Pharmacy

Editorial

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2 pages, 148 KiB

Open AccessEditorial

Medication Experiences

by Jon C. Schommer

Pharmacy 2021, 9(2), 79; https://doi.org/10.3390/pharmacy9020079 - 13 Apr 2021

Cited by 1 | Viewed by 2523

Abstract

Welcome to the “Medication Experiences” Special Issue in the journal—Pharmacy—an open access journal focused on pharmacy education and practice [...] Full article

(This article belongs to the Special Issue Medication Experiences)

Research

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20 pages, 1051 KiB

Open AccessArticle

The Association between Medication Experiences and Beliefs and Low Medication Adherence in Patients with Chronic Disease from Two Different Societies: The USA and the Sultanate of Oman

by Kamla M. Ibrahim, Jon C. Schommer, Donald E. Morisky, Raquel Rodriguez, Caroline Gaither and Mark Snyder

Pharmacy 2021, 9(1), 31; https://doi.org/10.3390/pharmacy9010031 - 3 Feb 2021

Cited by 13 | Viewed by 4008

Abstract

This cross-sectional study aimed to describe the association between medication experiences and beliefs and self-reported medication adherence in patients with chronic diseases in two different samples from two different societies: the USA and the Sultanate of Oman. The Morisky Medication Adherence Score (MMAS-8) [...] Read more.

This cross-sectional study aimed to describe the association between medication experiences and beliefs and self-reported medication adherence in patients with chronic diseases in two different samples from two different societies: the USA and the Sultanate of Oman. The Morisky Medication Adherence Score (MMAS-8) questionnaire was used to measure medication adherence. Three items (statements) were used for measuring medication experiences and beliefs variable on a four-point Likert scale adapted from the 2015 National Consumer Survey of the Medication Experience and Pharmacists’ Role (NCSME&PR). In the U.S., quantitative secondary data analysis of 13,731 participants was conducted using the 2015 NCSME&PR, a self-administered online survey coordinated by Qualtrics Panels between 28 April 2015 and 22 June 2015. The same variables were translated into Arabic, with studies conducted at the Royal Court Medical Center in Oman, and data from 714 participants were collected between 16 June 2019 and 16 August 2019. Data were analyzed using IMB/SPSS version 24.0 software. Chi-square analysis and descriptive statistics were used. The results showed that the low adherence rates for medication (MMAS-8 < 6) were 56% and 52% in Omani and U.S. groups, respectively. Approximately 90% of the U.S. and Omani participants believed that “medicines are a life-saver”; however, medication adherence was higher in Oman (30%) than in the United States (9%) for these participants. In total, 60% of the U.S. and 29% of Omani participants believed that “medicines are a burden”; however, about 60–65% of participants in both countries were in the low medication adherence group. Additionally, 63% of the U.S. and 83% of the Omani participants disagreed that “medicines do more harm than good”; however, medication adherence in the U.S. (15%) was higher than in Oman (8%). In conclusion, a decrease in low medication adherence was observed with positive medication experiences and beliefs. However, the impacts of medication experiences and beliefs on low medication adherence rates were different from one population to another. The “medication burden” statement resulted in the highest percentage of difference in terms of low medication adherence rates between those who agree and those who disagree in the U.S. group (20%), whereas the “medicines are a life-saver” statement resulted in a greater difference in the Omani group (30%). Proper communication between patients and healthcare providers based on the patient’s medication experiences and beliefs will substantially improve medication adherence. Full article

(This article belongs to the Special Issue Medication Experiences)

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9 pages, 1293 KiB

Open AccessArticle

Sentiment Analysis of Online Reviews for Selective Serotonin Reuptake Inhibitors and Serotonin–Norepinephrine Reuptake Inhibitors

by Chad Compagner, Corey Lester and Michael Dorsch

Pharmacy 2021, 9(1), 27; https://doi.org/10.3390/pharmacy9010027 - 23 Jan 2021

Cited by 3 | Viewed by 3284

Abstract

Background: Depression affects millions worldwide, with drug therapy being the mainstay treatment. A variety of factors, including personal reviews, are involved in the success or failure of medication therapy. This study looked to characterize the sentiment of online medication reviews of Selective Serotonin [...] Read more.

