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Background and objectives: Pharmacists use PDAs for performing various activities related to their profession. The objective of this study was to examine pharmacists’ utilization pattern and interest in usage of personal digital assistants (PDAs) in various facets of health care. Methods: A cross-sectional survey was conducted by distributing a pre-validated 23-item instrument to a convenience sample of pharmacists (n = 295) in the Houston area. Usage frequency (0 = never to 5 = frequently) and interest in future use (1 = extremely disinterested to 5 = extremely interested) of PDAs for various activities were evaluated and compared across pharmacy practice settings. Results: Most pharmacists reported maximum use of PDAs, as personal organizers (3.7 ± 1.8), in obtaining drug information (2.9 ± 1.8) and as medical calculators (2.6 ± 1.9). Similar results were obtained while evaluating interest of pharmacists who did not have PDAs and have never used PDAs for these three activities. Hospital pharmacists owned and used PDAs significantly (P

Objective To evaluate label characteristics (type size) of facsimile cards, which are placed in nonprescription-product areas of pharmacies to provide drug-related information and guide consumers to the pharmacist for pharmacy-access medications containing pseudoephedrine or ephedrine. Design: Cross-sectional. Setting: Six of eight major community chain pharmacies and grocery stores in Houston during the month of February 2006 that carried facsimile cards. Participants: Not applicable. Intervention: 187 facsimile cards for brand-name and generic pharmacy-access medications containing pseudoephedrine or ephedrine were evaluated for readability of information provided. Type size of printed drug-related information was measured with a compugraphic point system scale (1 inch=72 points). Main outcome measure: Readability of label characteristics, particularly type size, of printed information for brand-name and generic pharmacy-access medications containing pseudoephedrine or ephedrine. Results Median type size of drug-related printed information on facsimile cards was 4.00 points. For 172 cards (91.98%), the type size of printed information was below the Food and Drug Administration requirement of 6 points for nonprescription medication labeling. Conclusion Because of small type size, consumers may have difficulty reading information on facsimile cards for pharmacy-access products. Federal regulations or voluntary efforts are needed to improve and standardize information on facsimile cards for pharmacy-access medications.

Objective. To evaluate cognitive factors that might influence academic performance of students in Nigerian pharmacy schools. Methods. A cross-sectional, multi-center survey of Nigerian pharmacy students from 7 schools of pharmacy was conducted using 2 validated questionnaires measuring cognitive constructs such as test anxiety, academic competence, test competence, time management, and strategic study habits. Results. Female students and older students scored significantly better on time management skills and study habits, respectively. Test anxiety was negatively associated with academic performance while test competence, academic competence, and time management were positively associated with academic performance. These 4 constructs significantly discriminated between the lower and higher performing students, with the first 2 contributing to the most differences. Conclusion. Test and academic competence, test anxiety, and time management were significant factors associated with low and high academic performance among Nigerian pharmacy students. The study also demonstrated the significant effects of age, gender, and marital status on these constructs.

Background: Tobacco use continues to be the leading cause of death and disability in both developed and developing countries and is expected to remain so in 2020. Our research team has collected and analyzed survey based data on smoking habits from several countries around the world including China, India, Jordan, Saudi Arabia, and Taiwan. Our objectives here are to identify correlates of cigarette smoking that are common across these countries. Methods: A cross-sectional study conducted among 3,658 participants from a convenience sample of adults from each country collected between 2008-2011. The survey included questions on socio-demographic characteristics, current and history of cigarette smoking, family and peer smoking, and perceived harm. Multivariate logistic regression was used to determine predictors of cigarette smoking in the past 24 hours as well as in the past month. Results: Approximately 40% of the sample had smoked a cigarette in the past day and 44% in the past month. Significant predictors included male gender, aged 25 years or more, lower education level and school performance, medical profession, dyspepsia, feeling lonely and bothered by events, using other tobacco products, alcohol use and family and friend smoking. Those who received anti-smoking messages from teachers in schools were less likely to be smokers. Conclusions: Results underscore the importance of teachers and school based anti-smoking programs in smoking prevention across cultures and highlights the prominence of social peer pressure and smoking family members as major predictors of smoking that must be incorporated in any tobacco prevention or cessation program.

