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Olson PS, Ploylearmsang C, Sibounheuang P, Sookaneknun S, Manithip C, Watcharadamrongkun S, Jungnickel PW, Kittiboonyakun P. Development of a patient satisfaction questionnaire (PSQ) for diabetes management in Thailand and Lao PDR. PLoS One 2024; 19:e0300052. [PMID: 38452151 PMCID: PMC10919862 DOI: 10.1371/journal.pone.0300052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/16/2024] [Indexed: 03/09/2024] Open
Abstract
In a cross-sectional analytical study, a Patient Satisfaction Questionnaire (PSQ) for diabetes management was developed and tested in Thailand and Lao PDR. A systematic review of qualitative studies was conducted to formulate themes of the PSQ. The 20-item PSQ was prepared in Thai and translated to Lao, with subsequent backward translation. Both versions were tested for reliability and construct validity using confirmatory factor analysis and structural equation modeling. The study was performed at a university hospital in Thailand and two central hospitals in Vientiane, Lao PDR. There were 300 diabetic patients from Thailand (n = 150) and Lao PDR (n = 150). The 5-factor Thai version showed 74.52% of total explained variance with good internal consistency and satisfactory goodness-of-fit indices (χ2/df = 1.91, GFI = 0.83, CFI = 0.98, SRMR = 0.063, RMSEA = 0.078). The five factors were 1) Standard of Service, 2) Diabetic Service, 3) Competency of Providers, 4) Competency of Pharmacists, and 5) Communication with Providers. For the Lao version, 20 items showed a 3-factor structure with a total explained variance of 71.09%. Goodness-of-fit indices for the Lao model were satisfactory (χ2/df = 2.45, GFI = 0.78, CFI = 0.95, SRMR = 0.075 and RMSEA = 0.095). The results showed the PSQ Thai and Lao versions were valid and reliable for assessing patient satisfaction with diabetes management, however more testing of the questionnaire is appropriate.
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Affiliation(s)
- Phayom Sookaneknun Olson
- Faculty of Pharmacy, International Primary Care Practice Research Unit, Mahasarakham University, Khamriang Sub-District, Kantarawichai District, Maha Sarakham, Thailand
| | - Chanuttha Ploylearmsang
- Faculty of Pharmacy, International Primary Care Practice Research Unit, Mahasarakham University, Khamriang Sub-District, Kantarawichai District, Maha Sarakham, Thailand
| | - Phoutsathaphone Sibounheuang
- Faculty of Pharmacy, University of Health Sciences, Kao Ngot Villagem, Sisattanak District, Vientiane Capital, Lao PDR
| | - Santiparp Sookaneknun
- Mahasarakham Business School, Mahasarakham University, Khamriang Sub-District, Kantarawichai District, Maha Sarakham, Thailand
| | - Chanthanom Manithip
- Ministry of Health, Ban Thatkhao, Sisattanack District, Rue Simeuang, Lao PDR
| | | | - Paul W. Jungnickel
- Department of Pharmacy Practice, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, United States of America
| | - Pattarin Kittiboonyakun
- Faculty of Pharmacy, Health Service and Pharmacy Practice Research and Innovation Unit, Mahasarakham University, Khamriang Sub-District, Kantarawichai District, Maha Sarakham, Thailand
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Olson PS, Srimongkon P, Tan BK, Nacabu-An SMJ, Sibounheuang P, Setiawan CH, Van Hung N, Leelathanalerk A, Potisarach P, Sungthong B, Ploylearmsang C, Seesin T, Chanasopon S, Kanjanasilp J, Manwiwattanakun G, Jungnickel PW. Pharmacy students' preparation to provide pharmaceutical care for patients with non-communicable diseases in six ASEAN countries: A qualitative study. Curr Pharm Teach Learn 2022; 14:1353-1364. [PMID: 36127275 DOI: 10.1016/j.cptl.2022.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 08/09/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Pharmacy education programs prepare graduates to promote health for patients with noncommunicable disease (NCDs), but there is limited information concerning Association of South East Asia Nations (ASEAN) countries. The study aim was to synthesize academic staff's, alumni's, and alumni supervisors' perspectives on preparation for students to provide pharmaceutical care in NCDs. METHODS A qualitative research design was used. In-depth interviews with structured questions following the Context, Input, Process, and Product/Outcomes model framework were conducted with four academic staff, three alumni, and three alumni supervisors from six study sites in six countries. Interview questions were constructed in Thai and translated to English by using forward and backward translation. Verbatim transcriptions were used to perform thematic analysis with investigator triangulation. RESULTS Sixty participants were included. The context showed three main themes related to Burden of NCDs, Pharmacist Roles in NCDs, and Goals. The input showed three main themes of Teaching Methods, Development Plans for Academic Staff, and Budgets and Infrastructure. The process showed one main theme of Struggles in Teaching Methods. The outcomes/outputs showed three main themes of Individual, Organizational, and Professional Levels. Schools need curricula that focus on NCDs, pharmacist competency and skills, and academic preparation of students for practice. Gaps limiting achievement of goals included lack of well-trained academic staff, limited learning facilities, self-learning opportunities, acceptance from other health professionals, and career ladders. CONCLUSIONS The preparation of pharmacy students varied in six ASEAN countries. Pharmacy education programs must address existing gaps that limit achievement of goals related to NCDs.