Background: Depression affects millions worldwide, with drug therapy being the mainstay treatment. A variety of factors, including personal reviews, are involved in the success or failure of medication therapy. This study looked to characterize the sentiment of online medication reviews of Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin–Norepinephrine Reuptake Inhibitor (SNRIs) used to treat depression. Methods: The publicly available data source used was the Drug Review Dataset from the University of California Irvine Machine Learning Repository. The dataset contained the following variables: ID, drug name, condition, review, rating, date, and usefulness count. This study utilized a sentiment analysis of free-text, online reviews via the sentimentr package. A Mann–Whitney U test was used for comparisons. Results: The average sentiment was higher in SSRIs compared to SNRIs (0.065 vs. 0.005, p < 0.001). The average sentiment was also found to be higher in high-rated reviews than in low-rated reviews (0.169 vs. −0.367, p < 0.001). Ratings were similar in the high-rated SSRI group and high-rated SNRI group (9.19 vs. 9.19). Conclusions: This study supports the use of sentiment analysis using the AFINN lexicon, as the lexicon showed a difference in sentiment between high-rated reviews from low-rated reviews. This study also found that SNRIs have more negative sentiment and lower-rated reviews than SSRIs. Full article

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21 pages, 626 KiB

Open AccessArticle

Experiences of the Medication Use Process by People with Intellectual Disabilities. What a Pharmacist Should Know!

by Bernadette Flood and Martin C. Henman

Pharmacy 2021, 9(1), 24; https://doi.org/10.3390/pharmacy9010024 - 21 Jan 2021

Cited by 4 | Viewed by 4428

Abstract

There is a scarcity of information about the experience of people with intellectual disabilities in the medication use process. Six people with intellectual disabilities consented to be interviewed by a pharmacist to determine their knowledge and views of medication use. Data from semi-structured [...] Read more.

There is a scarcity of information about the experience of people with intellectual disabilities in the medication use process. Six people with intellectual disabilities consented to be interviewed by a pharmacist to determine their knowledge and views of medication use. Data from semi-structured interviews were analysed using a grounded theory approach. Self-determination and risk to the quality of the medication use process were identified as theories. Literature review provided two explanations—vulnerabilities of people with intellectual disabilities in healthcare and pharmacists have a role to play in ensuring a quality medication use process for people with intellectual disabilities. People with intellectual disabilities may be ‘expert patients’ and can provide valuable insights into their experience of medication use. They may be ‘high risk’ patients but may not be recognized as such by pharmacists. Full article

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7 pages, 208 KiB

Open AccessArticle

Impact of a Medication Adherence Packaging Service on Patient-Centered Outcomes at an Independent Community Pharmacy

by Catherine Phi, Lucas A. Berenbrok, Joni C. Carroll, Ashley Firm, Melissa Somma McGivney and Kim C. Coley

Pharmacy 2021, 9(1), 11; https://doi.org/10.3390/pharmacy9010011 - 5 Jan 2021

Cited by 3 | Viewed by 3171

Abstract

The purpose of this project was to evaluate the impact of a comprehensive medication adherence packaging (RxMAP) service on patient medication-taking behaviors and patient-centered outcomes. Adult patients who utilized a single independent community pharmacy, enrolled in the RxMAP service for at least two [...] Read more.

The purpose of this project was to evaluate the impact of a comprehensive medication adherence packaging (RxMAP) service on patient medication-taking behaviors and patient-centered outcomes. Adult patients who utilized a single independent community pharmacy, enrolled in the RxMAP service for at least two consecutive cycles, and managed their own medications were eligible. The RxMAP service consists of multi-dose blister packaging in 28-day cycles, medication synchronization, monthly touchpoint calls, and delivery/mailing. A 13-item telephonic survey was administered, and patients’ verbal responses were captured by audio-recording and detailed note taking. Descriptive statistics were used to quantify the results and illustrative quotes representing the interview domains were selected. There were 42 patients who completed the survey: 88% reported they missed fewer doses compared to before using RxMAP; 71% were more likely to take their medications on time each day; 86% were more confident with managing their medications; and 74% were more independent. Finally, 64% of patients stated their overall quality of life was better now compared to before using the packaging service. These results demonstrate that medication adherence packaging services can positively impact patients’ medication-taking behaviors, increase their confidence in medication management, and improve perceived quality of life. Full article

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17 pages, 505 KiB

Open AccessArticle

The Medication Experience: A Concept Analysis

by Lisa A. Hillman, Cynthia Peden-McAlpine, Djenane Ramalho-de-Oliveira and Jon C. Schommer

Pharmacy 2021, 9(1), 7; https://doi.org/10.3390/pharmacy9010007 - 31 Dec 2020

Cited by 6 | Viewed by 3971

Abstract

This is a concept analysis of the medication experience with a focus on how it applies to the pharmaceutical care practice framework used by pharmacist practitioners. The medication experience is a vital component of pharmaceutical care practice and of patient-centered care. Although the [...] Read more.

