ABOUT THE COLLECTION

All PharmD students at the University of Arizona College of Pharmacy must complete a research project as part of their graduation requirements. This repository collection contains the abstracts of these projects, and the full-text of projects that students have opted to make available.

Visit the College of Pharmacy Student Research Projects website for more information about the PharmD program and Student Research Projects.


QUESTIONS?

Contact Jennifer Martin, Associate Librarian & Clinical Instructor, Pharmacy Practice and Science, for more information about the student research projects in this collection.

Recent Submissions

  • Imatinib as a Dominant Therapeutic Strategy in the Treatment of Chronic Myelogenous Leukemia: A Decision-Analytic Approach

    Skrepnek, Grant; Ballard, Erin Elissa; College of Pharmacy, The University of Arizona (The University of Arizona., 2004)
    Objective: To develop and populate a decision-analytic model comparing the cost and efficacy of imatinib versus allogenic bone marrow transplantation (BMT) with a matched unrelated donor in the treatment of newly-diagnosed, Philadelphia positive (Ph (+)), chronic phase, chronic myelogenous leukemia (CML). Design: Markov cohort analysis and Monte Carlo microsimulation. Measurements and Main Results: Direct medical costs were measured from the perspective of a third-party payer. Efficacy data and probabilities were obtained from survivability findings emanating primarily from randomized controlled trials (RCTs). A two-year time horizon was employed with three month treatment cycles. BMT was established as the baseline comparator and the base case was defined as a 35 year old, Ph(+) male patient with newly-diagnosed CML. Results from the Monte Carlo trial found that the incremental cost-efficacy ratio was −$5,000 for imatinib (95th % Confidence Interval: −$70,000, $84,000). Analysis of the cost-efficacy plane indicated that imatinib dominated BMT in 84.69 percent of cases, while BMT was dominant in 0.76 percent of cases. Sensitivity analyses of costs and discount rates found results to be robust. Conclusion: Imatinib was observed in a majority of cases to be both less costly and more efficacious relative to BMT in the treatment of CML, suggesting that this pharmaceutical agent is a dominant therapeutic strategy. When available, the incorporation of long-term clinical data are required to assess cost-efficacy beyond the two-year time horizon of this study.
  • An Assessment of the HIPAA-Related Knowledge of Pharmacy Students at the University of Arizona

    Sauer, Karen Ann; Alfred, Timothy; Davis, Jabin; College of Pharmacy, The University of Arizona (The University of Arizona., 2004)
    Objectives: To assess students’ knowledge of HIPAA and to address the null hypotheses that knowledge scores on HIPAA-related questions did not differ by class year, months of work experience, or HIPAA training and work experience. Methods: This project used a cross-sectional survey design with a self-administered questionnaire distributed by the investigators in a classroom setting. The questionnaire consisted of 13 multiple-choice questions to assess students' knowledge of HIPAA as well as four descriptive items. The questions addressed the following HIPAA categories: general principles of HIPAA; minimum necessary standards for use of protected health information (PHI); permitted uses and disclosures of PHI for treatment, payment, and health care operations; personal representatives and PHI; PHI for marketing; and public health activities and PHI. The questionnaire was tested for content validity and item reliability. First, second, and third year pharmacy students who were enrolled during the spring 2004 semester and attended class the day the questionnaire was administered were eligible to participate. Results: Scores were derived for the 13 multiple-choice questions and mean scores for the three classes were compared using Kruskal-Wallis 1-way ANOVA by ranks. Pearson correlation coefficients were calculated for scores versus months of work experience. Spearman rank correlations were used to compare knowledge scores with the following: (1) work experience and HIPAA training, (2) work experience and no HIPAA training, (3) no work experience and HIPAA training, or (4) no work experience and no HIPAA training. ANOVA and Tukey’s tests were used to assess any differences between the HIPAA categories. Implications: Students training at experiential sites must be familiar with the HIPAA requirements. This assessment provided important curricular feedback to the College.
  • A Comparative Study of the Quality of Diltiazem and Verapamil Manufactured in Mexico Versus Those Manufactured in the United States