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Affiliation(s)
- Phayom Sookaneknun Olson
- International Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Pornchanok Srimongkon
- Clinical Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Bee Kim Tan
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, No. 1 Jalan Taylor's, 47500 Subang Jaya, Selangor Darul Ehsan, Malaysia.
| | - Shiela May J Nacabu-An
- Department of Pharmacy, College of Pharmacy, University of the Philippines Manila, Taft Ave., Manila 1000, Philippines.
| | - Phoutsathaphone Sibounheuang
- Faculty of Pharmacy, University of Health Sciences, Samsenthai Road, Kao ngot Villagem, Sisattanak District Vientiane Capital, P.O. Box 7444, Laos
| | | | - Nguyen Van Hung
- School of Pharmacy, Hai Phong University of Medicine and Pharmacy, No. 72A Nguyen Binh Khiem, Ngo Quyen, Hai Phong, Viet Nam.
| | - Areerut Leelathanalerk
- Clinical Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Pemmarin Potisarach
- International Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Bunleu Sungthong
- Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Chanuttha Ploylearmsang
- International Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Theerapong Seesin
- International Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Suratchada Chanasopon
- Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Juntip Kanjanasilp
- Clinical Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Greepol Manwiwattanakun
- Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand.
| | - Paul W Jungnickel
- Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantarawichai District, Maha Sarakham 44150, Thailand; Auburn University Harrison College of Pharmacy, Auburn University Alabama, 2316 Walker Building, 36849, USA.
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Evans RL, Duncan W, Jungnickel PW. Incorporating ACPE Standards in a Holistic Approach to School Operations and Accreditation. Am J Pharm Educ 2019; 83:7073. [PMID: 31065167 PMCID: PMC6498212 DOI: 10.5688/ajpe7073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 11/10/2018] [Indexed: 06/09/2023]
Abstract
Auburn University Harrison School of Pharmacy (AUHSOP) implemented a comprehensive, holistic process of continuous quality improvement (CQI) for its program using the Accreditation Council for Pharmacy Education's (ACPE) Accreditation Standards as the foundation. The process served as a way to increase the impact of the accreditation standards through continuous monitoring and programmatic improvements. Internally generated standards were also included in the CQI process. Design of the program included defining the program, establishing quality criteria, developing a table of measures that provided evaluation metrics, and assessing the program annually. Each year, faculty members, staff, students and other constituents assess the program for strengths, areas for improvement and insights. A CQI report is created and is made available to constituents, including ACPE through the Assessment and Management System (AAMS). Areas for improvement and new goals are then incorporated into the school's strategic plan and committee assignments for the year. Some of the suggestions included making the program appraisal more meaningful and on a continuous, ongoing basis compared to doing an appraisal for accreditation purposes at 8-year intervals. The process has increased constituent awareness of all aspects of the program and prompted numerous improvements since its adoption. A culture of assessment resulted from the process.