This is a concept analysis of the medication experience with a focus on how it applies to the pharmaceutical care practice framework used by pharmacist practitioners. The medication experience is a vital component of pharmaceutical care practice and of patient-centered care. Although the experience of taking medication has been studied across disciplines for decades, a concept analysis of the medication experience is lacking. Rodgers’ evolutionary concept analysis method was utilized. Ovid Medline, CINAHL, PsycINFO, Sociological Abstracts and Google Scholar databases, references and hand searches were used to compile an international dataset of 66 papers published from 1982 to 2020. As a result of the available literature, the medication experience is defined as one of ambivalence and vulnerability in which the patient is actively engaged in an ongoing process or negotiation, which is pragmatic to the ways in which they live and experience life, contextualized and nuanced within the social construction of their individual realities. The concept of medication experience is an important addition to the scientific literature. The definition of medication experience from the perspective of the patient will help to better explain the concept for future research and theory development to move the discipline of pharmaceutical care practice forward. Full article

(This article belongs to the Special Issue Medication Experiences)

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15 pages, 254 KiB

Open AccessArticle

Perspectives of Parents and Health Care Providers about (Non)Medical Treatment in Infants with Reflux

by Santina Gorsen, Koen Boussery, Myriam Van Winckel, Rolinde Demeyer and Eline Tommelein

Pharmacy 2020, 8(4), 226; https://doi.org/10.3390/pharmacy8040226 - 23 Nov 2020

Cited by 2 | Viewed by 2389

Abstract

Background: Reflux occurs in 50% of healthy infants at some point. This is most often a physiological condition and does not require drug treatment. Various studies have shown that the use of drugs affecting gastric acidity (DAGAs) in infants is increasing. This entails [...] Read more.

Background: Reflux occurs in 50% of healthy infants at some point. This is most often a physiological condition and does not require drug treatment. Various studies have shown that the use of drugs affecting gastric acidity (DAGAs) in infants is increasing. This entails disadvantages such as unnecessary exposure of infants to medication and their side effects and a higher cost to society. Objective: To get an image of the current practice in Flanders regarding diagnosis and treatment of gastro-oesophageal reflux disease (GORD) in infants and the associated use of DAGAs. To this end, we determined both parents’ and health care providers’ experiences and perceptions about these treatments. Method: An observational cross-sectional study was conducted in April and May 2019. We developed a questionnaire for parents and three different questionnaires for health care providers (HCPs), including midwives, general practitioners, paediatricians and community pharmacists (CPs). The questionnaire for parents was only available through an online platform. HCPs were questioned face-to-face and through an online platform. Results: This study made clear that the counselling of children with GORD is multidisciplinary as the median number of counselling HCPs is 3 (interquartile range (IQR) = 2–4). 63% of the included 251 parents also seek support through online forums and groups. 60% of parents report that no physical tests were performed before DAGAs were prescribed and 39% of parents additionally state they perceived no effect of the prescribed DAGAs. Although parents reported to understand HCPs well (average score 7.4/10), satisfaction with care and information provision was scored lower (between 4.8 and 6.1/10). On the other hand, 234 HCPs answered the questionnaire, of which 89 midwives, 78 community pharmacists and 67 physicians. Only 45 HCPs indicate that guidelines to diagnose or treat GORD are clear. Physicians confirm they perform very little physical testing before starting DAGAs. Provided nonmedical measures to patients are largely in line with the European guidelines, however perceived effectiveness is moderate. Conclusion: Parents are in need for more information about tests, nutrition and (non)medical measures. HCPs on the other hand are in need for clear guidelines on diagnosing and treating GORD. Full article

(This article belongs to the Special Issue Medication Experiences)

12 pages, 248 KiB

Open AccessArticle

Pharmacy Students’ Perceptions and Stigma Surrounding Naloxone Use in Patients with Opioid Use Disorder: A Mixed Methods Evaluation

by Alina Cernasev, Michael P. Veve, Taylor Talbott, Elizabeth A. Hall and Kenneth C. Hohmeier

Pharmacy 2020, 8(4), 205; https://doi.org/10.3390/pharmacy8040205 - 3 Nov 2020

Cited by 5 | Viewed by 2516

Abstract

Pharmacists represent a key group of healthcare professionals that can increase awareness and destigmatize naloxone use. The objective of this study was to investigate pharmacy student perceptions of the use, dispensing, and stigma surrounding naloxone. An electronic survey was administered to pharmacy students [...] Read more.

