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Background: Cervical cancer demonstrates a notable efficacy in treatment, evidenced by a 92% 5-year survival rate among cases diagnosed at a localized stage. In 2020, the estimated annual national expenditure for cervical cancer care amounted to $2.3 billion in the United States. Limited real-world data are available for racial disparities in health care expenditures for cervical cancer., Objective: To evaluate racial disparities associated with annual health care expenditures among patients diagnosed with cervical cancer in the United States., Methods: A retrospective observational cohort study of annual health care expenditures in patients with cervical cancer diagnosed during 2014-2019 was performed using the Medical Expenditure Panel Survey data. In addition to the descriptive weighted analysis, an unadjusted analysis of the annual health care expenditure was conducted. An adjusted linear regression model with log transformation of the outcome variable was used to evaluate the total annual health care expenditure as well as expenditures by category across the racial groups., Results: Overall, 826 patients with cervical cancer were identified from the Medical Expenditure Panel Survey during 2014-2019. The majority were classified as White patients (81.2%) and in the age group of 45-64 years (44.65%). On average, the total annual health care expenditure was $11,537 (95% CI = $9,887-$13,186) among the White cohort, $10,659 (95% CI = $6,704-$14,614) among the African American cohort, and $8,726 (95% CI = $6,113-$11,340) among the Hispanic cohort. After adjusting for covariates, the average total annual health care expenditure for the Hispanic cohort was 35% of the total health care expenditure of the White cohort ( P < 0.001) and 46% of the African American cohort's health care expenditure ( P = 0.02). Specifically, adjusted costs of office-based and outpatient visits for the Hispanic cohort were 47% ( P = 0.009) and 57% ( P = 0.005) lower than for the White cohort, respectively. The total annual home health care expenditure for the African American cohort was 49% lower than White patients ( P = 0.03 ), and the Hispanic cohort's total expenditure, excluding prescription medicines, was 57% lower than African American patients ( P = 0.02)., Conclusions: This study provides valuable information regarding the health care disparities that need to be addressed among certain minority races. Reducing the disparities in health care spending across racial groups should be included as a crucial element in tackling well-established health care inequities.

Introduction: The University of Houston College of Pharmacy (UHCOP) implemented a diversity and lifestyle experience score for use in its admission process. The goal of this research was to evaluate changes in the demographic makeup of individuals that interviewed, matriculated, and progressed before and after implementation of this diversity scoring tool., Methods: This was a retrospective study of student data from UHCOP in academic years 2016/2017 (pre-tool) and 2018/2019 (post-tool). Individuals ≥18 years who submitted UHCOP supplemental and Pharmacy College Application Service (PCAT) applications were eligible for inclusion. Exclusion criteria were individuals with incomplete applications, who did not meet minimum coursework requirements, or were missing component(s) of the PCAT, letters of reference, or volunteer service. Student demographic data and information collected from the life experience and diversity scores were compared across students invited to interview, interviewed, admitted, and that progressed after the first year at UHCOP. The chi-square test and analysis of variance followed by post hoc analyses was used to analyze results., Results: First-generation and socioeconomically disadvantaged students significantly increased in those who applied, interviewed, received offers, and matriculated when comparing 2016 and 2017 admissions cycles with 2018 and 2019 cycles (P < .05)., Conclusions: Use of a standardized holistic score that includes a life experiences and diversity scoring tool during the admissions process supports admission of a diverse student population., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Medication side-effects often arouse fear in the minds of consumers and therefore need to be communicated in a manner such that the intended message is clearly understood, without causing undue fear., Objectives: Considering the message format and contextual factors that influence perceptions of risk, this study aimed at assessing the interaction effects of message format and contextual factors (rate of occurrence and severity) on risk perception of medication side-effects., Methods: Using Rhormann's risk communication process model, a 2 (message format: words-only vs. words + numeric) X 2 (rate of occurrence: high vs low) X 2 (severity: mild vs severe) experimental factorial study was designed. Participants were presented with four of eight possible combinations of the three factors and were asked to indicate the risk perception with the associated side-effects. Repeated measures analysis was conducted while adjusting for control variables., Results: A total of 196 completed surveys were collected. Communication format did not have significant main effect on risk perception (P=0.4237) but demonstrated a significant interaction with rate of occurrence (P=0.0001). As compared to words-only format, least square means for words + numeric format were lower among low-rate side-effects but were higher among high-rate side-effects. Rate of occurrence (P<0.0001) and severity (P<0.0001) had significant main effects on risk perception as well as interaction effect with each other (P<0.0001)., Conclusions: The results indicated that effect of communication format on risk perception of side-effect is dependent on the underlying rate of occurrence of side-effect. Healthcare providers should therefore carefully construct risk communication messages for effective communication with patients., Competing Interests: The authors have no conflict of interest to disclose.