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Affiliation(s)
- R. Lee Evans
- Harrison School of Pharmacy, Auburn University, Auburn, Alabama
| | - Wendy Duncan
- College of Pharmacy, California Health Sciences University, Clovis, California
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Dornblaser EK, Ratka A, Gleason SE, Ombengi DN, Tofade T, Wigle PR, Zapantis A, Ryan M, Connor S, Jonkman LJ, Ochs L, Jungnickel PW, Abrons JP, Alsharif NZ. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations. Am J Pharm Educ 2016; 80:39. [PMID: 27170810 PMCID: PMC4857634 DOI: 10.5688/ajpe80339] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 08/11/2015] [Indexed: 05/11/2023]
Abstract
The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students.
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Affiliation(s)
| | - Anna Ratka
- Chicago State University College of Pharmacy, Chicago, Illinois
| | - Shaun E. Gleason
- University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
| | | | - Toyin Tofade
- University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Patricia R. Wigle
- University of Cincinnati James L. Winkle College of Pharmacy, Cincinnati, Ohio
| | - Antonia Zapantis
- Nova Southeastern University College of Pharmacy, Fort Lauderdale, Florida
| | - Melody Ryan
- University of Kentucky College of Pharmacy, Lexington, Kentucky
| | - Sharon Connor
- University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania
| | - Lauren J. Jonkman
- University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania
| | - Leslie Ochs
- University of New England College of Pharmacy, Portland, Maine
| | | | | | - Naser Z. Alsharif
- Creighton University Medical Center School of Pharmacy and Health Professions, Omaha, Nebraska
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Zeek ML, Savoie MJ, Song M, Kennemur LM, Qian J, Jungnickel PW, Westrick SC. Sleep Duration and Academic Performance Among Student Pharmacists. Am J Pharm Educ 2015; 79:63. [PMID: 26396272 PMCID: PMC4571043 DOI: 10.5688/ajpe79563] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/08/2014] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To identify sleep patterns and frequency of daytime sleepiness and to assess the association between sleep duration and academic performance among student pharmacists. METHODS A cross-sectional design was used. An anonymous self-administered paper questionnaire was administered to first-year through third-year students at a pharmacy school. RESULTS Questionnaires were completed by 364 student pharmacists (79.4% response rate and 93.8% cooperation rate). More than half of student pharmacists obtained less than 7 hours of sleep at night during a typical school week (54.7%) and a large majority on the night prior to an examination (81.7%). Almost half (47.8%) felt daytime sleepiness almost every day. Longer sleep duration the night prior to an examination was associated with higher course grades and semester grade point averages (GPAs). CONCLUSION A majority of student pharmacists had suboptimal durations of sleep, defined as fewer than 7 hours. Adequate sleep the night prior to an examination was positively associated with student course grades and semester GPAs.
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Affiliation(s)
- Megan L Zeek
- Auburn University Harrison School of Pharmacy, Auburn, Alabama
| | | | - Matthew Song
- Auburn University Harrison School of Pharmacy, Auburn, Alabama
| | | | - Jingjing Qian
- Auburn University Harrison School of Pharmacy, Auburn, Alabama
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Oliver W, McGuffey G, Westrick SC, Jungnickel PW, Correia CJ. Alcohol use behaviors among pharmacy students. Am J Pharm Educ 2014; 78:30. [PMID: 24672063 PMCID: PMC3965138 DOI: 10.5688/ajpe78230] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 09/07/2013] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To identify reasons for drinking, determine the patterns of alcohol abuse, and explore relationships between drinking motives and alcohol abuse patterns in pharmacy students. METHODS A cross-sectional anonymous, voluntary, self-administered paper survey instrument was administered to first-year (P1) through third-year (P3) pharmacy students as part of a professional seminar. RESULTS Survey instruments were completed by 349 pharmacy students (95.9% cooperation rate). Using the Alcohol Use Disorders Identification Test criteria, 23.2% of students reported hazardous or harmful use and 67.2% of students reported consuming alcohol at hazardous levels during the past year. Students who were male (37.0%), single (25.3%), and attended the main campus (26.2%) were more likely than their counterparts to report hazardous or harmful alcohol use. Pharmacy students reported social motives as the most common reason for drinking; however, coping and enhancement motives were more predictive of harmful or hazardous alcohol use. CONCLUSION Approximately 1 in 4 pharmacy students (23%) reported hazardous or harmful alcohol use. Education about the dangers of alcohol abuse and intervention programs from colleges and schools of pharmacy are recommended to help address this issue.