Pharmacists represent a key group of healthcare professionals that can increase awareness and destigmatize naloxone use. The objective of this study was to investigate pharmacy student perceptions of the use, dispensing, and stigma surrounding naloxone. An electronic survey was administered to pharmacy students that included questions about demographics, work history, naloxone use, and naloxone stigma. Separate qualitative interviews were performed to identify themes surrounding naloxone use. Two-hundred sixty-two participants completed the survey. The majority of participants were “highly willing” (74%) to fill a naloxone prescription for a patient and “somewhat comfortable” (38%) in counseling on naloxone; most were “somewhat comfortable” (38%) administering naloxone. Naloxone is “very rarely” (87%) recommended in community workplace settings, and the majority (64%) reported that patients never request information about naloxone availability. Seventy-six percent of respondents reported that naloxone-associated interactions have an influence on the way they communicate with patients in community pharmacy settings. Thematic analyses found that pharmacy students identify the importance of naloxone as a life-saving medication and the need for naloxone training, but patient-perceived stigma and limited access to naloxone remain prevalent. Pharmacy students are generally well-versed and inclined toward distributing, counseling on, and administering naloxone. Naloxone is rarely dispensed and patient conversations involving naloxone are infrequent in community settings. Future efforts focused on approaches toward difficult patient conversations and normalization of naloxone are needed to destigmatize and facilitate use. Full article

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18 pages, 721 KiB

Open AccessArticle

Decision-Making Process in Comprehensive Medication Management Services: From the Understanding to the Development of a Theoretical Model

by Isabela Viana Oliveira, Yone de Almeida Nascimento and Djenane Ramalho-de-Oliveira

Pharmacy 2020, 8(4), 180; https://doi.org/10.3390/pharmacy8040180 - 3 Oct 2020

Cited by 11 | Viewed by 5396

Abstract

In Comprehensive medication management (CMM), the practitioner applies a decision-making method to assess patients’ pharmacotherapy in order to identify and solve drug therapy problems. Grounded theory was used to understand how pharmacists make clinical decisions when providing CMM service. Data collection included individual [...] Read more.

In Comprehensive medication management (CMM), the practitioner applies a decision-making method to assess patients’ pharmacotherapy in order to identify and solve drug therapy problems. Grounded theory was used to understand how pharmacists make clinical decisions when providing CMM service. Data collection included individual semi structured interviews with 11 pharmacists, observation of clinical case discussions and CMM consultations provided by the participating pharmacists. Two main categories emerged: 1. Understanding the rational method of decision-making: the foundation of the patient care process. 2. Balancing the care equation: the objective and the subjective, which includes a theoretical proposal explaining the pharmacists’ decision-making process and the factors that can modify this process. The pharmacotherapy knowledge should guide the anamnesis. Thus, the professional can evaluate the indication, effectiveness, safety and convenience of medications used by the patient. After exploring patients’ medication experiences, pharmacists can follow two courses of action: helping the patient overcome barriers to medication use; or matching the pharmacotherapy to the patient’s routine. Professional autonomy and absence of the patient at the time of the decision were some factors that influenced the pharmacist’s decision. Findings provide a broad understanding of pharmacists’ decision-making process during the care of patients using medications. It can be applied as a basis for educational interventions to train professionals on decision-making. Full article

(This article belongs to the Special Issue Medication Experiences)

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15 pages, 292 KiB

Open AccessArticle

Understanding the Factors Influencing Older Adults’ Decision-Making about Their Use of Over-The-Counter Medications—A Scenario-Based Approach

by Shweta Shah, Aaron M. Gilson, Nora Jacobson, Apoorva Reddy, Jamie A. Stone and Michelle A. Chui

Pharmacy 2020, 8(3), 175; https://doi.org/10.3390/pharmacy8030175 - 18 Sep 2020

Cited by 9 | Viewed by 4556

Abstract

The potential risks of over-the-counter (OTC) medications are often aggravated in vulnerable populations, such as older adults. The elevated patterns of older-adult OTC medication use do not necessarily translate into a greater understanding of these medications or their safety implications. The objective of [...] Read more.

The potential risks of over-the-counter (OTC) medications are often aggravated in vulnerable populations, such as older adults. The elevated patterns of older-adult OTC medication use do not necessarily translate into a greater understanding of these medications or their safety implications. The objective of this study was to assess how older adults’ knowledge, beliefs, and attitudes inform their decision-making regarding OTC use. Situational interviews were conducted in three community pharmacies with 87 older-adult participants to capture how they intended to use an OTC medication. The interviews were transcribed and qualitatively analyzed, generating seven key themes: (1) medication use concerns; (2) following label instructions; (3) wait time until medication effect; (4) responses to medication not working; (5) decision to stop medication; (6) sources of information; and (7) safety implications. This study shows substantial variations in older-adult OTC medication use while providing insight on factors that influence older adults’ appropriate OTC medication use and, in some cases, the potential for harmful effects. Full article

