Class of 2016 Abstract / Objectives: Specific Aim #1: Assess no difference in patient satisfaction. Our working hypothesis is that there is no difference in satisfaction with follow-up calls in women receiving HRT from pharmacists or pharmacy intern students at Reed’s Compounding Pharmacy. Specific Aim #2: Assess patient satisfaction with follow-up calls from pharmacy student interns. Our working hypothesis is that women receiving HRT are satisfied with follow-up calls for their therapy when it is conducted by pharmacy student interns, which enhances proper treatment guidance and adherence. Methods: This study will be a descriptive, direct comparison study that will use data obtained through an online questionnaire consisting of the following: four questions determining the patient’s demographics and eighteen questions on patient satisfaction with follow-up calls from Reed’s Compounding Pharmacy with pharmacy student interns. Results: Of the estimated 60 patients sample size, only 31 questionnaires were completed. The largest proportion of patients was between the ages of 51 and 60 (58%). The length of therapy in participating women varied quite significantly with one-fourth of patients on HRT for 4-5 years or more (26%). The patient satisfaction of follow-up calls conducted by pharmacy intern students survey results indicated, in general, that patients agreed that they were satisfied with the service that they were receiving from the pharmacy interns. There was no disagreement with the items, the intern provides education that will help me understand how to take my medications, being pleased that the intern is following-up, having input on hormone therapy, and with the items regarding intern professionalism and intern knowledge. The greatest disagreement was with three items asking about comfort talking with either a female or male intern, and the item about paying extra to ensure follow-up calls. Results from this study were compared with results from five questions adapted using a questionnaire from DiMaggio et al. Note that this study used 7 response fields: strongly disagreed, somewhat disagreed, disagreed, no opinion, agreed, somewhat agreed, strongly agreed. Data from DiMaggio et al used 5 response fields: strongly disagreed, disagreed, no opinion, agreed, strongly agreed. Responses were grouped by strongly disagreed, somewhat disagreed, disagreed, and no opinion in one and strongly agreed, somewhat agreed, and agreed in the second. The data from both studies were compared by considering proportion of patients who agreed at some level with each item. There was no statistical difference between the two groups (p > 0.08); both groups showed a high level of agreement on the five satisfaction items. Conclusions: The women receiving hormone replacement therapy in this study were satisfied with follow-up calls from pharmacy student interns at Reed’s Compounding Pharmacy. There is no difference in satisfaction with follow-up calls in women receiving HRT from pharmacists or pharmacy student interns. In addition to satisfaction, women are satisfied with follow-up calls for their therapy when it is conducted by pharmacy student interns, which enhances proper treatment guidance and adherence.

Class of 2005 Abstract / Objectives: To assess whether the satisfaction of women with the pharmacist administered bio-identical hormone replacement therapy consultation service has improved since the implementation of a follow up call program at Reed’s Compounding Pharmacy. Methods: A questionnaire was mailed to 200 randomly selected women who had completed their HRT consultation and received all three follow-up calls provided by Reed’s Compounding Pharmacy within the time frame from July 22, 2003 to April 22, 2004. The returned surveys were then organized and analyzed using Microsoft Excel. Additionally, independent t-tests were used to compare data collected in 2001 vs. 2004 on relevant questionnaire items of interest. Main results: Of the 200 surveys sent out to patients, 125 replied (a response rate of 62.5%). Over 50% heard about it through referral from their provider, and almost 35.2% from a friend or a relative. Regarding the follow-up call service, 95.9% of the patients either agreed or strongly agreed that it was helpful; however, only 73.8% feel comfortable discussing their concerns with student interns, who are responsible for the follow-up calls. In the assessment of new health conditions developed after natural hormone therapy initiation, 94.3% of the respondents reported with no new health conditions. T-tests revealed an improvement in patient satisfaction items between 2001 and 2004 with p-values < 0.05. Principal Conclusions: The results of the study showed that there was an improvement in patient satisfaction with the consultation service since 2001, and most of the differences found were statistically significant. The survey result also showed that participants were happy about the follow-up calls, which in terms, perhaps contributed to the increase in satisfaction.

The focus of the research described in this section of the thesis is the synthesis of compounds expected to bind strongly to both the estrogen β and α receptors and act as estrogen agonists. Based on earlier results in our group and docking studies we prepared a series of A-CD analogs, compounds 1, in which the usual 13-methyl group was replaced by an ethyl group. Docking studies also indicated that substituents at C8 could lead to enhancement of binding to the estrogen receptor. With this in mind two such derivatives, compounds 2 were prepared. A major concern in the use of estradiol in hormone replacement therapy is its potential metabolism of dangerous ortho-quinones. The 1,2-naphthalenediol derivatives 3 avoid this possibility. They were predicted to be potent binders to the estrogen receptors with the naphthalene diol portion serving as rings A and B and the hydroxyl group taking the place of the 17-OH group of estradiol. The preparation of several derivatives of 2 is reported. The estrogen receptor binding [ERB] relative to estradiol as standard has been determined at the University of Illinois for a number of the compounds prepared in this thesis. Unfortunately, the results were not as encouraging as expected. Importantly, all of the 13-ethyl derivatives tested showed lower binding affinity compared to the 13-methyl analogs. Similarly, the derivatives with substituents at C8 do not show higher activity than those having only hydrogens at C8. Finally, the situation with the naphthalene derivatives is, at this stage, still not completely resolved. The binding for the compounds thus tested is quite low, but it must be admitted that the structures thus far synthesized have a much lower LogP than estradiol, a factor known to greatly decrease the binding constants to the estrogen receptors.

Class of 2008 Abstract / Objectives: The purpose of this study was to assess the effects of using compounded Bio-identical Hormone Replacement Therapy (BHRT) in menopausal women, by employing the MRS. Methods: This study used a one group pre-test/ post-test. Included were 25 menopausal women, whom at initial BHRT consultation at Reed’s Compounding Pharmacy filled out a baseline menopausal rating scale (MRS). Eleven weeks into therapy, patients were asked to participate in this study and if interest was expressed, they were asked to fill out another MRS for comparison. Results: There was a statistically significant decrease in overall MRS scores and in each of the 3 subscales (psychological, somatic and urogenital) (p</= 0.001). Additionally, when evaluating each MRS item individually, there were statistically significant decreases in all symptoms of menopause except for heart discomfort. Most improvements were seen in hot flushes/sweating, sleep and sexual problems (p<0.001). Conclusions: Patients using BHRT improved overall physically and mentally, which would be depicted by improved scores on the MRS.

No description available.

Decreased testosterone levels (hypogonadism) in middle-aged men (aged 45-64) has been associated with increased levels of depression. Studies have suggested that increases in anxiety and/or attention problems may also be associated with hypogonadism but have not provided empirical evidence to support these suggestions. The purpose of this quantitative study was to examine depression, anxiety, and attention problems in middle-aged men using a psychological self-report inventory. The theoretical model used in this study was the biomedical model, which combined pharmacological treatment with psychological self-report inventories to determine if there was an association or relationship between the testosterone levels in men and the psychological distress experienced by men who have become hypogonadal. A total of 179 males were recruited through local physicians. There was a statistically significant difference and a small size effect in the level of depression, anxiety, and/or attention issues experienced by those who were receiving TRT versus those who were not. This study may provide some guidance to medical clinicians, such as psychiatrists, primary-care physicians, and endocrinologists, as well as clinical psychologists who see middle-aged men in their practice settings.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 6 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Diss. Linköping : Univ., 2006.