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Affiliation(s)
- Wesley Oliver
- Harrison School of Pharmacy, Auburn University, Auburn, Alabama
| | - Grant McGuffey
- Harrison School of Pharmacy, Auburn University, Auburn, Alabama
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Jungnickel PW, Desimone EM, Kissack JC, Lawson LA, Murawski MM, Patterson BJ, Rospond RM, Scott DM, Athay J. Report of the AACP Special Committee on Substance Abuse and Pharmacy Education. Am J Pharm Educ 2010; 74:S11. [PMID: 21436899 PMCID: PMC3058467 DOI: 10.5688/aj7410s11] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Affiliation(s)
- Paul W. Jungnickel
- Harrison School of Pharmacy Auburn University 2316 Walker Building Auburn University, AL 36849
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Abstract
This paper reviews the literature, analyzes current and future practice, develops a list of competencies necessary for future pharmacists, and provides recommendations to pharmacy's academic enterprise regarding curricula of the future. Curricula of the future will center around 3 functional roles for pharmacists: patient-centered care, population-based care, and systems management; and must also foster the development of 5 cross-cutting abilities in student pharmacists: professionalism, self-directed learning, leadership and advocacy, interprofessional collaboration, and cultural competency. Future curricula must be developed in an evidence-based manner, focus less on information storage and retrieval, engage student pharmacists in a variety of highly interactive learning experiences, and expand experiential learning opportunities throughout all years.
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Abstract
OBJECTIVE This paper reviews the pharmacology, clinical efficacy, and tolerability of pantoprazole in comparison with those of other available proton pump inhibitors (PPIs). METHODS Relevant English-language research and review articles were identified by database searches of MEDLINE, International Pharmaceutical Abstracts, and UnCover, and by examining the reference lists of the articles so identified. In selecting data for inclusion, the author gave preference to full-length articles published in peer-reviewed journals. RESULTS Like other PPIs, pantoprazole exerts its pharmacodynamic actions by binding to the proton pump (H+,K+ -adenosine triphosphatase) in the parietal cells, but, compared with other PPIs, its binding may be more specific for the proton pump. Pantoprazole is well absorbed when administered as an enteric-coated, delayed-release tablet, with an oral bioavailability of approximately 77%. It is hepatically metabolized via cytochrome P2C19 to hydroxypantoprazole, an inactive metabolite that subsequently undergoes sulfate conjugation. The elimination half-life ranges from 0.9 to 1.9 hours and is independent of dose. Pantoprazole has similar efficacy to other PPIs in the healing of gastric and duodenal ulcers, as well as erosive esophagitis, and as part of triple-drug regimens for the eradication of Helicobacter pylori from the gastric mucosa. It is well tolerated, with the most common adverse effects being headache, diarrhea, flatulence, and abdominal pain. In clinical studies, it has been shown to have no interactions with various other agents, including carbamazepine, cisapride, cyclosporine, digoxin, phenytoin, theophylline, and warfarin. CONCLUSIONS Pantoprazole appears to be as effective as other PPIs. Its low potential for drug interactions may give it an advantage in patients taking other drugs.
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Affiliation(s)
- P W Jungnickel
- School of Pharmacy, Auburn University, Alabama 36849-5501, USA.
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11
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Murphy JE, Sickels J, Bradberry JC, Curry CE, Jungnickel PW, Prosser T. Opportunities for pharmacy specialists as the delivery of health care changes. Am J Health Syst Pharm 1999; 56:1342-7. [PMID: 10683134 DOI: 10.1093/ajhp/56.13.1342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J E Murphy
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson 85721-0207, USA.