    Mayersohn, Michael; Yau, Andrew; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objective: To determine whether or not the amount of active ingredient and content uniformity of diltiazem and verapamil products manufactured in Mexico are comparable to those manufactured in the U.S. Methods: High-performance liquid chromatography (HPLC) assay was used to compare the quantity of active ingredients contained in diltiazem 120 mg ER capsules and verapamil 120 mg ER tablets manufactured in Mexico vs. those manufactured in the United States. The content uniformity was also compared using guidelines contained in the U.S. Pharmacopoeia-National Formulary (USP- NF), with guidelines slightly modified to better suit the experiment. The acceptable range of variances in the quantity of active ingredient was taken from the USP-NF (90-110%). The mean active drug content from the samples manufactured in the U.S. was assumed to meet USP-NF standards at 100%. Results: The experimental results showed that the Mexican verapamil 120 mg ER capsules fell below the USP-NF acceptable range of 90-110% with a value of 83.2%, which is 11.2% less than the U.S. samples tested. The content uniformity of Mexican verapamil also fell below the USP-NF acceptable range of 90-110% with a value of 88.6%. The Mexican diltiazem 120 mg ER capsules fell above the USP-NF acceptable range of 90-110% with a value of 196.2%. The content uniformity was also above the acceptable range with a value of 183.0%. Conclusion: The results of this study showed that the drugs used in this experiment are not within the range that is deemed acceptable by USP-NF standards. The Mexican verapamil was below the range deemed acceptable while the Mexican diltiazem was above the range deemed acceptable. However, the study results cannot be generalized since they represent only a limited number of batches.
  • Enteral Nutrition versus Total Parenteral Nutrition for Acute Pancreatitis: A Cost-Effectiveness Analysis

    Armstrong, Edward P.; Erstad, Brian L.; Waara, James H.; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To develop a decision analytic model to compare the clinical and economic outcomes of enteral nutrition (EN) and total parenteral nutritional (TPN) support in acute pancreatitis patients. Methods: All randomized clinical trials comparing EN and TPN in acute pancreatitis patients published in the medical and pharmacy literature were identified. Six trials were identified by searching MEDLINE, Web of Science, Cochrane Controlled Trials Register, International Pharmaceutical Abstracts, HealthStar, Cumulative Index to Nursing & Allied Health Literature, and citation review of applicable literature. The costs used for the decision tree were from the perspective of a hospital. A literature based decision tree was formed based from these costs and the probabilities of events from the six identified clinical trials. The TreeAge Pro computer program (TreeAge Software, Inc.; Williamstown, MA) was used to conduct the cost effectiveness analysis. Therapeutic success was considered, for the purposes of the trial, as having no complications. Results: EN was associated with a lower risk of infections, a reduced length of hospital stay, and fewer surgical interventions. There was no statistical difference in the risk of mortality, adult respiratory distress syndrome or multiple organ failure between groups treated with EN or TPN. The results found that EN dominated TPN by being both less costly and more effective. The average costs for EN and TPN were $46,345 and $73,878, respectively. The success rates were 0.652 and 0.358 for EN and TPN, respectively. Conclusion: Enteral nutrition was the dominant route of administration for nutritional support, when compared to total parenteral nutrition both clinically and economically for acute pancreatitis patients.
  • Medication Compliance in Patients Taking Antiretroviral Therapy in the El Rio Health Center AIDS Drug Assistance Program (ADAP): A Retrospective Study

    Felix, Tony; Valdivia, Rosalee; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To determine compliance rate of patients enrolled in the AIDS Drug Assistance Program (ADAP) at El Rio Health Center. Methods: This study was a retrospective observational study design that utilized medication refill data obtained from computerized pharmacy records. Lists were created for each anti-retroviral drug that included the following data: medical record number, medication, quantity dispensed, days supply and refill date. Patient age, gender and ethnicity were also obtained. The data was compiled into a database using Microsoft Excel©. The medication possession ratio (MPR) was calculated for each drug as well as for each drug group. The subjects in this study were patients enrolled in the ADAP at El Rio Health Center who obtained prescription refills between December 1, 2003 and November 30, 2004. The mean age was 44.56 (range 25-78); 94.8% were male and 5.2% were female. Ethnic distribution included 52.6% Caucasian, 39.6% Hispanic, 3.2%African American, 1.3% Asian, and 3.2% other. Results: The MPR was calculated for each drug as well as for each drug group. MPRs for individual drugs ranged from 0.586-0.906; MPRs for drug groups ranged from 0.717-0.756. Implications: The results of the study indicated that ADAP patients did not have adequate (>95%) compliance rates. The implications of the results are that patients are not fully benefiting from their medication, while at the same time promoting the development of resistant strains of HIV.
  • Utilization of Angiotensin-Converting-Enzyme Inhibitors in the Treatment of Diabetics Within an Out-Patient Care Facility