(This article belongs to the Special Issue Medication Experiences)

10 pages, 545 KiB

Open AccessArticle

Evaluation of a Revised Home Medication Experience Questionnaire (HOME-Qv2)

by Matthew J. Witry, Olajide O. Fadare and Kassi Pham

Pharmacy 2020, 8(3), 169; https://doi.org/10.3390/pharmacy8030169 - 11 Sep 2020

Cited by 1 | Viewed by 3681

Abstract

The Home Medication Experience Questionnaire (HOME-Qv2) was developed to identify patient medication experience issues for pharmacist intervention. The study objectives were to (1) evaluate patient responses to the HOME-Qv2 medication experience questionnaire and (2) describe recommendations made by pharmacists in response to the [...] Read more.

The Home Medication Experience Questionnaire (HOME-Qv2) was developed to identify patient medication experience issues for pharmacist intervention. The study objectives were to (1) evaluate patient responses to the HOME-Qv2 medication experience questionnaire and (2) describe recommendations made by pharmacists in response to the identified medication experience issues and adoption of recommendations. The study sample was comprised of older adults, 55 years and above, who have one or more chronic illnesses for which they routinely take 4+ prescription medications. The HOME-Qv2 was administered to patients and a pharmacist made recommendations based on the responses. At 3 months, the research team followed up with participants via telephone, during which the HOME-Qv2 was again administered and participants shared their adoption of recommendations. Twenty-four patients completed the questionnaire, and twenty-one were available for follow-up. At 3 months, there was a significant decrease in patient self-reported HOME-Qv2 medication experience issues. There were 31 interventions/recommendations provided by the pharmacists, and 64.5% reported adopted. The HOME-Qv2 appears to facilitate patient disclosure of medication experience issues and informed targeted pharmacist recommendations. Full article

(This article belongs to the Special Issue Medication Experiences)

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10 pages, 420 KiB

Open AccessArticle

Stigma of Opioid Use Disorder and Its Indirect Effects on Student Pharmacists’ Perceptions and Attitudes

by Elizabeth A. Hall, Alina Cernasev, Umida Nasritdinova, Michael P. Veve and Kenneth C. Hohmeier

Pharmacy 2020, 8(3), 144; https://doi.org/10.3390/pharmacy8030144 - 14 Aug 2020

Cited by 8 | Viewed by 2887

Abstract

Objectives: Pharmacists play a vital role in serving patients during the ongoing nationwide opioid epidemic, and so it is also critical to educate the next generation of pharmacists on opioids and opioid use disorder (OUD). The primary objective of this study was to [...] Read more.

Objectives: Pharmacists play a vital role in serving patients during the ongoing nationwide opioid epidemic, and so it is also critical to educate the next generation of pharmacists on opioids and opioid use disorder (OUD). The primary objective of this study was to quantitatively characterize student perceptions of opioid use and the stigma associated with OUD. Secondary aims were to determine whether differences in perceptions exist based upon the student’s year in the Doctor of Pharmacy program or employment in a community pharmacy. Methods: First-, second-, third-, and fourth-year student pharmacists voluntarily completed an electronic survey regarding perceptions of opioid use and stigma associated with OUD. Results: Of the 9 survey items, students were most uncomfortable referring patients to community resources for addiction support and/or treatment (25.3% comfortable or very comfortable). Students working in a community pharmacy were significantly more comfortable talking to patients attempting to refill opioids early and providing opioid counseling as compared to their peers not working in community pharmacy. Fourth-year students reported a higher level of comfort talking to a patient attempting to refill an opioid prescription early, counseling a patient on an opioid prescription, and providing information about alternatives to opioids. Third-year students responded most favorably to the items regarding how well the curriculum has prepared them to interact with patients taking opioids and those with OUD. Conclusions: These findings reveal that students are comfortable counseling on opioids and discussing alternative options. Differences in perceptions were observed based upon the student’s year in the program and whether or not they were employed in a community pharmacy setting. Full article

(This article belongs to the Special Issue Medication Experiences)

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12 pages, 247 KiB

Open AccessArticle

The Significance of Taking Antiretroviral Medications for African-Born People Living with HIV and Residing in Minnesota

by Alina Cernasev, William L. Larson, Cynthia Peden-McAlpine, Todd Rockwood, Paul L. Ranelli, Olihe Okoro and Jon C. Schommer

Pharmacy 2020, 8(2), 108; https://doi.org/10.3390/pharmacy8020108 - 26 Jun 2020

Cited by 4 | Viewed by 2590

Abstract

Thanks to the development of antiretroviral (ART) medications, HIV is now a chronic and manageable disease. This study aimed to (1) capture the experiences of African-born persons living with HIV and taking antiretroviral treatment, and (2) explore the impact of social and cultural [...] Read more.