Background: Prescription medication adherence is a known health-related barrier for elderly patients, leading to insufficient disease control and negative health outcomes. The Centers for Medicare & Medicaid Services (CMS) have placed significant emphasis on medication adherence, through the Part D star measures, revolving around treatment for chronic disease states such as hypertension, diabetes, and hyperlipidemia. However, it is unclear if physicians fully grasp the extent of nonadherence within their patient populations with regard to these medications, specifically those patients enrolled in Medicare Advantage Prescription Drug (MA-PD) plans., Objectives: To (a) determine physicians' perceptions of medication adherence among their patients enrolled in MA-PD plans and (b) compare those perceptions with actual adherence rates obtained from claims data., Methods: A survey was developed and administered to primary care physicians (PCPs) contracted within a Texas MA-PD plan. The previously validated questionnaire was distributed during an all-PCP quarterly meeting and was collected prior to the meeting's conclusion to increase completion and return rates. PCPs were requested to indicate what percentage of their patients they believed to be adherent to each of the CMS Part D star medication classes, which includes statins, oral antidiabetic drugs (OADs), and reninangiotensin system (RAS) antagonists; what financial category they believe the majority of their patients fall under; and what percentage of their patients receive samples. The PCPs' perceived percentage of adherent patients were compared with the calculated percentage of patients, using a chi-square test at an a priori alpha level of 0.05. The calculated adherence was obtained from pharmacy claims data, meeting the CMS targeted adherence threshold (≥ 80%). This adherence rate was calculated using proportion of days covered (PDC) for all 3 medication categories in each PCP's patient population., Results: To compare PCP perception of patient adherence and actual adherence, 226 PCPs were used. The sample population shared similar sex and age distribution with the national physician average; however, there was more racial diversity represented. PCP perception of patient adherence, as well as the actual percentage of adherent patients, were significantly (P < 0.05) different across statins, OADs, and RAS antagonists; lowest perceived percentage, as well as actual percentage, were reported for statins. PCP perception of patient adherence and actual percentage of adherent patients were significantly different in the 3 medication categories. PCPs' correct estimations were significantly (P < 0.0001) lower than expected values, while over- and underestimations were significantly (P < 0.0001) higher than the expected values., Conclusions: PCPs were almost equally likely to over- or underestimate percentage of adherent patients in their patient pools.

Background: Generic drug discount programs (GDDPs) are an option to provide affordable prescription medication to low-income individuals. However, the factors that influence the use of GDDPs in low-income population are unknown., Objectives: To evaluate factors associated with utilization of generic a drug discount program in a low-income population., Methods: A survey was administered to adult participants at health centers and community-based organizations in Houston, Texas, USA (n = 525). Exploratory factor analysis was conducted to determine the construct validity of the survey instrument and to assess distinct factors associated with GDDP utilization. Descriptive statistics were used to summarize the distribution of patient socio-demographic characteristics and questionnaire responses. Multivariate logistic regression was used to compute adjusted odds ratios and to examine the strength of association with GDDP utilization after adjusting for participant socio-demographic features that were statistically significant at a priori level of P < 0.05., Results: In this study, 72% of respondents were aware of the GDDP, and 61% had utilized the GDDP. Participants were 4 times likely to use a GDDP when their physician (AOR: 4.0, 95% CI: 2.6-6.4, P < 0.001) or pharmacist (AOR: 4.0, 95% CI: 2.6-6.3, P < 0.001) talked to them about it. Participants indicated that the most important barriers to utilization of GDDPs were lack of awareness (44%), and lack of recommendation by a physician (19%)., Conclusions: Increased patient awareness and physician recommendation may increase the use of GDDPs, which may lead to improved compliance with medications, better health outcomes and reduced health care costs., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Objective: Our study aimed to assess patient's perceptions of generic drugs and utilization of generic drug discount programs., Design, Setting and Participants: A survey was administered to adult participants at community health centers and community-based organizations in Houston, Texas, USA (n=525)., Main Outcome Measures: Multivariate logistic regression was used to quantify the strength of association between generic drug perception and utilization of generic drug discount programs., Results: Respondents who agreed that "Generic prescription drugs are as effective as brand name prescription drugs," were 3 times as likely to utilize generic drug discount programs (AOR: 3.0, 95% CI: 1.8-4.8, P<.001). Compared to non-Hispanic Whites, African Americans (OR: 10.2; 95% CI: 1.4-76.4) and Hispanics (OR: 10.3; 95% CI: 1.3-79.4) were 10 times as likely to agree that generic drugs have more side effects than brand name drugs., Conclusion: Race/ethnicity had no impact in utilization of generic drug discount programs, despite racial disparities in perception toward generic drugs' side effects and generic drugs being inferior to brand name drugs.

This study evaluates the factors associated with utilization of generic drug discount program (GDDP) among federally qualified health center (FQHC) patients in Houston, Texas. A survey to determine awareness and use of GDDP was administered to 304 patients at three FQHCs in Houston, Texas. Patients at FQHCs treated with courtesy by pharmacy staff (OR: 14.1, 95% CI: 7.9-25.2), patients with a perception of positive impact of GDDP on their health (OR: 7.6, 95% CI: 4.5-12.7), those who found GDDP easy to use (OR: 6.6, 95% CI: 3.8-11.6), were more likely to utilize GDDP. Approximately 56% of the participants had utilized the GDDP at least once in the past 12 months. Approximately 85% of participants indicated that they would use GDDP if recommended by a physician. It is possible for FQHCs to be good venues for increasing awareness and utilization of GDDP.

The purpose of the study was to explore the influence of perceived benefits, barriers, and cues to action on Complementary and Alternative Medicine (CAM) use among university students. This was a prospective, cross sectional questionnaire-based study conducted at a large urban university in Houston, Texas. Of the 400 students surveyed, 143 (35.8%) were current CAM users (used CAM in the past 12 months). Biologically based medications such as herbs, vitamins, supplements and natural products were found to be most profoundly used among students (42%). Perceived benefits (OR 9.14, 95% CI 4.64-18), barriers to CAM use (OR 0.49, 95% CI 0.27-0.89) and cues to action (OR 5.21, 95% CI 1.02-26.51) were significant determinants of CAM use among students. Perceived ability of CAM to improve body defenses was found to be the major perceived benefit for CAM use while lack of sufficient scientific testing was found to be the major barrier. Recommendation by health care provider and CAM use by parents and grandparents significantly (p < 0.0001) influenced current CAM use among students. Thus, perceived benefits and cues to action for CAM use significantly promoted CAM usage while perceived barriers were found to hinder CAM use among students.