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Biomedical subjects

Lawrence M Brown

Publications and source records attributed to Lawrence M Brown.

5 recordsLinked to original sources
PubMed2006

Provision of risk management and risk assessment information: the role of the pharmacist.

BACKGROUND: There exists a need to conceptualize and understand the roles that pharmacists serve to help convince others such as patients, prescribers, and payers to value their contributions and to plan for the roles they could serve in the future within the health care system. OBJECTIVE: The purpose of this study was to (1) describe and track differences in pharmacists' and patients' views about the pharmacist's and physician's role in medication risk management and risk assessment in 1995, 1998, 2001, and 2004, and (2) describe associations between selected demographic variables and reported opinions about the pharmacist's role using data from 2004. METHODS: Brushwood's Risk Management/Risk Assessment Framework was used as a conceptual guide for developing 2 risk management and 2 risk assessment scenarios. For each scenario, study participants were asked to select the level of responsibility shared by physicians and pharmacists in addressing the drug therapy problem. Data were collected in 1995, 1998, 2001, and 2004 using random samples of pharmacists and patients as study subjects. Descriptive statistics and logistic regression analysis were used for analyzing the data. RESULTS: The results showed that pharmacists view their role as providing risk management information to patients and may view this role as adding value to patient care above and beyond a level that can be provided by a physician alone. In 2004, pharmacists started to view the risk assessment scenarios as being more their responsibility as well. Patients, on the other hand, consistently viewed their physician as having primary responsibility for their health care in all of the scenarios we studied. CONCLUSIONS: Pharmacists view their role as one that adds unique value to a patient's health through their provision of medication risk management and some types of risk assessment. However, patients do not yet view the pharmacist as the primary provider of either medication risk management or risk assessment information.

Attitude of Health Personnel↗
PubMed2006

Examining gender salary disparities: an analysis of the 2003 multistate salary survey.

BACKGROUND: Pharmacist salary and wage surveys have been conducted at the state and national level for more than 20 years; however, it is not known to what extent, if any, wage disparities due to gender still exist. OBJECTIVES: The overall objective of this study was to determine if wage disparities exist among male and female pharmacists at the multistate and individual state level for each of 6 states studied. A secondary objective was to explore the effect of various demographic variables on the hourly wages of pharmacists. METHODS: Data were collected from 1,688 pharmacists in 6 states during 2003 using a cross-sectional descriptive survey design. A multiple regression analysis on hourly wage testing the effects of state of practice, practice setting, position, terminal degree, and years in practice was conducted. Subsequent multiple regression analyses were conducted individually for each of the 6 states to test the effects of the above variables on hourly wage for both male and female pharmacists, followed by state-level analyses for male and female pharmacists, respectively. RESULTS: For the pooled data, all variables were found to be significant predictors of hourly wage, except for earning a PharmD degree without a residency or graduate degree. Gender was not a significant predictor of wage disparities in the state-level analyses. Position was the only significant predictor of wage disparities in all states (except Tennessee) such that pharmacists in management positions make significantly higher salaries than those in staff positions. CONCLUSIONS: The results of these analyses suggest that wage disparities due to gender do not exist at the state level for the 6 states surveyed, when controlling for practice setting, position, terminal degree, and years in practice. The larger number of men in management positions may explain lower wages for female pharmacists.

Cross-Sectional Studies↗
PubMed2004

Deletion of Ser-171 causes inactivation, proteasome-mediated degradation and complete deficiency of human transaldolase.

Homozygous deletion of three nucleotides coding for Ser-171 (S171) of TAL-H (human transaldolase) has been identified in a female patient with liver cirrhosis. Accumulation of sedoheptulose 7-phosphate raised the possibility of TAL (transaldolase) deficiency in this patient. In the present study, we show that the mutant TAL-H gene was effectively transcribed into mRNA, whereas no expression of the TALDeltaS171 protein or enzyme activity was detected in TALDeltaS171 fibroblasts or lymphoblasts. Unlike wild-type TAL-H-GST fusion protein (where GST stands for glutathione S-transferase), TALDeltaS171-GST was solubilized only in the presence of detergents, suggesting that deletion of Ser-171 caused conformational changes. Recombinant TALDeltaS171 had no enzymic activity. TALDeltaS171 was effectively translated in vitro using rabbit reticulocyte lysates, indicating that the absence of TAL-H protein in TALDeltaS171 fibroblasts and lymphoblasts may be attributed primarily to rapid degradation. Treatment with cell-permeable proteasome inhibitors led to the accumulation of TALDeltaS171 in whole cell lysates and cytosolic extracts of patient lymphoblasts, suggesting that deletion of Ser-171 led to rapid degradation by the proteasome. Although the TALDeltaS171 protein became readily detectable in proteasome inhibitor-treated cells, it displayed no appreciable enzymic activity. The results suggest that deletion of Ser-171 leads to inactivation and proteasome-mediated degradation of TAL-H. Since TAL-H is a regulator of apoptosis signal processing, complete deficiency of TAL-H may be relevant for the pathogenesis of liver cirrhosis.

Cells, Cultured↗
PubMedDate not supplied

Quality assessment of a collaborative approach for decreasing drug-related morbidity and achieving therapeutic goals.

BACKGROUND: Collaboration between physicians and pharmacists is one approach to address drug-related morbidity and achieve therapeutic goals. A collaborative practice of pharmaceutical care has been used in the Fairview Clinics System of Minneapolis-St Paul since 1999. METHODS: The quality of therapeutic determinations made by pharmacists within this collaborative practice of pharmaceutical care was studied by a 12-member panel of physicians and pharmacists who used randomly selected patient records. This was a quality improvement and care process validation component of a study evaluating the effects of drug therapy management in patients receiving prepaid medical assistance. An implicit review process was used to evaluate the clinical credibility of therapeutic determinations made by pharmaceutical care practitioners. RESULTS: A total of 5780 drug therapy problems were resolved for 2524 patients receiving pharmaceutical care. The rate of therapeutic goals achieved increased from 74% at the time of patients' initial pharmaceutical care encounters to 89% at patients' latest encounters. In this quality assessment analysis panel members performed a total of 4779 evaluations of clinical decisions. Panelists indicated agreement with the evaluations in 94.2% of cases, expressed a neutral opinion in 3.6% of cases, and disagreed in 2.2% of cases. Intraclass correlation coefficients ranged from 0.73 to 0.85. CONCLUSIONS: The decisions made by pharmaceutical care practitioners working in collaboration with physicians to provide drug therapy management services are clinically credible based on the evaluations and comments of a peer review panel. This study provides information on the quality of care provided by pharmacists when collaborating with physicians to provide drug therapy management services.

Cooperative Behavior↗