Thanks to the development of antiretroviral (ART) medications, HIV is now a chronic and manageable disease. This study aimed to (1) capture the experiences of African-born persons living with HIV and taking antiretroviral treatment, and (2) explore the impact of social and cultural factors on their decisions to follow the prescribed treatment. For this study, a qualitative approach was used. The participants were recruited via fliers, then screened for inclusion and exclusion criteria. Recruitment of the participants continued until data saturation occurred. The interview guide was developed based on the extensive literature and recommendations from the clinical team. In-person narrative interviews were conducted with 14 participants—African-born persons living with HIV and residing in Minnesota. Thematic Analysis revealed three emergent themes: “To exist I have to take the medicine”; barriers and facilitators in taking ART medications; and the power of spirituality and prayers. The findings of this study paint a picture of African-born persons living with HIV, and their experiences with ART medications. This study not only presents the participants’ medication experiences and their significance, but also tells their stories of how God and prayers play a significant role in helping them to get through the difficult moments of their lives. Full article

(This article belongs to the Special Issue Medication Experiences)

11 pages, 227 KiB

Open AccessArticle

“Stigma and HIV Are Like Brother and Sister!”: The Experience of African-Born Persons Living with HIV in the US

by Alina Cernasev, William L. Larson, Cynthia Peden-McAlpine, Todd Rockwood, Paul L. Ranelli, Olihe Okoro and Jon C. Schommer

Pharmacy 2020, 8(2), 92; https://doi.org/10.3390/pharmacy8020092 - 30 May 2020

Cited by 2 | Viewed by 3164

Abstract

Minnesota has seen an increase in the number of immigrants from Africa, notably in the mid-1990s, making up around 2% of Minnesota’s total population. This population also faces many impediments that cause important difficulties not only for HIV prevention but also for treatment [...] Read more.

Minnesota has seen an increase in the number of immigrants from Africa, notably in the mid-1990s, making up around 2% of Minnesota’s total population. This population also faces many impediments that cause important difficulties not only for HIV prevention but also for treatment and care options. The objectives of this study were to capture the experiences of Persons Living with HIV (PLWH) in Minnesota (US) and to elicit their stories about their diagnosis news and what management strategies they use for coping with the stigma associated with the disease. Participants were recruited via fliers in pharmacies, clinics, and HIV service centers located in Minnesota. Recruitment continued until thematic saturation was obtained. Fourteen subjects participated in audio-recorded, semi-structured interviews that were transcribed verbatim into written text. The transcriptions were analyzed using Thematic Analysis. Three themes emerged from the data. Theme 1: Cruel News: “HIV-Oooooo! I wish I was dead”, Theme 2: This is My Secret! and Theme 3: “Stigma and HIV are brother and sister”. The results demonstrate that stigma is an ever-present problem in African-born PLWH living in the US. Participants perceived the stigma associated with HIV status to affect their lives and culture at individual, familial, and societal levels. Full article

(This article belongs to the Special Issue Medication Experiences)

Other

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13 pages, 799 KiB

Open AccessCommentary

The Subjective Experience of Using Medications: What We Know and the Paths Forward

by Yone de Almeida Nascimento and Djenane Ramalho-de-Oliveira

Pharmacy 2021, 9(1), 50; https://doi.org/10.3390/pharmacy9010050 - 2 Mar 2021

Cited by 6 | Viewed by 3341

Abstract

Medications can cause bodily changes, where the associated benefits and risks are carefully assessed based on the changes experienced in the phenomenal body. For this reason, the phenomenology of Merleau-Ponty is an important theoretical framework for the study of experience related to the [...] Read more.

Medications can cause bodily changes, where the associated benefits and risks are carefully assessed based on the changes experienced in the phenomenal body. For this reason, the phenomenology of Merleau-Ponty is an important theoretical framework for the study of experience related to the daily use of medications. The aim of this study was to discuss the contribution of a recently developed framework of the general ways people can experience the daily use of medications—resolution, adversity, ambiguity, and irrelevance—and present reflections about the little-understood aspects of this experience. However, some issues raised throughout this article remain open and invite us to further exploration, such as (1) the coexistence of multiple ways of experiencing the use of medications, by the same individual, in a given historical time; (2) the cyclical structure of this experience; (3) the impact of habit and routine on the ways of experiencing the daily use of medications; and (4) the contribution of the concept of existential feelings to this experience and its impact on patients’ decision-making. Therefore, the experience with the daily use of medications is a complex and multifaceted phenomenon that directs the decision-making process of patients, impacting health outcomes. Full article

