Biomedical subjects

Marcia M Worley

Publications and source records attributed to Marcia M Worley.

6 recordsLinked to original sources

PubMed2006

Testing a pharmacist-patient relationship quality model among older persons with diabetes.

BACKGROUND: Considering recent changes to the Medicare program, pharmacists will have unique opportunities to be reimbursed for providing Medication Therapy Management Services to older persons with diabetes. A high-quality pharmacist-patient relationship can lay the foundation for effective provision of Medication Therapy Management Services and improved care in this cohort. OBJECTIVE: To test a pharmacist-patient relationship quality model in a group of older persons with diabetes from the patient's perspective. Antecedents to relationship quality were pharmacist participative behavior/patient-centeredness of relationship, patient participative behavior, and pharmacist-patient interpersonal communication. Pharmacist-patient relationship commitment was the outcome of relationship quality studied. METHODS: Data were collected via mailed questionnaire from a random sample of 600 community-dwelling adults in the United States who (1) were 65 years of age and older, (2) had type 1 or type 2 diabetes, (3) used at least one prescription medication to treat their diabetes, and (4) used some type of nonmail order pharmacy as their primary source of obtaining prescription medications. Model relationships were tested using path analysis. RESULTS: The adjusted response rate was 41.6% (221/531). The models explained 47% and 49% of the variance in relationship quality and relationship commitment, respectively. In the relationship quality model, pharmacist participative behavior/patient-centeredness of relationship (beta=.51, P<.001) and pharmacist-patient interpersonal communication (beta=.17, P=.008) had direct effects on relationship quality. In the relationship commitment model, relationship quality had a direct effect on relationship commitment (beta=.60, P<.001). Pharmacist participative behavior/patient-centeredness and pharmacist-patient interpersonal communication had indirect effects on relationship commitment through their effects on relationship quality, which is a mediator in the model. CONCLUSIONS: Results affirm findings from previous research showing that patients' perceptions of pharmacist participative behavior/patient-centeredness of relationship and pharmacist-patient interpersonal communication are positively related to perceptions of relationship quality. Also, relationship quality is a strong mediator between pharmacist participative behavior/patient-centeredness of relationship and relationship commitment, as well as between pharmacist-patient interpersonal communication and relationship commitment.

Age Factors↗

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

Relationships between Hispanic ethnicity and attitudes and beliefs toward herbal medicine use among older adults.

BACKGROUND: Little is known about the underlying intentions to use herbal medicines among Hispanic older adults. Understanding these intentions is critical to the provision of effective counseling. OBJECTIVES: The objectives were to (1) identify predictors of the intention to use herbal medicines for health problems in the next 6 months among Hispanic and non-Hispanic older adults using the Theory of Planned Behavior (TPB); and (2) compare their beliefs underlying significant predictors of intention with use herbal medicines for health problems in the next 6 months. METHODS: Using a cross-sectional research design, data were collected via self-administered questionnaires from convenience samples at a Senior Health Clinic and a Veterans Affairs Hospital outpatient pharmacy. Study subjects were community dwelling adults aged 65 years and older and able to complete the survey in English. Multiple regression analysis was used to identify the significant predictors of intention to use herbal medicines in the TPB within each ethnicity. Independent t tests were used to compare the beliefs underlying the significant predictors of intention with use herbal medicines across the 2 groups. RESULTS: For both Hispanic (N=80) and non-Hispanic (N=171) patients, attitudes toward using herbal medicines was the only significant predictor of the intention to use herbal medicines in the next 6 months (Hispanics, Adj. R(2)=0.59, beta=0.78, P<.001; non-Hispanics, Adj. R(2)=0.57, beta=0.66, P<.001). The magnitude of the beta coefficients did not differ significantly between the 2 ethnicities. Compared with non-Hispanics, Hispanics believed that herbal medicines are cheaper, have fewer side effects, work better, and are more convenient to use than other medicines. CONCLUSIONS: Understanding ethnic differences in behavioral beliefs underlying attitudes toward the use of herbal medicines can help pharmacists and other health care professionals in educating and formulating appropriate counseling strategies specific to older patients of different ethnicities.

Aged↗

PubMed2002

Interdisciplinary medication education in a church environment.