    Higbee, Martin; Titus, Timothy; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objective: The purpose of this study was to retrospectively determine if individuals within the SAVAHCS home-based patient population with a diagnosis of diabetes mellitus are receiving an angiotensin-converting-enzyme inhibitor (ACE-I) based on recent evidence supporting its use in these patients. Research Design: A retrospective, chart review of 41 patients with a diagnosis of diabetes mellitus from November 1, 2004 to December 31, 2005. Methodology: This was a retrospective, chart review of all patients within the SAVAHCS home-based population with an active diagnosis of diabetes mellitus. Once the patients were identified, their clinical profiles were extracted from the VISTA computer system. The patients had data regarding age, gender, diabetes type, diagnoses of heart disease and hypertension, type of ACE- Inhibitor prescribed, blood pressure, HgbA1c, and height and weight in order to calculate body mass index (BMI). The patients were classified as either having or not having ACE-Inhibitor therapy. Results: The total number of diabetic patients currently receiving an ACE-Inhibitor was 24 (58.5%). This was significantly lower than the value of 80% predetermined (p=0.0352). Thirty-one patients were also found to have a diagnosis of hypertension (75.6%), with 18 of these patients having a prescription for an ACE-Inhibitor (43.9%). Four patients (9.8%) who were not currently on an ACE- Inhibitor had a documented history of cough induced by the use of these drugs. Clinical Relationships: ACE-Inhibitors are drug agents used to treat hypertension. They have also been shown to be of significant clinical value in diabetic patients, in both renal protective effects as well as to reduce cardiovascular risk, the most common cause of morbidity and mortality in diabetic patients.
  • Pharmacy Students’ Training in Smoking Cessation and Confidence on Implementation in the Practice Setting

    Slack, Marion; Tilbury, Desiree; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To assess students’ confidence levels about smoking cessation implementation from different types of training experience and assess what factors contribute the strongest towards successful interventions for students in the practice setting. Methods: The project design involved the administration of a questionnaire for students distributed by the investigator to 1st, 2nd, and 3rd year University of AZ College of pharmacy students. Section I provided a grid which asked the student to fill in how many hours of each tobacco cessation training areas they had completed. Section II was focused on how the student addressed these issues in their work setting, and used confidence intervals to identify how confident they were in addressing these issues with patients. Section III focused on work history and addressed issues such as work hours, exposure to patients, counseling opportunities, etc., to get a feel for how active the students were in counseling at their worksite. Section IV of the questionnaire addressed the student’s demographic characteristics, such as race/ethnicity, marital status, and age. Question 18 at the end of Section IV provided the student space for constructive comments about the survey. Results: Scores were derived from the surveys and confidence intervals were compared to total training time using a Pearson r. The third year students were significantly more confident (p < 0.035) for all aspects of counseling, asking, advising, assessing readiness, arranging, and monitoring. Third year students were also more confident than second year students in all aspects of counseling except asking. The differences between the first and second years were not significant for any of the aspects of counseling (p > 0.05). Third year students also had significantly more experience (2.9 years) than first (1.1 years) or second (1.8 years) year students (p = 0.001). Correlations were drawn to compare confidence and: total training hours, work experience, times counseled; to correlate training time and times counseled, and to compare work experience to actual times counseled. The highest correlation drawn to actual times counseled was shown to be total training time, suggesting this is the most important predictor of patient counseling for pharmacy students. ANOVA tests were used to assess any differences in demographics between year of student categories. Implications: Students effectively counseling patients on smoking cessation is most closely related with formal training they complete, rather than how confident they feel or how knowledgeable they are about the effects of smoking.
  • Use of Atypical Antipsychotics in a Community Mental Health Center: Evaluation of Dosing, Drug Combinations, and Gender