(This article belongs to the Special Issue Medication Experiences)

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27 pages, 1070 KiB

Open AccessCommentary

Communicative and Discursive Perspectives on the Medication Experience

by Lewis H. Glinert

Pharmacy 2021, 9(1), 42; https://doi.org/10.3390/pharmacy9010042 - 17 Feb 2021

Cited by 1 | Viewed by 5378

Abstract

Taking the ‘medication experience’ in the broad sense of what individuals hear and say about their medication, as well as how they experience it, this paper explores diverse research on medication information available to patients and their modes and capacities for interaction, including [...] Read more.

Taking the ‘medication experience’ in the broad sense of what individuals hear and say about their medication, as well as how they experience it, this paper explores diverse research on medication information available to patients and their modes and capacities for interaction, including personal circles, doctors and pharmacists, labeling and promotion, websites, and the patient’s own inner conversations and self-expression. The goal is to illustrate, for nonspecialists in communication, how the actors, messages, mediums, genres, and contextual factors within a standard ethnographic and social semiotic model of discourse and communication are operating, not always effectively or beneficially, to mediate or construct a patient’s medication experience. We also suggest how disparate insights can be integrated through such a model and might generate new research questions. Full article

(This article belongs to the Special Issue Medication Experiences)

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9 pages, 211 KiB

Open AccessBrief Report

Community Pharmacist Telephonic Medication Reviews with Uncontrolled Asthma Patients: A Pilot Study

by Kathryn A. Hartley, Kendall D. Guthrie, Steven C. Stoner, Justin R. May, D. Matthew Hartwig and Yifei Liu

Pharmacy 2021, 9(1), 25; https://doi.org/10.3390/pharmacy9010025 - 22 Jan 2021

Viewed by 2455

Abstract

This study reports the process of telephonic medication reviews conducted by community pharmacists for patients with asthma. The study occurred at an independent community chain in association with a Missouri Medicaid consulting group. Participants were identified utilizing claims data and met the National [...] Read more.

This study reports the process of telephonic medication reviews conducted by community pharmacists for patients with asthma. The study occurred at an independent community chain in association with a Missouri Medicaid consulting group. Participants were identified utilizing claims data and met the National Quality Forum criteria for uncontrolled moderate-to-severe persistent asthma. A pharmacist performed the initial encounter via telephone which included a knowledge questionnaire, symptom control assessment, and medication review. Pharmacists identified drug-related problems (DRPs) and faxed recommendations to patients’ primary care providers (PCPs). Thirty days later, pharmacists called to follow up with the patients and faxed PCPs to resolve any outstanding DRPs, new DRPs, or recommendations. Questionnaire scores and symptom control assessments were compared and analyzed utilizing a paired t-test, Chi-squared test, or Fisher’s exact test. The number and categories of DRPs, recommendations made by pharmacists, and intervention time were reported. Fourteen participants completed initial encounters with twelve completing follow-up. The majority answered ‘yes’ to at least one symptom control assessment question indicating partially controlled to uncontrolled asthma. The average knowledge assessment score was 5.17 out of 7 initially and 5.42 for the follow-up. Pharmacists identified 43 DRPs and made 41 recommendations with a mean intervention time of 65 min. Full article

(This article belongs to the Special Issue Medication Experiences)

9 pages, 575 KiB

Open AccessCommentary

Reframing the Medication Experience in Pharmacy Using Seminal Concepts of Patient-Centered Care—Implications for Practice

by Brian Isetts, Anthony Olson and Jon Schommer

Pharmacy 2021, 9(1), 9; https://doi.org/10.3390/pharmacy9010009 - 5 Jan 2021

Cited by 3 | Viewed by 2250

Abstract

Team-based, Patient-Centered Care is essential to chronic disease prevention and management but there are differing ideas about the concept’s meaning across healthcare populations, settings and professions. This commentary’s objective is to empirically evaluate the theoretical relationships of the [a] Medication Experience, [b] Patient-Centeredness [...] Read more.

