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Background: Improving adherence to medication is a persistent challenge within the health system. Adherence is influenced by many factors at the patient, provider, treatment and health system levels. Adherence may also be affected by continuity of care; defined as the consistent professional relationship between a health provider or source of care and a patient. Objective: To estimate the strength of association between continuity of community pharmacy care and adherence to statin medication among persons initiating statin therapy in Nova Scotia between 1998 and 2008.  Methods: This was a retrospective cohort study using administrative data from the Nova Scotia Seniors’ Pharmacare program. Subjects were included if they were dispensed at least one prescription for a statin medication between 1998 and 2008. Continuity of care was calculated via two methods: the Usual Provider of Care (UPC) index and the Continuity of Care Index (COCI), which measure the density and dispersion of relational continuity of care, respectively. Adherence was calculated using the medication possession ratio. The strength of association between continuity of care and adherence was analyzed using hierarchical regression. Results: During the study period, 31 592 individual subjects received a first statin dispensation. Adjusted hierarchical regression showed that for each 0.10 increase in continuity of care, the odds of adherence increase by 3% (95% CI: 1.01-1.05). Continuity of care measured by the UPC is highly correlated with continuity of care measured by the COCI (r=0.98). Conclusions: Continuity of community pharmacy care is positively associated with adherence to statins among Nova Scotian seniors who initiated statin therapy between 1998 and 2008.

Class of 2017 Abstract / Objectives: To determine if there is a correlation between both awareness and utilization of pharmacy care services and patient satisfaction at an independent community pharmacy in Benson, Arizona. Subjects: Patients who visited the pharmacy within a 45-day period in 2016 and who have filled at least one prescription at that location. Methods: A self-reported questionnaire was administered by pharmacy staff to assess patients’ satisfaction ratings on the pharmacy’s performance. The questionnaire also inquired about patients’ awareness and use of pharmacy services as well as demographic information including a history of specific disease states. Data were evaluated using analytic software. Results: Questionnaires were completed by 48 men (mean age = 65.8; SD = 12.57) and 69 women (mean age 60.3; SD = 15.06), with the mean number of select health conditions being 1.63 (SD = 1.16) and 1.49 (SD = 1.24), respectively. There was no correlation between the number of services for which a patient was aware, nor the number of services utilized, and overall satisfaction (p=0.466 and p=0.384, respectively). However, there was a significant positive correlation between awareness and utilization of pharmacy services (r=0.208, p=0.019). Over 74% of respondents rated satisfaction for all measures “excellent,” with professionalism of the pharmacist (92.1%) and pharmacy staff (89.9%) ranking highest. The only category that received a “poor” rating was how well the pharmacist explains medication side effects. Conclusions There was no apparent correlation between awareness of pharmacy care services and patient satisfaction at The Medicine Shoppe in Benson, nor between utilization of pharmacy services and satisfaction. However, patient satisfaction scored high in all categories surveyed.

Class of 2010 Abstract / OBJECTIVES: To assess the comfort level of pharmacists and 4th year pharmacy students regarding their ability to develop business plans and their perception of available resources to help them. METHODS: A questionnaire sought information on the comfort level on multiple sections of a business plan: mission statement, executive summary, description of business/service, marketing, operations, and finances. The questionnaire was sent electronically to pharmacy preceptors and pharmacy students at The University of Arizona College of Pharmacy. RESULTS: Questionnaires were completed by a total of 94 pharmacists and student pharmacists (30% response rate). Of those 94 respondents, 55 were pharmacists, 35 were student pharmacists, and 4 were left unknown. Individuals between the ages of 21-29 were less comfortable with business plan concepts (p-values range from 0.005 to 0.028). Men were more comfortable with the business plan than women (all p-values <0.002). Pharmacists had shown to be more comfortable than student pharmacists in all areas of the business plan (all p-values <0.005). Forty-six percent of the individuals said there are currently not enough resources available and 83% of individuals said that there is a definite need for more training opportunities. Live, web-based CE courses and elective pharmacy curriculum courses were thought as the most beneficial training opportunities (29%, 30%, and 22%, respectively). CONCLUSIONS: There is a need for more resources and training opportunities to improve the comfort levels that pharmacists and student pharmacists have for business plans in order to help implement new innovative ideas that will continue to expand pharmacy services.

Class of 2009 Abstract / OBJECTIVES: To determine if there is a correlation between student involvement in pharmacy organizations and self-reported professional development. METHODS: A cross sectional, prospective, print-based questionnaire was submitted to students in their last didactic year of the Doctor of Pharmacy program at one university. The questionnaire was administered during a well attended, regularly scheduled class and students self-assessed their professionalism on the Behavioral Professionalism Assessment and provided data on their degree of involvement in pharmacy professional organizations. RESULTS: The questionnaire was completed by 78 of 84 students (a 93% response rate). Nearly 94% of participants reported that involvement in pharmacy organizations played some role in their professional development and approximately 30% of these students based this opinion on participation, leadership, and networking opportunities offered by professional organizations. A significant positive correlation between self-reported professionalism and involvement (i.e., the number of: brown bags/health fairs and organizational meetings attended, p<0.05 for each) was identified. CONCLUSIONS: A relationship was identified between professionalism and involvement at one college of pharmacy. Further research should be conducted at other colleges of pharmacy to determine if these data can be generalized to the larger pharmacy student population.