    Fankhauser, Martha P.; Rodriguez, Aaron; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To describe the dosing of atypical antipsychotics among outpatients diagnosed with schizophrenia at a community mental health center in Tucson, AZ, and to contrast this to dosing recommendations set by the manufacturer during clinical trials. Methods: A prescription database from January 01, 2004 to July 31, 2004 was used to evaluate the dosing of atypical antipsychotics (Abilify®, Clozaril®, Geodon®, Seroquel®, and Zyprexa®) in patients with schizophrenia. The average daily doses were evaluated for differences from recommended dosing using the physician desk reference. Differences in dosing were also analyzed for gender and monotherapy vs. patients taking multiple atypical antipsychotics. Results: Overall differences in dosing when comparing gender and monotherapy vs. patients on multiple atypicals were not significant for all five atypical antipsychotics studied. Overall, Geodon® had the highest percentage (51.9%) of patients above recommended guidelines while Clozaril® and Seroquel® had the highest percentage (70.6% and 47.4% respectively) below recommended guidelines. Implications: This study illustrates that dosing of these atypical antipsychotics at this outpatient community mental health center differs for many patients with schizophrenia from the guidelines set by the companies during clinical trials. This information will aid in the prescribing of physicians at this community mental health center and will possibly lead to larger studies to further look at reasons for these differences in dosing.
  • A Retrospective Study of Factors Associated with Uncontrolled Hypertension in Community Pharmacies

    Jacobson, Rachel; Raupe, Robyn M.; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To evaluate results of a hypertension (HTN) screening provided to patients by community pharmacists at various Bashas’ United Drug Stores. Information evaluated includes risk factors for HTN and blood pressure values. Methods: This is a retrospective study analyzing results documented during clinical services provided at community pharmacies in Tucson and Phoenix, Arizona between December 2002 and January 2004. Data from 535 patients was collected. Data included risk factors (e.g. age, tobacco use, cardiovascular exercise, family history of HTN) and a blood pressure measurement by a pharmacist. For analysis, patients were separated into two groups based on HTN diagnosis status. The two groups were compared across each risk factor variable and blood pressure measurements. Results: Seven patients were excluded because they did not specify previous HTN status, leaving a total of 528 patients. Significant differences were found between the two groups regarding the following characteristics: age (p < 0.001), HTN management with drugs (p < 0.001), cardiovascular exercise (p < 0.05), family history of HTN (p < 0.001), salt intake (p < 0.001), diabetes (p < 0.001), measured systolic blood pressure (p < 0.001) and diastolic blood pressure (p < 0.05). Implications: Patients with diagnosed HTN were determined to be older, more likely to receive HTN treatment, at a greater level of cardiovascular exercise, greater family history of HTN, more likely diagnosed with diabetes and had a higher systolic and diastolic measurement taken by the pharmacist when compared to the undiagnosed group.
  • The Impact of JNC-7 and New Clinical Studies on Antihypertensive Drug Prescribing

    Jones, William; Malone, Daniel; Rasmussen, Kelly; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: The objectives of this study were to assess the number of antihypertensive prescriptions by therapeutic class including beta-blockers, calcium channel blockers (CCBs), diuretics, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs), dispensed in the fiscal years 2002 through 2004. Methods: The project was a retrospective analysis of pharmacy data for medications used to treat hypertension from October 2002 through December 2004 (FY02 through the first quarter of FY05). Drug classes used to treat hypertension were obtained from the VA Integrated Service Network 18 (VISN 18). Within the drug classes, only drugs within the class having at least 100 prescriptions were included for the class. Rates of prescriptions dispensed by quarter over the three-year period of interest were obtained. Descriptive statistics were used to compare the before and after ALLHAT and JNC-7 time periods. Results: After the publication of The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), The Australian National Blood Pressure Study 2 (ANBP2), and Joint National Committee (JNC-7) guidelines, dihydropyridine CCB use declined to from 1.80% to 1.65% and non-dihydropyridine CCB use declined from 0.99% to 0.83% of all prescriptions from the first quarter 2002 to the first quarter 2004. In addition, after the publication of ALLHAT, hydrochlorothiazide use increased from 1.42% to 1.83% and ACE-inhibitor use increased from 4.26% to 4.79% of all prescriptions. Implications: The findings have several implications for encouraging our prescribing patterns to follow national guidelines and clinical studies more closely. Health care providers need to accept some responsibility through continuous education to be able to maintain appropriate therapy.
  • Does Delivery of Medications Increase Adherence in an Elderly Population?

