Abstract

Welcoming Remarks

APHA 2022 Annual Meeting and Expo

Abstract

Role and Value of Pharmacists in a Federally Funded Research and Development Center

Niyati Vakil, PharmD, Sharon Yeske, MSPharm, Robert Lieberthal, PhD The MITRE Corporation

APHA 2022 Annual Meeting and Expo

Most pharmacists are employed by pharmacies, drug stores, and hospitals (69%) with smaller proportions in government, academia, and pharmaceutical industry. A smaller, non-traditional area of pharmacy practice is applied research that takes place at non-profits, many of which have an explicit or implicit public health mission. Federally Funded Research and Development Centers (FFRDCs) are government-owned, contractor-operated non-profits that support a federal agency’s mission. The purpose of this study is to characterize the role and value of pharmacists in one such FFRDC, MITRE.

The first step will be to complete a descriptive report of pharmacists currently or previously employed by MITRE including the number of pharmacists employed, education, training, previous and current work experience compared to published data on the broader population of pharmacists. The second step will be to conduct an anonymized survey of MITRE employees (anticipated sample size of 20) with qualitative questions on their attitudes on the value of pharmacy training and experience, as well as possible additional training and skills needed to enhance the public health impact of pharmacists.

We will report the results of the descriptive report and survey.

This study will elucidate this lesser-known cohort of pharmacists within FFRDCs and may inform current or future FFRDC-employed pharmacists who would like to expand their role. Our study may be used as a use-case to explore the evolving area of applied public health research.

Abstract

Factors Affecting Medication Adherence in Native Hawaiians, Other Pacific Islanders, and Asian Americans

Wesley Sumida, Pharm.D.; Tetine Sentell, PhD; Todd B. Seto, MD, MPH; Deborah A. Taira, ScD

APHA 2022 Annual Meeting and Expo

Background: Prior studies have shown that Native Hawaiians (NH), Other Pacific Islanders (PI), and Filipinos (FI) are less likely to adhere to medications for chronic conditions and more likely to have potentially preventable hospitalizations for heart disease and diabetes.

Purpose: Examine factors affecting medication adherence in NHPI, Japanese, Filipino, and white FI patients with potentially preventable hospitalizations for diabetes or heart disease.

Methods: We conducted a secondary analysis of deidentified survey data for patients who were hospitalized for diabetes or heart disease (n=144). Multivariable logistic regression models were used to examine factors affecting medication adherence.

Results:
Approximately 45% said they delayed or did not get a medicine that a doctor prescribed. In terms of reasons, 46% said they didn’t think the problem was serious enough, 40% said they were too sick to seek care, 32% said they had transportation problems, 30% were worried about the cost, 28% said they were too busy with work or other commitments to go to the doctor, 21% could not get there when the doctor’s office was open, 18% said it takes too long to get to the doctor, 22% said they could not get through to their doctor’s office on the phone, 14% said their insurance was not being accepted, 13% said their health plan wouldn’t pay, 13% could not get an appointment soon enough, 11% did not trust the healthcare system.

Conclusion: These findings add to our understanding of factors influencing medication adherence in NHPI and Asian Americans.

Abstract

Supporting BIPOC students across the continuum of pharmacy training - What DEI looks like from over here!

Olihe Okoro, PhD, MPH University of Minnesota, College of Pharmacy

APHA 2022 Annual Meeting and Expo

Unequal treatment in healthcare delivery has persisted, resulting in health disparities that adversely affect racial minorities. Racial/ethnic concordance in healthcare encounters have been shown to foster greater patient satisfaction with care and consequently better health outcomes. Diversifying the healthcare workforce is a strategy that has potential to significantly narrow the disparities in healthcare. Building the future healthcare workforce that adequately represents the racially diverse patient population in the US requires ensuring representation in training programs in the present time. As pharmacy programs make concerted effort to admit students of underrepresented racial/ethnic background, they need to equally make efforts to provide support that is responsive to the unique needs of these students to enable them thrive and excel academically.

BIPOC pharmacy students are a diverse group. Some of the more common challenges include:
-Experiences of microaggression, stereotypes and racial discrimination
-Sociocultural isolation
-Lack of social support (emotional and instrumental)
-Cultural taxation
-Linguistic barriers
-Constant burden of proof of competence
-likelihood of non-traditional student status
-Race-based curricular content

These challenges when unaddressed have significant impact on health and mental well-being, self confidence/ self-assessed competency, and consequently academic progress.

Key strategies to ensure adequacy of support include
-Representation in professional capacities - faculty, preceptors, mentors, guest lecturers, etc.
-Linkage to their community (affinity group, wider community)
-More self-awareness and sensitivity of educators and peers
-Feedback mechanisms for reporting microaggressions, discrimination, misrepresentation
-Academic approaches that focus on the why not the what

Conclusion: Supporting BIPOC students is critical to achieving a more diverse workforce.

Abstract

Adherence to refill-prescriptions for patients with chronic diseases: A population-based study using national health insurance claims data

Christy Pu¹, Yen-Wen Chuang², Chiun-Ho Hou³ (1)National Yang Ming Chaio Tung University, (2)National Yang-Ming Chiao Tung University, (3)1. Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan, 2.Department of Ophthalmology, National Taiwan University, Taiwan

APHA 2022 Annual Meeting and Expo

Background: The prevalence of hypertension, diabetes and glaucoma has been rising over the past few decades around the globe. Chronic diseases require long-term control and good medication adherence. Many countries have set up refill-prescription systems to cope with increasing cost of medication for chronic diseases. Since the implementation of Taiwan's National Health Insurance (NHI) in 1995, the NHI has adopted a policy on prescription refills for chronic diseases, aiming at reducing costs for patients. However, such policies may come at an expense of lowered medication adherence. Studies to date have not evaluated whether patients adhere to medication refill under such a policy.

Objectives: (1) To investigate the adherence rate for prescription refills using the NHI claim data in Taiwan. (2) To determine factors associated with refill adherence. These factors include social demographic factors and medical institute characteristics.

Methods: Patients with hypertension, type 2 diabetes mellitus, or open-angle glaucoma were identified using the NHI data. Patients who were prescribed with >=1 medication with refill-prescription during 2011 to 2019 were included in the study. The unit of analysis is prescription. Trends for refill for the three diseases over time were described. Logistic regression and ordinal logistic regression models were used to estimate the likelihood for non-refill. Potential confounders such as social demographic factors and medical institute characteristics were identified. Results are presented as marginal effects.

Results: During the period 2011 to 2019, return rates ranges from 47.48% to 58.86% for hypertension, 59.72% to 68.90% for type 2 DM, and 29.43% to 42.97% for open-angle glaucoma. About 90% of the patients returned to the original clinic/hospital or refills. Only 10% were received refills in community pharmacies. In the baseline year (2019), there was no statistically significant differences in social demography factors.

Conclusions and implication for public health: While refill policies may save cost, health administrators must be aware of the possible unintended consequences, which is lowered medication adherence rate. We found that the return rates were not satisfactory in the diseases analyzed over the years. Policies should take into consideration such possible unintended consequences in an attempt to save costs by prescribing refill prescriptions.

Abstract

Concluding Remarks

APHA 2022 Annual Meeting and Expo