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Jungnickel PW, Wisehart DA. Evaluation of community pharmacists' experiences with cholesterol screening programs. J Am Pharm Assoc (Wash) 1997; NS37:640-6. [PMID: 9425793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess the cholesterol screening experiences of Nebraska community pharmacists. DESIGN A mail survey was used to assess pharmacists' experiences with and involvement in cholesterol screening and patient follow-up based on National Cholesterol Education Program guidelines. SETTING A college of pharmacy in an academic health center. PATIENTS OR OTHER PARTICIPANTS Pharmacists-in-charge of all Nebraska community pharmacies. INTERVENTIONS None. MAIN OUTCOME MEASURES Participants' responses to survey items. RESULTS Of 308 respondents, 83 indicated that cholesterol screenings had been held in their pharmacies. Whereas 95% felt that the screenings had been conducted appropriately, only 61% had actually monitored the screening process. Pharmacists were somewhat aware of the types of information being provided to patients being screened, although few were aware of the specific procedures used to identify high-risk patients. Eight of 80 pharmacists indicated that they obtained a list of patients who were told to contact their physicians based on their cholesterol screening results. Only 3 of 30 pharmacists responding to a question asking whether they contacted such patients to remind them to contact their physician reported actually doing so. CONCLUSION Pharmacists were relatively uninvolved in both the screening process and the provision of information to the patients who were screened. Few pharmacists initiated-up contact with patients who were referred for physician evaluation.
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Affiliation(s)
- P W Jungnickel
- Auburn University, School of Pharmacy, AL 36849-5501, USA.
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Abstract
OBJECTIVE To compare the effects of pretreatment with two aspirin regimens and placebo on niacin-induced cutaneous reactions. DESIGN Randomized, double-blind, placebo-controlled, crossover study. SETTING Internal medicine clinic in an academic health center. PARTICIPANTS Forty-two healthy subjects (22 males and 20 females) between the ages of 35 and 65 (mean age 44.2 years) were recruited and completed the study. Subjects received aspirin 325 mg, aspirin 650 mg, and placebo for 4 consecutive days, and on the fourth day also ingested 500 mg of immediate-release niacin 30 minutes after taking aspirin or placebo. They reported the intensity of flushing, headache, pruritus, tingling, and warmth on a 10-cm visual analogue scale. Reactions were evaluated at time 0 (before the niacin dose), and at 15, 30, 60, and 120 minutes following the niacin dose. Cutaneous reactions were compared at each evaluation time and scored by two other methods. The peak intensity was the highest score recorded at any of the four evaluation times after niacin administration. An intensity-time factor was calculated by totaling the scores of each of the four evaluation times. MEASUREMENT AND MAIN RESULTS The symptom scores for flushing, itching, tingling, and warmth were all significantly reduced by both aspirin regimens (p < .05 in all cases), although there were no significant differences between the 325-mg and 650-mg doses. The results were similar for each scoring method. CONCLUSIONS An aspirin regimen of 325 mg is effective in suppressing niacin-induced cutaneous reactions. Increasing the dose to 650 mg does not provide additional benefit.
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Affiliation(s)
- P W Jungnickel
- Department of Clinical Pharmacy Practice, Auburn University, Ala. 36849-5501, USA
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Abstract
Geurian concludes that recommendations for the management of hypercholesterolemia are difficult to make because a previously black and white issue is becoming "increasingly gray." Actually, it appears that the opposite is occurring. Our knowledge of atherogenesis, as well as the mechanisms by which thromboembolic events occur, continues to expand. We are gaining new insights into the mechanisms by which cholesterol-lowering therapy can prevent the development of coronary events. Newer cholesterol-lowering agents are more potent than those previously available and make substantial reductions more readily achievable. Finally, we are gaining a better understanding of the relative benefits of cholesterol-lowering therapy in various patient populations, although more work is needed, particularly in women and older patients. Cholesterol-lowering therapy has had an important positive impact on CHD, particularly in preventing recurrent events and reducing mortality when used as secondary prevention. Clearly, there are substantial numbers of patients who will benefit greatly from cholesterol-lowering drugs, and clinicans should not be dissuaded from providing this valuable form of drug therapy.
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Affiliation(s)
- P W Jungnickel
- Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha 68198, USA.
