Motivational Interviewing from Theory to Practice: Engaging the Patient Throughout the MTM Encounter

The application of motivational interviewing (MI) can be used to improve patient communication and outcomes. MI techniques can be used in conversations with patients to identify their readiness to change health-related behaviors and collaborate with them in achieving these changes. It is particularly helpful when determining why patients may be taking their medications improperly, or not at all. The technique enhances the pharmacists’ communication with patients and can make a difference in their health outcomes. Presented at the 2015 MTM and Medication Adherence Innovations Summit, Nashville, TN

Ohmic contacts for organic optoelectronic devices

In last three decades, great progress has been made in the field of organic electronics. Researchers have put tremendous efforts to make new materials and device architectures, which has resulted in a great commercial success of organic light emitting diodes in mobile phone and television display screens. Despite that, still today it is challenging to make organic electronic devices that are efficient in performance, stable in operation and are economical in production at the same time. The objective of this thesis is to understand fundamental charge transport properties of small molecules based organic semiconductors and to develop novel organic electronic device architectures. One of the prime requirements for efficient organic optoelectronic devices is to have ohmic charge injection contacts. Therefore, first a charge injection strategy for making ohmic hole contacts is developed. Using this strategy, ohmic hole contacts are achieved on organic semiconductors with an ionization energy up to 6 eV. As a result, the hole transport in a wide range of organic small molecules with ionization energy between 5 to 6 eV could be investigated. Despite the difference in their chemical structures, similar bulk hole mobilities in the range of $1\times10^{-4}$ cm$^{2}$V$^{-1}$s$^{-1}$ were observed for all molecules. The hole transport was also investigated using molecular multiscale simulations, an excellent agreement was obtained with the experimental results. Despite fullerene derivatives being known as electron conductors, It was found that the fullerene derivative ICBA has a very good hole mobility of $1.4\times10^{-3}$ cm$^{2}$V$^{-1}$s$^{-1}$ which is the same as bulk electron mobility, demonstrating the intrinsic bipolar charge-trasnport character of organic semiconductors. It is found that charge trapping is causing the frequently observed unipolarity in organic semiconductors, causing preferential conduction of either holes or electrons. This limits the efficiencies and stabilities of the organic optoelectronic devices. By investigating charge trapping in a wide range of organic semiconductors, we have identified that when the electron affinity is lower than 3.6 eV, electron transport becomes trap limited and when ionization energy is higher than 6 eV hole transport becomes trap limited. As a result, within this energy window of about 2.4 eV trap-free charge transport is observed. Combining this energy window for trap-free transport with our developed charge injection strategy, an efficient and stable single layer OLED based on a neat thermally activated delayed fluorescence emitter is demonstrated. The OLED has a maximum external quantum efficiency of 19% at a luminance of $500$ cdm$^{-2}$and a lifetime to 50% of initial luminance of $1000$ cdm$^{-2}$ of 1,880 h. It has an exceptionally low operating voltage of 2.9 V at a luminance of $10,000$ cdm$^{-2}$, which resulted in a maximum power efficiency of $87$ lmW$^{-1}$

Implementation of a Pediatric Behavioral Health Medication Safety Initiative in a State Medicaid Program

The poster will address concerns about an increase in the use of behavioral medications in children and the need to manage prescribing practices to ensure appropriate use of the drugs. Presented at the American Drug Utilization Review Society 2015 Conference

Adherence Measurement and Incidence of Bleeding and Systemic Embolism with Dabigatran in a Medicaid Population

BACKGROUND: The use of warfarin for the treatment of atrial fibrillation (AF) is often complicated by the associated narrow therapeutic index and frequent monitoring. Dabigatran, an oral direct thrombin inhibitor, does not require routine monitoring, produces rapid therapeutic anticoagulation, and has the potential to improve thromboprophylaxis through increased adherence. As such, it is important to evaluate adherence and the incidence of bleeding and systemic embolism with dabigatran in a real-world population with AF. OBJECTIVE: To measure adherence and incidence of bleeding and systemic embolism with dabigatran in a state Medicaid population with AF. METHODS: Medicaid members \u3e18 years of age with AF were included if they had \u3e1 paid claim for dabigatran between February 1, 2011 and September 30, 2011. Members were excluded if they had breaks in Medicaid coverage, supplemental insurance or were a female of childbearing age. The index date was defined as the date of the first pharmacy claim for dabigatran. Adherence was measured using medication possession ratios (MPR) for members with \u3e2 paid claims for dabigatran and members with an MPR \u3e0.8 were considered adherent. The incidences of bleeding, stroke and all-cause hospitalization were determined using medical claims data for one year post-index date. Pharmacy claims data was used to report changes in anticoagulant therapy within one year post-index date. RESULTS: The average MPR was 0.87 and 69% of members were considered adherent. Of the members that started dabigatran, 42.9% continued dabigatran while 21.4% switched to warfarin. Overall, 16.7% of members experienced a systemic embolism and only one bleeding event occurred during the study period. While chest pain and dyspepsia were the most common adverse events, 45.2% of members had no adverse events. CONCLUSIONS: This evaluation found that while members were adherent to dabigatran therapy, the discontinuation rate suggests poor tolerance to therapy