An Instrument to Assess Subjective Task Value Beliefs Regarding the Decision to Pursue Postgraduate Training

Objectives. To develop and validate an instrument to assess subjective ratings of the perceived value of various postgraduate training paths followed using expectancy-value as a theoretical framework; and to explore differences in value beliefs across type of postgraduate training pursued and type of pharmacy training completed prior to postgraduate training. Methods. A survey instrument was developed to sample 4 theoretical domains of subjective task value: intrinsic value, attainment value, utility value, and perceived cost. Retrospective self-report methodology was employed to examine respondents’ (N=1,148) subjective task value beliefs specific to their highest level of postgraduate training completed. Exploratory and confirmatory factor analytic techniques were used to evaluate and validate value belief constructs. Results. Intrinsic, attainment, utility, cost, and financial value constructs resulted from exploratory factor analysis. Cross-validation resulted in a 26-item instrument that demonstrated good model fit. Differences in value beliefs were noted across type of postgraduate training pursued and pharmacy training characteristics. Conclusions. The Postgraduate Training Value Instrument demonstrated evidence of reliability and construct validity. The survey instrument can be used to assess value beliefs regarding multiple postgraduate training options in pharmacy and potentially inform targeted recruiting of individuals to those paths best matching their own value beliefs

Pharmaceutical systematics: Description and preliminary investigation of an alternative method for structuring drug information

Objectives: To identify the 30 most common adverse drug events or reactions (ADE/ADRs) within the top 200 medications: (1) by raw incidence, (2) weighted by prescription volume, (3) and weighted by retail dollars. Methods: The Pharmacy Times Top 200 Medications (as ranked by prescription volume) was utilized to identify the top 200 medications in 2008. The ADE/ADRs for each medication were obtained from Facts and Comparisons, Micromedex, and Lexi-Comp and entered into a database. These ADE/ADRs were compiled and summed, identifying the number of times each appeared. These then were ranked to identify the 30 most common ADE/ADRs. The actual prescription volume and total retail dollars for each medication were obtained and listed next to each medication's ADE/ADR. The incidence of each ADE/ADR then was weighted by actual prescription volume and retail dollars to determine the top 30 most common ADE/ADRs. Results: Initial evaluation resulted in 9829 individual ADE/ADRs and summed into 1477 distinct ADE/ADRs, after adjusting for interchangeable terminology. Examples of the 30 most common ADE/ADRs (raw incidence) included: dizziness/vertigo, headache, nausea, vomiting, and diarrhea/loose stools. The list remained the same after weighting by actual prescription volume. After weighting by retail dollars, the order of ADE/ADRs changed slightly. Conclusion: Knowledge of ADE/ADRs is important for pharmacists in all healthcare settings. Consolidating ADE/ADRs for medications may enable pharmacists to recall the most common side effects and aid in earlier identification of ADE/ADRs, which may positively impact patient safety across practice settings. Type: Original Researc

An evaluation of the spread and scale of PatientToc™ from primary care to community pharmacy practice for the collection of patient-reported outcomes: A study protocol

Background Medication non-adherence is a problem of critical importance, affecting approximately 50% of all persons taking at least one regularly scheduled prescription medication and costing the United States more than $100 billion annually. Traditional data sources for identifying and resolving medication non-adherence in community pharmacies include prescription fill histories. However, medication possession does not necessarily mean patients are taking their medications as prescribed. Patient-reported outcomes (PROs), measuring adherence challenges pertaining to both remembering and intention to take medication, offer a rich data source for pharmacists and prescribers to use to resolve medication non-adherence. PatientToc™ is a PROs collection software developed to facilitate collection of PROs data from low-literacy and non-English speaking patients in Los Angeles. Objectives This study will evaluate the spread and scale of PatientToc™ from primary care to community pharmacies for the collection and use of PROs data pertaining to medication adherence. Methods The following implementation and evaluation steps will be conducted: 1) a pre-implementation developmental formative evaluation to determine community pharmacy workflow and current practices for identifying and resolving medication non-adherence, potential barriers and facilitators to PatientToc™ implementation, and to create a draft implementation toolkit, 2) two plan-do-study-act cycles to refine an implementation toolkit for spreading and scaling implementation of PatientToc™ in community pharmacies, and 3) a comprehensive, theory-driven evaluation of the quality of care, implementation, and patient health outcomes of spreading and scaling PatientToc™ to community pharmacies. Expected impact This research will inform long-term collection and use of PROs data pertaining to medication adherence in community pharmacies

Preparing for the spread of patient-reported outcomes (PROs) data collection from primary care to community pharmacy: stakeholder insights