    Saldamando, Daniel; Pate, Amber; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To determine if delivery of medications to an independent living facility increases patient adherence. Methods: Retrospective review of patient pharmacy refill records was completed using a data extraction form in order to calculate a number of days deviation from a projected refill date based on days supply. Data on the use of express pay, auto fill, and delivery service and payment type was collected as well as age and gender. Residents of The Fountains independent living facility were eligible to be included in this study if they had complete data in the pharmacy refill records for at least one scheduled maintenance medication taken for a continuous, three-month period. Results: There were 21 subjects in the delivery group and 18 in the pick-up group. Both groups were primarily women (76.2 percent and 61.1 percent respectively). Age was also similar (85.8 and 83.8, p=0.285). The delivery group had significantly more maintenance medications than the pick-up group (mean=2.8, SD=1.1 and mean=1.7, SD=1.1 respectively). Seven of the nine time deviations were greater for the pick-up group than for the delivery group (p= 0.09 for sign test). Implications: It appears that a delivery service can increase adherence, particularly in a population of advanced age.
  • A Comparative Study of the Quality of Lorazepam and Phenytoin Manufactured in Mexico and the United States

    Mayersohn, Michael; Pak, Chang; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To determine whether the quantity of active ingredient and content uniformity of lorazepam and phenytoin manufactured in Mexico is comparable with those manufactured in the United States. Methods: A high-performance liquid chromatography (HPLC) assay based on slightly modified United States Pharmacopoeia- National Formulary (USP-NF) guidelines was used. Relative quantification of the active ingredient was accomplished using the US products as standards. The US products were assumed to contain 100% of the active ingredient. Lorazepam 1mg tablets and phenytoin 100mg capsules were tested using the assays. Results: The quantity of active ingredient in the Mexican lorazepam 1mg tablets were within the acceptable range of the USP-NF guidelines at 100%. The content uniformity was also within the acceptable range of the USP-NF guidelines at 104.6%. The quantity of active ingredient in the Mexican phenytoin 100mg capsules as well as content uniformity were also within the acceptable range of the USP-NF guidelines at 101.6% and 98.2%, respectively. Implications: The results of this study showed that lorazepam and phenytoin manufactured in Mexico were comparable to those manufactured in the US with no significant differences regarding amount of active ingredient and content uniformity.
  • Assessment of Japanese Pharmacists’ Perceptions towards Community Pharmacy

    Armstrong, Edward; Okumoto, Kaci; Sanagawa, Harumi; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: The objectives of this study were to 1) describe Japanese pharmacists’ perceptions about community pharmacy on a variety of issues and 2) compare the perceptions between different groups. Methods: A questionnaire was administered to a convenience sample of community pharmacists in the Tokyo metropolitan area and Hiroshima prefecture. Pharmacists were surveyed on various issues such as job satisfaction, the separation of prescribing and dispensing, their relationship with patients and physicians, and pharmacy education. A five-point Likert scale was used to measure responses. Results: One hundred forty-four questionnaires were completed. Eighty-four percent of respondents were female, 37.5% had more than ten years of practice experience, and 81.9% worked in Tokyo. Japanese community pharmacists are neutral or satisfied with their jobs. However, respondents were not satisfied with the current state of community pharmacy in Japan (2.81 + 0.83), did not feel respected by patients (2.74 + 0.99) and physicians (1.99 + 0.95), felt that four years of education was not enough to provide adequate patient care (1.96 + 1.01), and would like to do more clinical oriented activities (3.77 + 0.84). Significant differences were found in some responses between groups such as males versus females and pharmacists with more versus less than ten years of practice experience. Conclusions: Respondents were not satisfied with the current state of community pharmacy in Japan. Areas that could use improvement are respect from patients and physicians, involvement in clinical activities, and assistance at work. Significant differences were found in the perceptions of the groups studied.
  • Comparison of Content and Uniformity of American versus Mexican Manufactured Acyclovir and Cephalexin