Team-based, Patient-Centered Care is essential to chronic disease prevention and management but there are differing ideas about the concept’s meaning across healthcare populations, settings and professions. This commentary’s objective is to empirically evaluate the theoretical relationships of the [a] Medication Experience, [b] Patient-Centeredness and other relevant component concepts from pharmaceutical care (i.e., [c] Therapeutic Relationship, [d] Patient-specific preferences for achieving goals of therapy and resolving drug therapy problems) so as to provide practice-based insights. This is achieved using a secondary analysis of 213 excerpts generated from in-depth semi-structured interviews with a national sample of pharmacists and patients about Patient-Centeredness in pharmacist practice. The four component concepts (i.e., a–d) related to the objective were examined and interpreted using a novel 3-archetype heuristic (i.e., Partner, Client and Customer) revealing common practice-based themes related to care preferences and expectations in collaborative goal setting, enduring relationships, value co-creation and evolving patient expectations during challenging medical circumstances. Most practice-based insights were generated within the Partner archetype, likely reflecting high congruence with pharmacist and patient responses related to the Medication Experience and Therapeutic Relationship. The practice-based insights may be especially useful for new practitioners and students accelerating their advancement in providing effective and efficient Patient-Centered Care. Full article

(This article belongs to the Special Issue Medication Experiences)

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12 pages, 676 KiB

Open AccessCommentary

Opioid Use Disorders in People Living with HIV/AIDS: A Review of Implications for Patient Outcomes, Drug Interactions, and Neurocognitive Disorders

by Alina Cernasev, Michael P. Veve, Theodore J. Cory, Nathan A. Summers, Madison Miller, Sunitha Kodidela and Santosh Kumar

Pharmacy 2020, 8(3), 168; https://doi.org/10.3390/pharmacy8030168 - 11 Sep 2020

Cited by 8 | Viewed by 4231

Abstract

The opioid epidemic has had a significant, negative impact in the United States, and people living with HIV/AIDS (PLWHA) represent a vulnerable sub-population that is at risk for negative sequela from prolonged opioid use or opioid use disorder (OUD). PLWHA are known to [...] Read more.

The opioid epidemic has had a significant, negative impact in the United States, and people living with HIV/AIDS (PLWHA) represent a vulnerable sub-population that is at risk for negative sequela from prolonged opioid use or opioid use disorder (OUD). PLWHA are known to suffer from HIV-related pain and are commonly treated with opioids, leading to subsequent addictive disorders. PLWHA and OUD are at an increased risk for attrition in the HIV care continuum, including suboptimal HIV laboratory testing, delayed entry into HIV care, and initiation or adherence to antiretroviral therapy. Barriers to OUD treatment, such as medication-assisted therapy, are also apparent for PLWHA with OUD, particularly those living in rural areas. Additionally, PLWHA and OUD are at a high risk for serious drug–drug interactions through antiretroviral-opioid metabolic pathway-related inhibition/induction, or via the human ether-a-go-go-related gene potassium ion channel pathways. HIV-associated neurocognitive disorders can also be potentiated by the off-target inflammatory effects of opioid use. PLWHA and OUD might require more intensive, individualized protocols to sustain treatment for the underlying opioid addiction, as well as to provide proactive social support to aid in improving patient outcomes. Advancements in the understanding and management of PLWHA and OUD are needed to improve patient care. This review describes the effects of prescription and non-prescription opioid use in PLWHA. Full article

(This article belongs to the Special Issue Medication Experiences)

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7 pages, 178 KiB

Open AccessCommentary

The National Pharmaceutical Council: Endorsing the Construction of Imaginary Worlds in Health Technology Assessment

by Paul C Langley

Pharmacy 2020, 8(3), 119; https://doi.org/10.3390/pharmacy8030119 - 13 Jul 2020

Viewed by 2030

Abstract

All too often, organizations embrace standards for health technology assessment that fail to meet those of normal science. A value assessment framework has been endorsed that is patently in the realm of pseudoscience. If a value assessment framework is to be accepted, then [...] Read more.

All too often, organizations embrace standards for health technology assessment that fail to meet those of normal science. A value assessment framework has been endorsed that is patently in the realm of pseudoscience. If a value assessment framework is to be accepted, then claims for the value of competing products must be credible, evaluable and replicable. If not, for example, when the assessment relies on the construction of an imaginary lifetime incremental cost-per-quality-adjusted-life-year (QALY) world, then that assessment should be rejected. Such an assessment would fail one of the central roles of normal science: the discovery of new facts through an ongoing process of conjecture and refutation where provisional claims can be continually challenged. It is no good defending an endorsement of a value framework that fails expected standards on the grounds that it has been endorsed by professional groups and reflects decades of development. This is intellectually lazy. If this is the case, then the scientific revolution of the 17th century need not have happened. The purpose of this commentary is to consider the recommended standards for health technology assessment of the National Pharmaceutical Council (NPC), with particular reference to proposed methodological standards in value assessment and the commitment to mathematically impossible QALYs. Full article

(This article belongs to the Special Issue Medication Experiences)

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