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Jungnickel PW, Maloley PA. Pharmacoepidemiology of niacin. Ann Intern Med 1995; 122:392-3. [PMID: 7847654 DOI: 10.7326/0003-4819-122-5-199503010-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Jungnickel PW, Shaefer MS, Maloley PA, Campbell JR, Shawaryn GG, Goris GB, Oliphant TH. Blind comparison of patient preference for Flavored Colestid Granules and Questran Light. Ann Pharmacother 1993; 27:700-3. [PMID: 8329785 DOI: 10.1177/106002809302700603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To compare the sensory and mixability characteristics of Flavored Colestid Granules (a new colestipol formulation) with Questran Light (the most recent cholestyramine formulation). METHODOLOGY Seventy-two nonsmoking adults between the ages of 25 and 64 years were enrolled in the study. Subjects assessed the sensory and mixability characteristics of each product in chilled bottled water and orange juice after at least a one-hour fast. Products were administered in a double-blind, randomized fashion. The sensory characteristics that were rated included overall rating, aftertaste, appearance, aroma, color, consistency, flavor, sweetness, mouthfeel, and thickness. Each characteristic was rated with a nine-point hedonic scale. Mixability of the products was assessed on a five-point scale. Subjects also were asked to choose which product they preferred as to sensory and mixability characteristics in each vehicle. RESULTS Fifty-three of the 72 subjects preferred the sensory characteristics of Flavored Colestid Granules in water (p < 0.001). Questran Light was preferred by 61 subjects when mixed in orange juice (p < 0.001). The sensory characteristic rating scores also supported subject preferences for Flavored Colestid Granules in water and Questran Light in orange juice. Mixability of Flavored Colestid Granules was rated significantly better (p < 0.001) than Questran Light in water. There was no significant difference for mixability between the products in orange juice. CONCLUSIONS Questran Light was significantly preferred on a sensory basis when mixed in orange juice. Flavored Colestid Granules was significantly preferred over Questran Light for both sensory and mixability characteristics with water as the vehicle.
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Affiliation(s)
- P W Jungnickel
- University of Nebraska Medical Center, Department of Pharmacy Practice, Omaha 68198
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Jungnickel PW, Cantral KA, Maloley PA. Pravastatin: a new drug for the treatment of hypercholesterolemia. Clin Pharm 1992; 11:677-89. [PMID: 1511541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The chemistry, pharmacology, pharmacokinetics, clinical trials, adverse effects, role in lipid-lowering therapy, and dosage and administration of pravastatin are reviewed. Pravastatin sodium is a new 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor for the treatment of hypercholesterolemia. Its structural formula is similar to those of lovastatin and simvastatin, but it is active in the parent form. It competitively inhibits HMG-CoA reductase, reduces hepatic cellular cholesterol synthesis, increases the expression of hepatic low-density lipoprotein (LDL) receptors, and reduces hepatic very low-density lipoprotein (VLDL) synthesis. Pravastatin has been demonstrated to reduce cholesterol in patients with familial and nonfamilial polygenic hypercholesterolemia and patients with diabetes mellitus. In doses of 10-40 mg/day, pravastatin has been shown to reduce total cholesterol by 15-30% and LDL cholesterol by 15-40%. It also increases high-density lipoprotein cholesterol by 2-20% and reduces triglycerides. It is generally well tolerated, with few adverse effects reported in clinical trials. Pravastatin reduces LDL cholesterol and increases HDL cholesterol comparably to lovastatin but possibly with fewer adverse effects. Further studies and clinical use will be needed to confirm potential differences in adverse effect profiles between the two drugs.
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Jungnickel PW, Maloley PA. Comment: adverse-effect profile of sustained-release niacin. DICP 1991; 25:1014-5. [PMID: 1949965 DOI: 10.1177/106002809102500925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Abstract
This double-blind, crossover trial compared the sensory and product preparation characteristics of two cholestyramine powder preparations. The study involved 100 healthy volunteers, aged 22-65 (mean 42 years). Questran, a currently marketed product containing sucrose as a sweetener, was compared with Questran Light, a new formulation substituting aspartame for 90 percent of the sucrose. Comparisons were conducted with the two products mixed in water and orange juice. The subjects expressed a significant overall preference for the new formulation mixed in either water (77 percent) or orange juice (80 percent) (p less than 0.01 in both comparisons). Subjects expressed an overwhelming preference for the old product (99 percent) with respect to ease of preparation, although the ratings of the new product were generally neutral rather than negative. The new product is somewhat more difficult to prepare compared with the old cholestyramine preparation, but offers significantly increased patient acceptance based on sensory evaluations.