Background There is a steady growth in the Spanish-speaking population in the United States. Language may be a barrier in accessing nonprescription medication information for the non-English-speaking population. Objective The objective of this study was to compare consumer-reported ease of use, product knowledge, and intention to purchase over-the-counter (OTC) medications using bilingual Product Information Labels (PILs) and currently available label formats in a sample of Spanish-speaking consumers. Methods Participants were randomly selected from Spanish-speaking consumers shopping for OTC medications in pharmacy or grocery stores in Houston, TX. Participants viewed 3 label formats (old, new, and PILs) for acetaminophen, ibuprofen, and aspirin in a random order. Questionnaires in English and in Spanish were provided to consumers after they viewed each label format. Domains measured in the questionnaires included ease of use, product knowledge, and purchase intention. All responses were measured on a 7-point Likert-type scale. Data were recoded and analyzed using SAS ® (version 9.0) (SAS Institute Inc, Cary, NC) to obtain mean scores for each domain. Participants were classified according to language proficiency into "Spanish only" and bilinguals. Comparative statistics were computed to compare mean scores between label formats in each consumer category. Results A total of 225 questionnaires were collected. The mean (±standard deviation) age of participants was 38.91 (±11.95) years. A majority of respondents were Hispanic (97.75%), female (60.54%), and married (62.44%). Mean scores from viewing PILs on ease of use, product knowledge, and purchase intention were higher than those from viewing the other label formats. In the category of consumers who spoke Spanish only, mean scores of PILs were significantly higher as compared to those of old and new label formats ( P Conclusion Information provided in Spanish on PILs may be very helpful to the Spanish-speaking community when selecting nonprescription medications. Policy makers and health care providers should consider PILs as an effective means of reducing language barriers and providing OTC medication information to the Spanish-speaking population in the United States.

The objective of this study was to evaluate the effect of incentives on student performance on comprehensive cumulative examinations administered at the College of Pharmacy, University of Houston.This study is a retrospective longitudinal study conducted over a period of 6 years, from 2000 to 2005. Passing rates on the cumulative examinations administered during the first 3 years of the doctor of pharmacy curriculum were obtained. These cumulative examinations, known as the Milemarker assessments, involve 3 examinations: Milemarker I, II and III, each offered after completion of each progressive year. Milemarker I and II examinations were phased in throughout the years with various incentives to increase student performance. Incentives for these examinations included books, achievement letters, bonus points, and remediation exercises. Incentives with respect to Milemarker III examination was determination of students' progression into the experiential year of the curriculum and did not change over the study period. Passing rates were compared for these examinations before and after the implementation of these incentives.Passing rates for Milemarker I increased significantly by 185% from 2003 to 2004 when incentives were changed from awards such as books and achievement letters from the Dean's office to bonus points towards future examinations and a remediation process. Similar results were seen for Milemarker II, where the passing rates increased by 590% during the same period for similar incentives. However, passing rates were much higher throughout the time period for Milemarker III due to the high-stakes incentive of stops on progression to the next year.Appropriate incentives may be effective in changing student performance on comprehensive cumulative examinations.

The objective of this study was to examine factors such as academic competence, test competence, time management, strategic studying, and test anxiety, and identify whether these factors could distinguish differences among students, based on academic performance and enrollment in the experiential program.A cross-sectional study design utilizing questionnaires measuring previously validated constructs was used to evaluate the effect of these factors on students with low and high cumulative grade point averages (GPAs). Pharmacy students (N = 198) enrolled at the University of Houston participated in the study.Academic performance was significantly associated with factors such as academic competence and test competence. Students with a cumulative GPA of 3.0 or greater significantly differed in their level of test competence than those with a GPA of less than 3.0. Students enrolled in their experiential year differed from students enrolled in their second year of curriculum on factors such as test anxiety, academic competence, test competence, and time management skills.Test competence was an important factor to distinguish students with low vs. high academic performance. Factors such as academic competence, test competence, test anxiety and time management improve as students' progress in their experiential year.

BACKGROUND: Over-the-counter (OTC) medication packages are important sources of information for consumers during product selection and use. Consumers may not be able to access information from OTC packages if external tags, namely price or anti-theft tags, are improperly placed. OBJECTIVE: To determine the amount and type of information concealed by anti-theft tags and price tags affixed on OTC drug packages. METHODS: A field study was performed by evaluating packages containing acetaminophen and combinations of acetaminophen in stores located in Houston. Five packages for 4 products selected from each store after an initial survey for presence of an external tag were examined. A data collection sheet was prepared that extracted the type and amount of information concealed by these tags. Data were analyzed by performing descriptive analyses to provide an understanding of the information obscured. RESULTS: A total of 24 stores were considered in the study, and 67 products and 285 packages were evaluated. External tags, both anti-theft and price tags, obscured significant amounts of information on the principal display panel (53.4%) and the Drug Facts panel (47.7%) of OTC packages. These tags concealed crucial information on various aspects of labels such as brand names (42.3%), product description (36.3%), warnings (51.5%), uses (10.4%), and purposes (7.2%). CONCLUSIONS: Results suggest that improper use of external tags clearly obscured important information on OTC medication packages necessary for consumers to make informed decisions regarding product selection and use. Tagging practices should be altered to allow consumers full access to drug information on the product.

A study was undertaken to determine consumer knowledge and perceptions of formularies. A prevalidated survey containing 11 scored items was administered to 714 consumers waiting to receive prescription medications at 72 community pharmacies in Houston. Overall, these consumers were satisfied with their prescription insurance plans, but their attitudes toward formularies were negative, and the negative perceptions were significantly correlated with satisfaction scores. However, only 25% of the surveyed population had a copy of the formulary, so that a large majority had no knowledge of their formulary or the types of drugs it covered. Efforts to educate patients may reduce the difficulty faced by pharmacists in explaining formulary issues to consumers.

