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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Susan J. Blalock, PhD and Rajul A. Patel, PharmD. Pharmacy Practice, University of the Pacific, 3601 Pacific Avenue, Stockton, CA 95211, 209-946-3151, sblalock@uop.edu
The cost associated with drug-related morbidity and mortality in the US was estimated at $177.4 billion in 2000. Improved therapeutic monitoring, to identify existing and potential problems before they result in substantial harm, could reduce these costs. The pharmaceutical care movement has increased awareness of the potential role that pharmacists can play in monitoring and improving the outcomes associated with pharmacotherapy. Yet, many barriers, including lack of time, inhibit the integration of pharmaceutical care services into routine pharmacy practice. To provide comprehensive pharmaceutical care, pharmacists must first assess patients’ drug therapy problems. Typically, this is accomplished by reviewing patients’ prescription profiles and conducting problem-focused interviews with patients. To facilitate the interview process, a self-administered questionnaire was developed to assess patients’ drug therapy concerns. A pool of 78 items was created to assess drug therapy concerns in seven domains: perceived efficacy of therapy (e.g., My medication helps me stay healthy.), overmedication concerns (e.g., Sometimes I think I take too many medications.), adverse drug reaction concerns (e.g., I am not worried about the potential side effects of the medication I take.), perceived adequacy of knowledge (e.g., I am not sure how to take my medication.), financial concerns (e.g., It is difficult to pay for my medication), perceived adherence problems (e.g., It is hard to remember to take my medication), and intrusiveness of the therapeutic regimen (e.g., I think my medication limits my ability to do certain things.). The items were incorporated into a self-administered questionnaire that subsequently was completed by 213 adults recruited at community pharmacies and senior citizen residential communities. Respondents rated the extent to which they either agreed or disagreed with each item in the questionnaire on a 5-point response scale with endpoints of “Strongly Agree” and “Strongly Disagree”. Item analyses and factor analyses were performed to identify those items that best assessed the domains identified. A total of 27 items were retained in the final Drug Therapy Concerns Scale (DTCS). The DTCS is comprised of seven subscales, corresponding to the seven domains identified above. Each subscale demonstrated good internal consistency, with all Cronbach’s alphas exceeding 0.75. Additional work is needed to examine the validity and sensitivity of the DTCS. Following refinement of the scale, research will be needed to determine how best to incorporate the DTCS into routine pharmacy practice. Ultimately, research will be needed to determine whether using the DTCS leads to improved therapeutic outcomes.
Learning Objectives:
Keywords: Prescription Drug Use Patterns, Pharmacies
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.