Class of 2007 Abstract / Objectives: To design and assess a novel evaluation tool for advanced pharmacy practice experiences (APPEs). Methods: APPE students and faculty of the University of Arizona College of Pharmacy (UA COP) completed an electronic survey assessing their level of agreement with nine questions regarding the evaluation tool’s format, content, and usefulness; they were also asked to select which of two grading systems, current (S, P, C, D, E) or alternate (pass/fail), they prefer. Results were compared with a 50% satisfaction benchmark using a Chi-square test (p<0.05). No identifying/demographic data was collected. Results: Surveys were completed by 48 of 107 eligible participants, giving a 45% response rate. The averaged response rank reflected agreement with all survey questions but number six. When compared to the benchmark, the results were significantly positive except for question number six (p=0.07). No significant difference existed between the current grading system group and the alternate group preferences (p=0.449). Conclusions: UA COP faculty and students should continue to use this evaluation tool to assess proficiency during the APPE portion of their college of pharmacy curriculum. The subjects responded positively to the evaluation, indicating that it is valuable to both faculty and students. Subjects, however, were reluctant to endorse that it facilitates communication between students and preceptors. Future changes to the adjectival scale, accessibility, and the grading system could be investigated.

M.Com. (Business Management) / Please refer to full text to view abstract

Abstract available in the Journal of Oncology Pharmacy Practice.

Oral antineoplastics (OAs) have become an emerging and rapidly growing field in cancer treatment. As with any chemotherapeutic agent, clinicians must be aware of potential drug interactions. Drug information databases are a common resource utilized to check for interactions between OAs and patient’s home medications. A major concern with OAs is that they are usually taken at home as well as picked up at a pharmacy by the patient themselves. The objective of this study was to determine the reliability of these databases for identifying potential interactions with OAs in a real-world setting. Hospital records were used to identify patients with common malignancies (leukemia, sarcoma, colon, lung, thyroid, prostate, kidney and liver cancers) treated with OAs from 2013 to 2014. To be included patients must have started an OA during the study period and have adequate records to evaluate OA use as well as home medications. The patient’s regimen is then entered into Drugs.com and Lexicomp™ interaction databases. In addition to documenting the number of interactions flagged by both databases, the severity of the interaction and disagreements between databases were analyzed. A major interaction was defined as either a “D” or “X” by Lexicomp™ and “major” by Drugs.com. As of this preliminary analysis, 407 of 876 subjects have been screened. Of the 407 screened, 9 patients (one patient with 3 different OAs) have been enrolled. Lexicomp™ flagged 34 interactions, of which 10 were major interactions. Drugs.com flagged 34 interactions, of which 6 were major interactions. Between the 2 databases there was only 60% agreement in flagging major interactions. These discrepancies are of concern in that clinicians hope resources they utilize are congruent with one another and allow them to practice in the safest manner in terms to avoid clinically significant drug interactions OA.

Background: Primary cilia are cellular organelles project from the cell surface of mammalian cell and play important roles in vertebrate development, organogenesis, health, and others genetic diseases. Primary cilium functions as a mechano-sensor and chemo-sensor. Defect in primary cilia causes the progression of polycystic kidney disease (PKD) which further leads to the inflammatory responses. We, therefore, investigated the role of Toll-like receptors 4 and 9 (TLR) in primary cilia towards PKD. Purpose: The main purpose of the proposed study is to identify and target the immune reactive proteins i.e. TLRs in the primary cilia. By targeting those primary cilia immune reactive proteins using suitable agonist and antagonists to study the control of cystic formation and their progression mechanisms. Methods: To target the ciliary immune TLR proteins (TLR4 and TLR9), we did immunostaining to evaluate their localization on primary cilia. Cilia lengths were measured and compared using differential interference contrast (DIC) and fluorescent imaging techniques. The in vitro3D cyst progression was monitored by adding agonists lipopolysaccharide (LPS) and oligodeoxynucleotides (ODN) and antagonist 4-hydroxy chloroquine (HCQ). Results: From our results we found that the TLR antagonist HCQ increases ciliary length in treated scrambled control, Pkd2knockout (KO) and TLR4KOcells as an immune response, whereas opposite results were observed with TLR9KO. However, the selected agonists for TLRs (LPS/ODN) increases cilia length in TLR9KO cells and decreases scrambled control, Pkd2KO and TLR4KO. In our 3D cyst cultures, we used agonists and antagonist for both the TLRs and observed that the cyst formations and progressions were inversely related to the cilia lengths. From these observations, we speculated that the new ciliary TLR proteins have a role in cystic progression. In conclusion, we found that the TLRs agonists/antagonist can modulate cilia length and TLRs role in inflammatory actions. The primary cilium already has central roles throughout cell biology, but here we propose, for the first time, that the cilium and the regulation of its structural importance in inflammation of PKD.