This study was undertaken to evaluate the attitudes of physicians toward formularies as well as services provided by the pharmacy department in a large integrated delivery system (IDS) with a multispecialty group practice. Surveys were sent to all 282 practitioners in the IDS, requesting information on their use of and satisfaction with the existing printed "Formulary Quick List" (FQL), their satisfaction with pharmacy services, and their attitudes toward formularies in general. A five-point rating scale was used. The response rate was 32%, with the majority from staff physicians. Results indicated that practitioners were very satisfied with the services offered by the pharmacists. Their attitudes toward the FQL were very positive. However, their attitudes toward formularies in general were very negative. There was a significant, negative correlation between attitudes toward formularies in general and attitudes toward pharmacy services, as well as toward the FQL.

The objective of this study was to evaluate the effects of consumer involvement on information processing from over-the-counter (OTC) medication labels. A sample of 256 students evaluated simulated OTC product labels for two product categories (headache and cold) in random order. Each participant evaluated labels after reading a scenario to simulate high and low involvement respectively. A questionnaire was used to collect data on variables such as label comprehension, attitude-towards-product label, product evaluation, and purchase intention. The results indicate that when consumers are involved in their purchase of OTC medications they are significantly more likely to understand information from the label and evaluate it accordingly. However, involvement does not affect attitude-towards-product label nor does it enhance purchase intention.

Direct-to-consumer drug advertising is a useful medium for educating people and disseminating product information. Consumers make product purchase decisions based on the information gained from advertisements. If advertisements are misleading, consumers may not have adequate drug knowledge to detect this misinformation. The objective of this study was to evaluate print advertisements for over-the-counter (OTC) products. Five clinical pharmacists evaluated print advertisements appearing in three consumer periodicals. Advertisements were selected over a nine month period beginning January 1994. Accuracy of information on OTC advertisements was determined based on federal guidelines. Additionally, reviewers identified deficiencies in advertisements that may mislead consumers. According to reviewers, around 50% of advertisements lacked accurate statements. Side effects were indicated on only one advertisement. All advertisements were indicated by reviewers to be more promotional than educational. Reviewers indicated that more than 50% of advertisements lacked information essential for consumers to make an informed choice during self-medication decisions. This study indicates that OTC drug advertisements lack information necessary for consumers to make informed purchase decisions. Inaccurate information and lack of information on side effects could mislead consumers causing harmful adverse events.

Background, aims and scope: Diabetes is a considerable economic burden on the healthcare system and is one of the leading chronic diseases targeted by managed care organization to reduce cost. Methods: The current study aimed to evaluate the impact of an employer initiated, patient-centered diabetes disease management program in a community pharmacy setting on reducing per member per year medical services and prescription drug costs and utilization. Further, improvement in clinical indicators from baseline was assessed in this cohort. Trained pharmacists administered the program including, but not limited to, clinical assessments, developing a personalized medication plan, patient education and self-monitoring guidance. Individualized follow-up visits were scheduled approximately every 2 months to monitor routine progress. The diabetes disease management program was initiated in 2007 and continued through 2008. It was anticipated that the effect of the intervention would not be immediate; thus, outcomes were compared across the 2 years of the intervention: 2007 and 2008. A comparison of economic and clinical outcomes was conducted on 85 enrollees who had at least 3 visits. Economic outcomes were assessed in terms of difference in all-cause utilization and costs, for prescription drugs and medical services. Results: Prescription drug utilization increased significantly by 12 claims per member per year from 2007 to 2008 (p=

This study focuses on determining the predictors of cigarette smoking in a cohort of adults in urban cities of India.

The study compared elderly and young adults in their behavior and involvement in the decision making process of over-the-counter (OTC) medication purchases. Elderly subjects were more involved in the decision making process to purchase OTC medications compared to young adults. The elderly not only purchase and spend more money on medications but also read OTC labels completely. They requested help from the pharmacist more frequently than young adults. Needs of the elderly in making an OTC medication purchase were different compared to young adults. The two age groups differed on importance rating for several attributes regarding OTC medications, such as; ease of opening the package, child resistant package, side effects of medicine, manufacturer of medicine, print size on package labels, and greater choice of medicine.

In their recent commendable article, “A Cross-site Qualitative Study of Physician Order Entry,” Ash et al.1 concluded that collaboration and trust among organizational members and active engagement of clinicians are important factors in successfully implementing computerized physician order entry (CPOE) systems. The article contributed to our understanding of the reasons behind physicians' resistance and the factors that might promote successful CPOE implementations. Although the article mentioned “pharmacists as team members,” their role was not described explicitly. We would like to recommend active incorporation of clinical pharmacists in the health care team involved in using CPOE. Well-designed CPOE systems can improve the safety of patient care and reduce health care costs2–4 caused by medication errors. Yet, as the authors of this study mention, many physicians have been reluctant to use CPOE.1,6–9 From the physicians' perspective, CPOE generally takes more time than writing prescriptions on paper.6,9 Hence, most physicians still prefer the traditional method. It is important to note, however, that the CPOE process is a two-way communication between the physician and …