    Mayersohn, Michael; Nii, Sarah; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To determine whether acyclovir and cephalexin produced in Mexico are equivalent in content and uniformity to products made in the United States. Methods: High-pressure liquid chromatography (HPLC) assays were performed on drug samples of Mexican products and U.S. products using U.S. Pharmacopeia – National Formulary (USP-NF) guidelines.5 Content and content uniformity of the products from the U.S. and Mexico were compared. Results: Acyclovir produced in Mexico had 75.4% content and 78.1% content uniformity compared to the acyclovir produced in the United States. The Mexican manufactured cephalexin had 99.0% content and 99.9% content uniformity compared to the U.S. manufactured cephalexin. Implications: Not all Mexican manufactured drugs are equivalent in content and content uniformity to American manufactured drugs.
  • A Comparison of Content and Quality of Atenolol and Captopril Manufactured in Mexico and the United States

    Mayersohn, Michael; Newkirk, Alicia; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To determine whether the quantity of active ingredient and content uniformity of atenolol and captopril manufactured in Mexico are comparable with those manufactured in the United States. Methods: An adapted United States Pharmacopoeia-National Formulary (USP-NF) guideline was utilized for a high-performance liquid chromatography (HPLC) assay to quantify the active ingredient of each medication. The US products were considered to contain 100% of the active ingredient, with acceptable variance range of 90-110%. Atenolol 50 milligrams (mg) and captopril 50 mg tablets, manufactured from either Mexico or US, were tested in this comparative study. Results: Quantification of active ingredient in Mexican captopril 50 mg tablets were within the acceptable range of the USP-NF guidelines at 94.2%. The content uniformity was also within the acceptable range of the USP-NF guidelines at 99.0%. The quantity of active ingredient in the Mexican atenolol 50 mg tablets, as well as content uniformity, was also within the acceptable range of the USP-NF guidelines at 110.0% and 95.0%, respectively. Implications: The results of this study showed that captopril and atenolol manufactured in Mexico were comparable to those manufactured in the US with no significant differences regarding amount of active ingredient and content uniformity.
  • Qualitative Analysis of Erythro-Methylphenidate Isomers Contained within Methylphenidate HCl Capsules using TLC

    Durazo, Enrique; Nakai, Jodi S.; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objective: The goal of this study was to determine the presence of erythro-methylphenidate (erythro-MPH) isomers contained within methylphenidate HCl (Metadate CD®) capsules. Methods: This experiment was conducted at a pharmaceutical manufacturing facility located in Tucson, Arizona. Methylphenidate HCl (MPH) capsules by Celltech Pharmaceuticals, Inc. were analyzed and compared to a reference standard. Thin-layer chromatography (TLC) was the technique used to qualitate the samples. The main outcome measure was the Rf values which were used to determine whether or not the MPH capsules contained erythro-MPH. Results: The study included ten, 20 mg MPH capsules and a reference standard (50 mg strength USP MPH related compound). The Rf value of the reference standard was 0.073 while the Rf value of the MPH samples ranged from 0.42 - 0.85. Conclusion: In this qualitative analysis of MPH capsules, there was no erythro-MPH isomers present in the MPH capsules.
  • Determining the Effects of Arthritis on Work Productivity

    Grizzle, Amy; Sirjani, Elizabeth Munch; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To evaluate potential productivity differences among working-age individuals with arthritis in the United States, and to determine the costs associated with these differences. Methods: Health risk assessment survey data was obtained through the You First internet survey group. Five hundred seventy-nine individuals with and 579 without arthritis, matched for age, were evaluated for differences in survey responses. The arthritis group was also evaluated to determine the association of pain severity level and activity limitations with work days missed. Results: Arthritis respondents were found to have significantly more work days missed, emergency room visits, hospital visits, and physician visits than respondents without arthritis. Arthritis respondents missed 6.14 more work days in the 12 months before taking the survey than non-arthritis respondents, costing US $12.9 billion in the United States each year. Arthritis respondents were significantly more limited in their activities than non-arthritis respondents. Arthritis pain and activity limitation were found to be positively correlated with work days missed. Implications: The data from this study demonstrate that work productivity is impaired in individuals with arthritis, pain and physical activity limitations are positively correlated with missed work days, and missed work days constitute a substantial annual cost to employers. Given the evidence of costly productivity impairment in arthritis patients vs. a general population, lost productivity should be included with direct medical costs in studies determining the burden of arthritis in the United States, especially from the employer’s perspective.
  • Prioritization of Pharmacist Activities in the ICU: An Analysis of the Costs and Consequences of Interventions

