Joseph B. Wiederholt

The association of prescription status, patient age, patient gender, and patient question asking behavior with the content of pharmacist-patient communication

AbstractPurpose and Methods. Data from 358 pharmacist−patient encounters in 12 community pharmacies were used to investigate the association of prescription status, patient age, patient gender, and patient question asking with the content of pharmacist−patient communication. Results. There was an association between prescription status and the provision of five types of information, patient age and gender were associated with the provision of the same two types of information, and patient question asking was associated with the provision of eight types of information. Conclusions. An important cue for improvement of pharmacist−patient communication was patient question asking. Thus, it is imperative to find ways to increase question asking by patients and understand why some patients are reluctant to ask their pharmacist questions.

Measuring Patients’ Medical Care Preferences: Care Seeking versus Self-Treating

The objectives of this study were (1) to develop a scale to measure patient preferences for using medical care, (2) to assess the reliability and validity of the scale, and (3) to examine factors predicting preferences. Preferences were defined along a continuum, anchored by self-treating preferences and care-seeking preferences. A nine-item scale was developed and mailed to a random sample of 3500 Wisconsin consumers age 50 and older. Ordinary least squares regression was used to examine whether preferences were predicted by demographic and health status variables. A 56.9% usable response rate was obtained. The Medical Care Preference Scale was unidimensional and had a Cronbach’s alpha of 0.879. Younger individuals, women, individuals in better health, and individuals from rural areas had significantly stronger self-treating preferences. Significant correlations between the preference scale and two measures of health care utilization provided evidence of predictive validity. Individuals with care-seeking preferences used an average of 1.98 more prescription drugs and had 0.50 more physician visits in the past month than individuals with self-treating preferences. The Medical Care Preference Scale should be a useful tool for research on health care utilization.

Concordance in cancer medication management

This article explores how the concept of concordance can help to identify gaps and opportunities for research on consumer-provider communication related to cancer medication management. The relationship of concordance, patient-centered care and shared decision making is examined. Research on unmet patient agendas, quality of life issues related to symptom management and tools to assist communication about patient somatic experience are discussed. The need for research on patient communication with pharmacists, nurses and other health team members beyond physicians is noted. Research implications for longitudinal, descriptive and intervention studies are offered.

Cooperation in Pharmacy-Drug Wholesaler Relations

AbstractObjective. The objective of this study was to investigate the associations between characteristics of pharmacy—wholesaler relations and cooperation in those relations. Design/Sample. Data were obtained from 326 pharmacies about 214 pharmacy-primary wholesaler relations and 112 pharmacy-secondary wholesaler relations. Measures. Separate multiple regressions were performed to test the hypotheses for both types of pharmacy—wholesaler relationship. For each regression, cooperation was the dependent variable, while the independent variables were customer service level, trust, pharmacy influence, wholesaler influence, and duration of relations. Results. For primary wholesalers (adjusted R-square = 0.59), three variables had significant associations with cooperation: trust, pharmacy influence, and customer service level. Conversely, the model for secondary wholesalers (adjusted R-square 0.60) showed that only trust and pharmacy influence were significantly related to cooperation. Conclusions. Trust and perceived pharmacy influence are important to all wholesalers in fostering and maintaining cooperation from their customers. In addition, level of customer service is an important variable for primary wholesalers working to develop cooperation with their customers.

The Effectiveness of Auxiliary Prescription Labels: A Pilot Study

Affixed auxiliary prescription labels are widely used in the practice of pharmacy because they supposedly provide the patient with pertinent information that is not contained within the prescription signature. Yet, whether the labels are effective is not known, nor is it known whether the labels elements, such as color, form, and logo, affect perception of the written text. Sound scientific analyses of these questions are limited. Therefore, a pilot study involving a series of experiments was designed to determine whether individual perception of pertinent information is affected by the use of affixed auxiliary prescription labels. The second objective of this study was to evaluate how color and logo differences affected perception of the labels written text. Participants were selected for the experiments after being screened for color blindness, corrected vision, and, in some cases, previous pharmacy employment. Subjects viewed labels affixed to prescription vials via a two-channel tachistoscope. The tachistoscopic methodology measured perception, and its accuracy was verified through a forced-choice instrument. Results from the pilot study were threefold: (1) a sound scientific analysis found affixed auxiliary labels to be effective, (2) significant variance could be attributed to both individual and subject differences, and (3) the unique effects of color and logo could not be determined.

Selecting Health Insurance

This study determined how important rescription drug coverage was to consumers in selecting their healt 1 insurance plans, the specific pharmacy factors they considered, and the importance of factors considered. A mail survey questionnaire was sent to 800 state eovernment and universitv emulovees residine in the Madison, Wisconsin area; 453 questionaires wire returned. The majority (59.0 percent) of respondents aware of health insurance prescription coverage placed at least moderate importance on that coverage when selecting their health insurance plan. The specific factors considered most often were cost, location, convenience, and flexibility to choose or change pharmacies. The importance ratings for cost, location, flexibility, and the pharmacist varied among respondents enrolled in different health insurance plans.