Contribution of thirdhand smoke to overall tobacco smoke exposure in pediatric patients: study protocol.

BackgroundThirdhand smoke (THS) is the persistent residue resulting from secondhand smoke (SHS) that accumulates in dust, objects, and on surfaces in homes where tobacco has been used, and is reemitted into air. Very little is known about the extent to which THS contributes to children's overall tobacco smoke exposure (OTS) levels, defined as their combined THS and SHS exposure. Even less is known about the effect of OTS and THS on children's health. This project will examine how different home smoking behaviors contribute to THS and OTS and if levels of THS are associated with respiratory illnesses in nonsmoking children.MethodsThis project leverages the experimental design from an ongoing pediatric emergency department-based tobacco cessation trial of caregivers who smoke and their children (NIHR01HD083354). At baseline and follow-up, we will collect urine and handwipe samples from children and samples of dust and air from the homes of smokers who smoke indoors, have smoking bans or who have quit smoking. These samples will be analyzed to examine to what extent THS pollution at home contributes to OTS exposure over and above SHS and to what extent THS continues to persist and contribute to OTS in homes of smokers who have quit or have smoking bans. Targeted and nontargeted chemical analyses of home dust samples will explore which types of THS pollutants are present in homes. Electronic medical record review will examine if THS and OTS levels are associated with child respiratory illness. Additionally, a repository of child and environmental samples will be created.DiscussionThe results of this study will be crucial to help close gaps in our understanding of the types, quantity, and clinical effects of OTS, THS exposure, and THS pollutants in a unique sample of tobacco smoke-exposed ill children and their homes. The potential impact of these findings is substantial, as currently the level of risk in OTS attributable to THS is unknown. This research has the potential to change how we protect children from OTS, by recognizing that SHS and THS exposure needs to be addressed separately and jointly as sources of pollution and exposure.Trial registrationClinicalTrials.gov Identifier: NCT02531594 . Date of registration: August 24, 2015

Older Adult Perceptions of a Self-reported Medication Risk Questionaire: A Focus Group Study

Background: Medication therapy management (MTM) has been shown to resolve medication-related problems and decrease health care expenses. Public and private health insurers, providers, and other stakeholders are looking for ways to involve patients in the MTM process. One option is to engage patients through the use of a medication risk questionnaire. Objective: To investigate older adults' perceptions of completing a medication risk questionnaire and receiving a rating of their risk for medication-related problems. Methods: Four, 75 to 90 minute focus groups were conducted using a semi-structured interview guide and copies of a medication risk questionnaire to collect qualitative data from 36 community dwelling older adults in Iowa, USA. Sessions were audio-recorded, transcribed, and analyzed thematically using an iterative process. Results: The thematic analysis yielded a general theme of comprehensive medication reviews, and two themes on the medication risk questionnaire: "process and items" and "risk category reactions." Overall, participants were unfamiliar with pharmacist services beyond counseling. They were open to the questionnaire, but suggested it would be more useful as a topic for discussion with a provider than to screen patients. Despite their medication risk rating, most did not express interest in seeking a comprehensive medication review based on the result of the questionnaire as they considered themselves at low risk for problems. Conclusions: Using a medication risk questionnaire as a topic for discussion could provide health insurance plans or providers an opportunity to increase beneficiary familiarity with MTM. These beneficiary perspectives may be useful to health plan administrators and MTM providers as they pursue new ways to involve patients in the medication management process.   Type: Student Projec

Older Adult Perceptions of a Self-reported Medication Risk Questionaire: A Focus Group Study

Background: Medication therapy management (MTM) has been shown to resolve medication-related problems and decrease health care expenses. Public and private health insurers, providers, and other stakeholders are looking for ways to involve patients in the MTM process. One option is to engage patients through the use of a medication risk questionnaire. Objective: To investigate older adults’ perceptions of completing a medication risk questionnaire and receiving a rating of their risk for medication-related problems. Methods: Four, 75 to 90 minute focus groups were conducted using a semi-structured interview guide and copies of a medication risk questionnaire to collect qualitative data from 36 community dwelling older adults in Iowa, USA. Sessions were audio-recorded, transcribed, and analyzed thematically using an iterative process. Results: The thematic analysis yielded a general theme of comprehensive medication reviews, and two themes on the medication risk questionnaire: “process and items” and “risk category reactions.” Overall, participants were unfamiliar with pharmacist services beyond counseling. They were open to the questionnaire, but suggested it would be more useful as a topic for discussion with a provider than to screen patients. Despite their medication risk rating, most did not express interest in seeking a comprehensive medication review based on the result of the questionnaire as they considered themselves at low risk for problems. Conclusions: Using a medication risk questionnaire as a topic for discussion could provide health insurance plans or providers an opportunity to increase beneficiary familiarity with MTM. These beneficiary perspectives may be useful to health plan administrators and MTM providers as they pursue new ways to involve patients in the medication management process.Witry, Matthew J.; Chang, Elizabeth H.; Mormann, Megan M.; Doucette, William R.; Newland, Brand A.. (2011). Older Adult Perceptions of a Self-reported Medication Risk Questionaire: A Focus Group Study. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/116887

