Examination of Pharmacy Accessibility in Two Racially Diverse Metropolitan Areas: Development of a Pharmacy Access Model Using Multiple Discriminant Analysis

Prior research has shown disparities in pharmacy access related to race/ethnicity, income, and other sociodemographic factors. There is currently no consistent definition of low pharmacy access and there is no federal designation for areas underserved by pharmacies. The purpose of this study was to expand on prior pharmacy accessibility research and develop a conceptual model of pharmacy access in selected racially diverse urban areas of the United States. Through the application of geographic information software (GIS) mapping, the enhanced two-step floating catchment area (E2SFCA) methodology, and multiple discriminant analysis, the pharmacy landscape and relative pharmacy access were qualitatively and quantitatively described for the study areas. Models of pharmacy access based on distance and travel time were also derived. Pharmacy access varied by racial composition. Factors most influential to pharmacy access included socioeconomic position, transportation use, and population vulnerability

Evaluating Design Improvements to a Preceptor Performance and APPE Assessment Tool Using Pharmacy Student Focus Groups

Class of 2014 AbstractSpecific Aims: The final year of the Doctor of Pharmacy program at the University of Arizona is comprised of seven 6-week Advanced Pharmacy Practice Experiences (APPEs). Students evaluate rotations via voluntary anonymous, web-based assessments at the end of each rotation. The purpose of this study was to evaluate an original and a modified assessment tool using pharmacy student focus groups to determine if student feedback via the assessment tools accurately reflected opinions of rotation content and preceptor performance. Methods: Two moderators conducted tape-recorded focus groups with fourth-year pharmacy students using 10 standardized prompts. The first focus group included 5 students from the class of 2013. Based on data from that session, the assessment tool was modified. The second focus group included 5 students from the class of 2014 to evaluate the outcome of these modifications. Session transcripts and notes were used to construct thematic analysis tables and draw conclusions. Main Results: Focus group data revealed feedback via both assessment tools was not completely honest because of concerns about anonymity. The Class of 2013 felt limited by evaluating only their primary preceptor. The Class of 2014 stated that some revisions to the evaluation tool, such as item-specific comment boxes and separate evaluative sections for rotation site, preceptor, and rotation experience were helpful; however, they found the assessment tool lengthy, leading to survey fatigue. Conclusion: Student feedback from either assessment tool was not completely reflective of true attitudes of rotation experiences. Continued improvements to the tool and its delivery may provide more accurate feedback for quality improvement purposes.This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Librarian and Clinical Instructor, Pharmacy Practice and Science, [email protected]

Health related quality of life among myocardial infarction survivors in the United States: a propensity score matched analysis

Background: Little is known regarding the health-related quality of life among myocardial infarction (MI) survivors in the United States. The purpose of this population-based study was to identify differences in health-related quality of life domains between MI survivors and propensity score matched controls. Methods: This retrospective, cross-sectional matched case-control study examined differences in health-related quality of life (HRQoL) among MI survivors of myocardial infarction compared to propensity score matched controls using data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) survey. Propensity scores were generated via logistic regression for MI survivors and controls based on gender, race/ethnicity, age, body mass index (BMI), smoking status, and comorbidities. Chi-square tests were used to compare differences between MI survivors to controls for demographic variables. A multivariate analysis of HRQoL domains estimated odds ratios. Life satisfaction, sleep quality, and activity limitations were estimated using binary logistic regression. Social support, perceived general health, perceived physical health, and perceived mental health were estimated using multinomial logistic regression. Significance was set at p 15 days in the month (AOR = 1.63, 95% CI: 1.46-1.83) and poor mental health > 15 days in the month (AOR = 1.25, 95% CI: 1.07-1.46) compared to matched controls. There was no difference in survivors compared to controls in level of emotional support (rarely/never: AOR = 0.75, 95% CI: 0.48-1. 18; sometimes: AOR = 0.73, 95% CI: 0.41-1.28), hours of recommended sleep (AOR = 1.14, 95% CI: 0.94-1.38), or life satisfaction (AOR = 1.62, 95% CI: 0.99-2.63). Conclusion: MI survivors experienced lower HRQoL on domains of general health, physical health, daily activity, and mental health compared to the general population.UA Open Access Publishing Fund.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Measurement characteristics of a concept classification exam using multiple case examples: A Rasch analysis

Objective: To determine if an exam using multiple cases to test research design concepts measured only one cognitive skill, concept classification, and to determine if item difficulty varied according to the research design used for the case. Methods: The exam consisted of 50 multiple choice items associated with five example abstracts: a randomized controlled trial, pretest-posttest, crossover, retrospective cohort, and descriptive designs. A Rasch analysis was conducted to determine dimensionality (i.e., measured a single skill). Items were stratified by design to explore the relationship between item difficulty and study design. Overall difficulty was assessed using an item person map. Results: The exam was administered to 101 students; the mean was 88.4% (mean score = 44.2; SD = 3.5). The Rasch analysis indicated the exam primarily measured one cognitive skill, presumably concept classification. The stratified analysis indicated that overall no single research design was more difficult than other designs; however, the type of research design and item topic interacted so that an easy item for one design could be difficult when associated with a different study design. Conclusions: The exam appeared to function more like a mastery exam documenting that most students performed well rather than as an exam for ranking students by ability. That item topic interacted with study design to affect item difficulty, indicates that items on the same topic are needed to test basic design concepts across study designs. (C) 2015 Elsevier Inc. All rights reserved.12 month embargo; available online 6 November 2015.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

A Systematic Review of the Prevalence and Diagnostic Workup of PIK3CA Mutations in HR+/HER2– Metastatic Breast Cancer

PIK3CA mutation frequency varies among breast cancer (BC) subtypes. Recent evidence suggests combination therapy with the PI3K inhibitor (PI3Ki) alpelisib and endocrine therapy (ET) improves response rates and progression-free survival (PFS) in PIK3CA-mutant, hormone receptor positive (HR+) BC versus ET alone; thus, better understanding the clinical and epidemiologic elements of these mutations is warranted. This systematic review characterizes the PIK3CA mutation epidemiology, type of testing approaches (e.g., liquid or tissue tumor biopsy), and stability/concordance (e.g., consistency in results by liquid versus solid tumor sample, by the same method over time) in patients with HR+/HER2– advanced (locally unresectable) or metastatic disease (HR+/HER2– mBC) and explores performance (e.g., pairwise concordance, sensitivity, specificity, or predictive value) of respective mutation findings. A comprehensive search of PubMed/MEDLINE, EMBASE, Cochrane Central, and select conference abstracts (i.e., AACR, ASCO, SABCS, ECCO, and ESMO conferences between 2014 and 2017) identified 39 studies of patients with HR+, HER2– mBC. The median prevalence of PIK3CA mutation was 36% (range: 13.3% to 61.5%); identified testing approaches more commonly used tissue over liquid biopsies and primarily utilized next-generation sequencing (NGS), polymerase chain reaction (PCR), or Sanger sequencing. There was concordance and stability between tissues (range: 70.4% to 94%) based on limited data. Given the clinical benefit of the PI3Ki alpelisib in patients with PIK3CA mutant HR+/HER2– mBC, determination of tumor PIK3CA mutation status is of importance in managing patients with HR+/HER2– mBC. Prevalence of this mutation and utility of test methodologies likely warrants PIK3CA mutation testing in all patients with this breast cancer subtype via definitive assessment of PIK3CA mutational status