    Erstad, Brian; Kopp, Brian; Mrsan, Melinda; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: The purpose of this retrospective investigation is to compare the quantity, importance, and associated cost implications of drug-related problems identified (and ultimately resolved) through order entry/verification versus other clinical activities of a decentralized critical care pharmacist. Methods: The data from this study was collected by one decentralized pharmacist assigned to a surgical intensive care unit. A standard form was used to document all interventions during the period of this observation. For the purposes of this retrospective evaluation the following data will be extracted from the existing database: amount of time spent performing various clinical activities, how drug-related problems were identified (e.g., order entry verification versus chart reviews), the time it took to identify and resolve drug-related problems, a general description of interventions, the importance of the intervention, and the estimated economic impact associated with interventions. Results: In only a 41⁄2 month period, 111 patients would have likely experienced an adverse drug event had the ICU pharmacist not intervened. This equals a cost avoidance to the institution of anywhere from $200,000 to $280,000 for as little on average of 15-30 minutes of the pharmacist time. Implications: As previous studies have shown, the presence of a pharmacist in an ICU is crucial to lowering the incidence of adverse drug events. Our results have proven the interventions pharmacist make during team rounding and chart review are not only cost effective, but substantially improve patient care.
  • Factors Affecting the Selection of Pharmacy as a Profession: Students vs. Practitioners

    Slack, Marion; Measom, Hal; Montierth, Robert; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: To explore the factors that motivate current pharmacy students to enter the field of pharmacy, and compare these motivational factors to currently registered and practicing pharmacists. Methods: Identical questionnaires were distributed to the student and pharmacist populations. The questionnaire collected ratings on how influences such as job security, earnings potential, community service, and family obligation affected decisions to enter the profession of pharmacy. Other data regarding salary information, satisfaction with the profession, first career choices, and basic demographics were also collected. Results: Questionnaires were completed and returned by 214 students and 84 practitioners. Statistically significant differences were found between groups for all demographic descriptors (p<0.001). Differences were also seen amongst rating scores applied to most of the various motivational factors listed. However, when put in ranking order, the top 4 motivating influences for choosing pharmacy were consistent across all survey groups. The factor with the least influence on study participants was also consistent amongst all groups. Implications: People that are choosing pharmacy as a profession today differ demographically from experienced pharmacists; however the influences on selecting pharmacy as a profession are similar.
  • Evaluation of Neonate-Specific Gentamicin Dosing Protocols Using a Pooled Patient Data Set: A Retrospective Analysis

    Murphy, John E.; McCormick, Nate; Stoffel, Shaun; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
    Objectives: First, to evaluate five recent gentamicin dosing protocols that are specific for neonates and determine how frequently each protocol yields desirable peak and trough concentrations. Second, to make our evaluation more robust, we included AUC as one of the pharmacokinetic parameters and compared it to traditional parameters. Finally, to evaluate a fixed dosing protocol (3 mg/kg Q24-hours) that is currently being used at one Arizona hospital (UMC). Methods: This retrospective evaluation involved datasets from three independent sources. Dataset 1 was from a previously published study, while datasets 2 and 3 were derived for this study. Datasets 1 and 2 were pooled to evaluate the five dosing protocols, while dataset 3 was used to evaluate the fixed dosing protocol used at UMC. For all subjects, demographic and laboratory data was obtained from hospital databases or charts. The data collected was used to construct pharmacokinetic values, which in turn were used in simulations with the five protocols. Dataset 3 was evaluated as a whole for frequency of desired peaks and troughs, then for subsets based on weight, gestational age, and Apgar scores. Results: Of the five evaluated, the Avent protocol yielded the fewest potentially toxic troughs. The Murphy-Carter protocol stood out in that it was the easiest to use, most universally applicable, and it yielded only slightly fewer desired troughs then the Avent protocol. AUC values proved to be a novel and exceptionally useful tool in evaluating the dosing protocols. The fixed dosing protocol used at UMC was shown to consistently produce favorable trough concentrations as a whole as well as in our subset analyses. Implications: The multitude of dosing protocols that have been offered can create confusion among health care professionals and lead to discrepancies in dosing. The primary goal of any of these protocols is to minimize the risk of toxicity while avoiding subtherapeutic doses. A dosing protocol that can consistently meet these criterion, yet offer simplicity and wide applicability, then we can come that much closer to a universal standard.

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