What drives job satisfaction among community pharmacists? An application of relative importance analysis

Background: Pharmacy employers want to improve pharmacists' job satisfaction, but ratings of job satisfaction are highly subjective, as evaluating job satisfaction involves weighing simultaneously the importance of multiple correlated determinants that are often perceived unequally. Objectives: To 1) describe the application of relative importance analysis in estimating the predictive ability of correlated determinants of job satisfaction, and to rank the determinants in order of relative importance, and 2) explore how the perceived relative importance of job satisfaction predictors may vary across community pharmacists' age, gender, and work setting categories. Methods: Data were obtained from the 2019 National Pharmacy Workforce Survey administered to 96,110 licensed U.S. pharmacists. Multiple regression analysis (MR) and relative weight analysis (RWA) were used to assess the predictive ability of determinants to explain pharmacists' job satisfaction. Subgroup analyses were performed to explore variations in the perceived relative importance of predictors across pharmacists' age, gender and work setting categories. Results: Over the entire sample of community pharmacists, no personal experience of workplace discrimination [RW = 0.0613, rank = 1] and less reported engagement in advanced dispensing activities [RW = 0.0235, rank = 2] were most associated with greater job satisfaction, as both predictors jointly accounted for 67.5% of the predicted criterion variance (R2). Pharmacists' compensation was observed to have the lowest perceived relative importance for predicting job satisfaction [RW = 0.0005, rank = 6], accounting for 0.5% of R2. Between-group comparisons showed that, no personal experience of workplace discrimination had the highest perceived relative importance for job satisfaction across pharmacists' age groups, among women, and across most work settings except small chain pharmacies. Within-group comparisons showed that pharmacists' compensation was significantly more important than professional interactions (ΔRW(PC-PPI) 0.2900 [0.0637, 0.5360]) for job satisfaction among pharmacists in large chain pharmacies, while patient-care services was significantly more important than compensation for job satisfaction in independent (ΔRW(PPS-PC) 0.1761 [0.0017, 0.5980]) and health system retail pharmacists (ΔRW(PPS-PC) 0.4190 [0.0444, 0.8303]). Conclusions: Relative importance analysis corroborated multiple regression and provided a more interpretable presentation of variable influence on community pharmacists job satisfaction as the importance of personal and workplace characteristics in how pharmacists evaluate their job satisfaction varied across age, gender and work setting categories

National Pharmacist Workforce Study (NPWS): Description of 2019 Survey Methods and Assessment of Nonresponse Bias

National Pharmacist Workforce Studies (NPWS) have been conducted in the U.S. every five years since 2000. This article describes the online survey methods used for the latest NPWS conducted in 2019 and provides an assessment for nonresponse bias. Three waves of emails containing a link to the online survey were sent to a random sample of about 96,000 pharmacists licensed in the United States. The survey asked about pharmacist employment, work activities, work–life balance, practice characteristics, pharmacist demographics and training. A total of 5467 usable responses were received, for a usable response rate of 5.8%. To assess for nonresponse bias, respondent characteristics were compared to the population of U.S. pharmacists and a benchmark, while a wave analysis compared early and late respondents. The pharmacist sample–population comparison and the benchmark comparison showed that the NPWS respondents had a higher percentage of female pharmacists and a lower proportion of young pharmacists compared to the population of U.S. pharmacists and the benchmark sample. In some contrast, the wave analysis showed that the early respondents had a higher percentage of males and older pharmacists compared to the late respondents. Both the wave analysis and the benchmark comparison showed that the NPWS respondents (and early respondents) had a lower percent of pharmacists with a PharmD degree than did the late respondents and the benchmark group. These differences should be considered when interpreting the findings from the 2019 NPWS

National Pharmacist Workforce Study (NPWS): Description of 2019 Survey Methods and Assessment of Nonresponse Bias

National Pharmacist Workforce Studies (NPWS) have been conducted in the U.S. every five years since 2000. This article describes the online survey methods used for the latest NPWS conducted in 2019 and provides an assessment for nonresponse bias. Three waves of emails containing a link to the online survey were sent to a random sample of about 96,000 pharmacists licensed in the United States. The survey asked about pharmacist employment, work activities, work–life balance, practice characteristics, pharmacist demographics and training. A total of 5467 usable responses were received, for a usable response rate of 5.8%. To assess for nonresponse bias, respondent characteristics were compared to the population of U.S. pharmacists and a benchmark, while a wave analysis compared early and late respondents. The pharmacist sample–population comparison and the benchmark comparison showed that the NPWS respondents had a higher percentage of female pharmacists and a lower proportion of young pharmacists compared to the population of U.S. pharmacists and the benchmark sample. In some contrast, the wave analysis showed that the early respondents had a higher percentage of males and older pharmacists compared to the late respondents. Both the wave analysis and the benchmark comparison showed that the NPWS respondents (and early respondents) had a lower percent of pharmacists with a PharmD degree than did the late respondents and the benchmark group. These differences should be considered when interpreting the findings from the 2019 NPWS