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Affiliation(s)
- M S Shaefer
- University of Nebraska Medical Center, Omaha 68198-2135
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Bhargava VO, Schaaf LJ, Berlinger WG, Jungnickel PW. Effect of an enteral nutrient formula on sustained-release theophylline absorption. Ther Drug Monit 1989; 11:515-9. [PMID: 2510372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The effect of an enteral nutrient formula (Osmolite) on the absorption of a single oral dose of sustained-release theophylline (Slo-bid) was studied in healthy men. In a randomized, crossover design, subjects received the enteral nutrient diet (2,400 ml/day) or food diet (F) of similar caloric, fat, carbohydrate, protein, and sodium content for 7 days. On day 6 of each diet, volunteers received a single oral dose (600 mg) of sustained-release theophylline (SRT) after fasting or with hourly oral boluses (100 ml) of enteral nutrient formula (ENF). Serial blood samples were collected for 48 h and serum concentrations were analyzed by enzyme multiplied immunoassay. Slight differences (p less than 0.01; paired t test) in Cmax (7.1 +/- 1.2 versus 8.2 +/- 1.3 mg/L) and Tmax (10.7 +/- 2.4 vs. 7.1 +/- 1.1 h) were observed between the ENF and F diets, respectively. However, areas under the curve values were similar (215 +/- 72 versus 211 +/- 70 mg h/L). This study suggests that ENF does not affect the extent of absorption of SRT when administered as a single oral dose.
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Affiliation(s)
- V O Bhargava
- College of Pharmacy, University of Nebraska Medical Center, Omaha
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Cantral KA, Schaaf LJ, Jungnickel PW, Monsour HP. Effect of sucralfate on theophylline absorption in healthy volunteers. Clin Pharm 1988; 7:58-61. [PMID: 3345643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The effect of oral administration of sucralfate concurrently with a single oral dose of non-sustained-release theophylline was studied in eight healthy male volunteers. A two-way, randomized, cross-over study design was used. During the control phase, each subject received a single 5-mg/kg dose of a non-sustained-release theophylline product. During the treatment phase, a 1-g sucralfate tablet was ingested four times a day for two days before the theophylline dose, with the theophylline dose, and six hours after the dose. Plasma samples were collected at frequent intervals for 24 hours after theophylline dosing. Plasma theophylline concentrations, determined by high-performance liquid chromatography, were similar in the absence and presence of sucralfate. No significant differences in theophylline half-life or mean residence time between the control and treatment phases were observed. A significant decrease in the area under the plasma drug concentration-time curve was observed in the presence of sucralfate. However, the magnitude of this change was minimal and unlikely to be clinically important. In these healthy subjects, the concomitant administration of sucralfate with a single dose of non-sustained-release theophylline did not alter the rate or extent of theophylline absorption to a clinically important degree.
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Affiliation(s)
- K A Cantral
- College of Pharmacy, University of Nebraska Medical Center, Omaha 68105
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Shaefer MS, Jungnickel PW, Jacobs EW, Maloley PA. Acceptability of cholestyramine or colestipol combinations with six vehicles. Clin Pharm 1987; 6:51-4. [PMID: 3816107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Preferences for cholestyramine or colestipol in combination with orange drink, orange juice, grape juice, apple juice, water, or apple sauce were evaluated in 40 healthy adults. Each subject evaluated the taste, texture, and smell of 30-mL samples of 12 drug-vehicle combinations (two drugs, six vehicles) using modified five-point wine-tasting scales. Samples were prepared to contain either cholestyramine 1.0 g or colestipol hydrochloride 1.3 g. The products were tested at room temperature and were administered in a random order. Subjects and observers were blinded to the identity of the products. Acceptability scores for taste, texture, and smell were significantly higher for cholestyramine than for colestipol. Total mean preference scores for cholestyramine-vehicle combinations ranged from 9.9 to 11.7; for colestipol, 6.3 to 8.9. Orange drink, apple juice, grape juice, and orange juice were the preferred vehicles for cholestyramine. The preferred vehicles for colestipol were orange drink, apple sauce, and apple juice.
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