A medication education program for ambulatory care patients implemented in a church setting was studied. The program at each of 20 churches in Ohio consisted of a one-hour orientation for pharmacists/interns, a 20-minute presentation on medications and health, a question-and-answer session led by a pharmacist and a nurse, a one-on-one session with a pharmacist, and an exit interview with a nurse. Before the program, patients completed a form to assess their current experiences with medications and their interactions with health care professionals in the preceding six months. During an exit interview at the end of the program, patients were asked whether the program has been understandable and beneficial and whether taking medications affected their lifestyle. A follow-up interview was conducted six months later. A total of 187 patients completed both the exit and follow-up interviews. Almost all reported that the church setting was a good place for the program and that the program was beneficial. During the six months after the program, the patients took significantly fewer drugs each day than during the six months before the program and had fewer drug-related problems. Significantly more patients sought drug information after completing the program than before it. High rates of medication misuse were identified, leading to 359 pharmacist recommendations. An interdisciplinary program in a church setting successfully provided medication education.

Adult↗

PubMedDate not supplied

Optimizing pharmacists' effectiveness as medication therapy managers through a segmentation approach.

OBJECTIVE: To determine whether older persons could be segmented into meaningful subgroups that shared similar patterns in terms of self-assessments of medication-related knowledge, beliefs, and perceived abilities. DESIGN: Secondary analysis of data previously collected from a cross-sectional, descriptive study. SETTING: United States. PARTICIPANTS: A total of 500 community-dwelling older persons, 65 years and older, using at least one prescription medication. INTERVENTION: Mail survey. MAIN OUTCOME MEASURES: Older persons' self-assessments of medication-related knowledge, beliefs, and perceived abilities, as well as perceptions of pharmacist-patient relationships. RESULTS: The data set contained usable responses from 330 respondents out of 496 surveys presumably delivered (66.5%). Cluster analysis revealed three groups of older persons who showed differences in terms of medication-related beliefs and perceived abilities. Older persons in group 1 reported worse health, used the most prescription medications, sought the most advice from pharmacists, and had the lowest perceived abilities. Older persons in group 2 reported good health, took the fewest medications, sought pharmacists' advice least frequently, and had the lowest beliefs and high perceived abilities. Older persons in group 3 reported the best health, had the highest beliefs, high perceived abilities, and the highest perceptions of pharmacist participative behavior, patient-centeredness, relationship quality, and commitment. CONCLUSION: Pharmacists can use a segmentation approach to target those older persons who are most in need of medication therapy management.

Aged↗

PubMedDate not supplied

Osteoporosis health beliefs and self-care behaviors: an exploratory investigation.

OBJECTIVES: (1) To determine whether women could be segmented into meaningful subgroups with similar profiles of osteoporosis health beliefs; (2) to explore associations among osteoporosis belief profiles and calcium/vitamin D and soy supplement use. The associations between group membership and three other self-care behaviors (cigarette smoking, weight-bearing exercise, and limiting alcohol intake) that may influence bone health also were explored. DESIGN: Cross-sectional study. SETTING: Minnesota. PARTICIPANTS: 990 community-dwelling women aged 45 and older living in Minnesota. INTERVENTIONS: Mailed survey. MAIN OUTCOME MEASURES: Measures of osteoporosis health beliefs and proportions of respondents using calcium/vitamin D supplements, soy-containing products, smoking cigarettes, exercising fewer than three times weekly, and drinking alcohol more than three times weekly. RESULTS: Cluster analysis revealed three distinct subgroups of respondents. Members of the first believed they were susceptible to osteoporosis and perceived many benefits and few barriers to using calcium or soy supplements. Women comprising the second group believed they were susceptible to osteoporosis and that its consequences were serious, but also perceived significant barriers and few benefits associated with calcium or soy supplements. Members of the third group perceived a lack of susceptibility to osteoporosis, strong general health beliefs, and had few opinions regarding calcium or soy supplement use. Members of group 1 were most likely to use calcium/vitamin D supplements. Women comprising groups 1 and 3 were more likely than those in group 2 to use soy supplements. CONCLUSION: Women can be segmented into groups based upon osteoporosis belief profiles. These profiles are associated significantly with calcium and soy supplement use, as well as other self-care behaviors that may have an effect on bone health. Pharmacists could use this information to tailor interventions in this population.

Aged↗