Medication non-adherence is a significant public health problem. Patient-reported outcomes (PROs) offer a rich data source to facilitate resolution of medication non-adherence. PatientToc™ is an electronic PRO data collection software originally implemented at primary care practices in California, United States (US). Currently, the use of standardized PRO data collection systems in US community pharmacies is limited. Thus, we are conducting a two-phase evaluation of the spread and scale of PatientToc™ to US Midwestern community pharmacies. This report focuses on the first phase of the evaluation. The objective of this phase was to prepare for implementation of PatientToc™ in community pharmacies by conducting a pre-implementation developmental formative evaluation to (1) identify potential barriers, facilitators, and actionable recommendations to PatientToc™ implementation and (2) create a draft implementation toolkit

Experiences Applying Technology to Overcome Common Challenges in Pharmacy Practice-Based Research in the United States

Despite the importance of pharmacy practice-based research in generating knowledge that results in better outcomes for patients, health systems and society alike, common challenges to PPBR persist. Herein, we authors describe PPBR challenges our research teams have encountered, and our experiences using technology-driven solutions to overcome such challenges. Notably, limited financial resources reduce the time available for clinicians and researchers to participate in study activities; therefore, resource allocation must be optimized. We authors have also encountered primary data collection challenges due to unique data needs and data access/ownership issues. Moreover, we have experienced a wide geographic dispersion of study practices and collaborating researchers; a lack of trained, on-site research personnel; and the identification and enrollment of participants meeting study eligibility criteria. To address these PPBR challenges, we authors have begun to turn to technology-driven solutions, as described here

First Ultracompact Roche Lobe–Filling Hot Subdwarf Binary

We report the discovery of the first short-period binary in which a hot subdwarf star (sdOB) filled its Roche lobe and started mass transfer to its companion. The object was discovered as part of a dedicated high-cadence survey of the Galactic plane named the Zwicky Transient Facility and exhibits a period of P = 39.3401(1) minutes, making it the most compact hot subdwarf binary currently known. Spectroscopic observations are consistent with an intermediate He-sdOB star with an effective temperature of T_(eff) = 42,400 ± 300 K and a surface gravity of log(g) = 5.77 ± 0.05. A high signal-to-noise ratio GTC+HiPERCAM light curve is dominated by the ellipsoidal deformation of the sdOB star and an eclipse of the sdOB by an accretion disk. We infer a low-mass hot subdwarf donor with a mass M_(sdOB) = 0.337 ± 0.015 M⊙ and a white dwarf accretor with a mass M_(WD) = 0.545 ± 0.020 M⊙. Theoretical binary modeling indicates the hot subdwarf formed during a common envelope phase when a 2.5–2.8 M⊙ star lost its envelope when crossing the Hertzsprung gap. To match its current P_(orb), T_(eff), log(g), and masses, we estimate a post–common envelope period of P_(orb) ≈ 150 minutes and find that the sdOB star is currently undergoing hydrogen shell burning. We estimate that the hot subdwarf will become a white dwarf with a thick helium layer of ≈0.1 M⊙, merge with its carbon/oxygen white dwarf companion after ≈17 Myr, and presumably explode as a thermonuclear supernova or form an R CrB star

KELT-24b: A 5M_J Planet on a 5.6 day Well-Aligned Orbit around the Young V=8.3 F-star HD 93148

We present the discovery of KELT-24 b, a massive hot Jupiter orbiting a bright (V=8.3 mag, K=7.2 mag) young F-star with a period of 5.6 days. The host star, KELT-24 (HD 93148), has a T_(eff) =6508±49 K, a mass of M∗ = 1.461^(+0.056)_(−0.060) M_⊙, radius of R∗ = 1.506±0.022 R_⊙, and an age of 0.77^(+0.61)_(−0.42) Gyr. Its planetary companion (KELT-24 b) has a radius of R_P = 1.272^(+0.021)_(−0.022) R_J, a mass of MP = 5.18^(+0.21)_(−0.22) M_J, and from Doppler tomographic observations, we find that the planet's orbit is well-aligned to its host star's projected spin axis (λ = 2.6^(+5.1)_(−3.6)). The young age estimated for KELT-24 suggests that it only recently started to evolve from the zero-age main sequence. KELT-24 is the brightest star known to host a transiting giant planet with a period between 5 and 10 days. Although the circularization timescale is much longer than the age of the system, we do not detect a large eccentricity or significant misalignment that is expected from dynamical migration. The brightness of its host star and its moderate surface gravity make KELT-24b an intriguing target for detailed atmospheric characterization through spectroscopic emission measurements since it would bridge the current literature results that have primarily focused on lower mass hot Jupiters and a few brown dwarfs