições de Medicamentos , Marketing de Serviços de Saúde , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
18.
Am J Health Syst Pharm ; 65(16): 1539-44, 2008 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-18693209

RESUMO

PURPOSE: Pharmacy-focused journals that are available in open-access (OA), freely accessible, hybrid, or traditional formats were identified. METHODS: Relevant journals were accessed from PubMed, International Pharmaceutical Abstracts, EMBASE, and the Pharmacology and Pharmacy category of Thomson Scientific Journal Citation Reports. Criteria were established to select journals that satisfied the definition of pharmacy focused. Journals were assessed based on accessibility, copyright transfer requirements, and restrictions. If tracked, the journal's impact factor (IF) was identified according to classification, and medians were calculated for each journal category. RESULTS: A total of 317 pharmacy-focused journals were identified. The majority of pharmacy-focused journals identified were traditional/non-OA (n = 240). A smaller number of journals were freely accessible/ non-OA (n = 37), freely accessible/non-OA with content restrictions (n = 20), or freely available/non-OA with date restrictions (n = 18). The fewest number of journals were completely OA (n = 2). The median IF for the 185 journals whose IF was tracked was 2.029. The median IF for freely accessible and hybrid journals (n = 42) was 2.550, whereas the median IF for traditional journals (n = 143) was 1.900. CONCLUSION: A very small number of pharmacy-focused journals adhere to the OA paradigm of access. However, journals that adopt some elements of the OA model, chiefly free accessibility, may be more likely to be cited than traditional journals. Pharmacy practitioners, educators, and researchers could benefit from the advantages that OA offers but should understand its financial disadvantages.


Assuntos
Farmácia , Editoração/organização & administração , Humanos , Disseminação de Informação , Armazenamento e Recuperação da Informação/métodos , Internet , Publicações Periódicas como Assunto , Editoração/economia
19.
Curr Ther Res Clin Exp ; 69(2): 130-41, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24692792

RESUMO

BACKGROUND: Direct-to-consumer advertising (DDTCA) of medications, a marketing tool used by the pharmaceutical industry to increase patient awareness of products, affects both consumer behavior and, ultimately, physician prescribing practices. Billions of dollars are budgeted each year for DTCA, and its influence is far-reaching. However, little information is available about patient-initiated physician interactions in which television-bbased DTCA has played a role in consumer behavior. OBJECTIVE: The objective of this study was to explore the influence of television-based DTCA on treatment changes in patient-initiated medication use. METHODS: A 68-item survey instrument consisting of dichotomous, multiple-choice, and open-ended questions was constructed and sent to a convenience sample of US residents during 3 consecutive months ending in February 2005. The survey, which was accessed through an Internet link provided in the e-mail, was designed to capture data about patient perceptions and behaviors regarding television-based DTCA of prescription medications used for seasonal allergy and asthma as well as demographic information. Inferential and descriptive analyses were performed. Key tests included Crosstabs analysis and normal approximation to the binomial test with the z score. RESULTS: Surveys were sent to 2500 individuals. A total of 427 valid surveys were returned for a 17.1% response rate. Of the 402 respondents (94.1%) who stated that they had seen DTCA for seasonal allergy medication, 50 (12.4%) said they had discussed the advertised medication with their physician and 22 of those discussions (44.0%) resulted in a change in treatment. Three hundred forty-two respondents (80.1%) stated that they had viewed DTCA for prescription asthma medications, and 23 of those respondents (6.7%) said that they had discussed the brand of asthma medication viewed on television with their physician. Those discussions resulted in a change in treatment for 9 respondents (39.1%). CONCLUSION: Within th his limited, self-reported, survey sample, patient-initiated discussions with physicians regarding television-based DTCA of allergy and asthma medications resulted in a change of treatment in 44.0% and 39.1% of respondents, respectively.

20.
Drug Dev Ind Pharm ; 32(10): 1207-18, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17090443

RESUMO

The objective of the present study was to develop a tablet formulation with a zero-order drug release profile based on a balanced blend of three matrix ingredients. To accomplish this goal, a 17-run, three-factor, two-level D-Optimal mixture design was employed to evaluate the effect of Polyox (X1), Carbopol (X2), and lactose (X3) concentrations on the release rate of theophylline from the matrices. Tablets were prepared by direct compression and were subjected to an in vitro dissolution study in phosphate buffer at pH 7.2. Polynomial models were generated for the responses Y4 (percent released in 8 h) and Y6 (similarity factor or f2). Fitted models were used to predict the composition of a formulation that would have a similar dissolution profile to an ideal zero-order release at a rate of 8.33% per hour. When tested, dissolution profile of the optimized formulation was comparable to the reference profile (f2 was 74.2, and n [release exponent] was 0.9). This study demonstrated that a balanced blend of matrix ingredients could be used to attain a zero-order release profile. Optimization was feasible by the application of response surface methodology, which proved efficient in designing controlled-release dosage forms.


Assuntos
Preparações de Ação Retardada , Acrilatos/química , Administração Oral , Broncodilatadores/administração & dosagem , Broncodilatadores/farmacocinética , Química Farmacêutica , Preparações de Ação Retardada/química , Portadores de Fármacos/química , Desenho de Drogas , Humanos , Técnicas In Vitro , Lactose/química , Polietilenoglicóis/química , Comprimidos , Teofilina/administração & dosagem , Teofilina/farmacocinética
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