Aspects Of Medication Use Research Articles

Information support of the pharmacist's communication in the process of pharmaceutical assistance of the population

Because of the systematization of the pharmacist's communication features in the process of drug assistance to the population, we proposed a schematic model of this process. The survey, which involved 320 pharmacists, revealed that 94.68% of them possess verbal communication skills and active engage in counseling patients during medication dispensing, including from the Rx list. Pharmacists have access to essential information sources about medicines and possess and possess the necessary knowledge and skills to identify and evaluate patients' health problems, particularly when it comes to selfmedication treatments and can be involved in monitoring these processes. The lack of operational information tools from the information systems in operation, (directly in the medication assistance process) regarding the aspects of medication use, taking into account the clinical manifestations of the disease and the total lack of the possibility to access objective information about the patient's characteristics, regarding his health needs, was highlighted. These tools can be developed within the existing information systems as well as by integrating the pharmaceutical information systems into the medical assistance system of the population in outpatient conditions, through the electronic prescription module under development and implementation. The study also identified various mitigating factors and professional duties that influence the pharmacist's communication process with patients, as well as some professional activities that the pharmacist performs as work duties: perfecting documents, records, management, monitoring drug stocks, patient flow etc.

The Carer Assessment of medicaTion management guidanCe for people living with dementia at Hospital discharge (CATCH): Preliminary analysis for a national cross-sectional survey.

Medication therapy management for people living with dementia is a major contributing factor to adverse events after discharge from hospital. Carers play an important role in overseeing medication management for the person with dementia. We aimed to evaluate medication management guidance provided to carers of people with dementia at hospital discharge. This was a cross-sectional survey disseminated across Australia. Data was captured using the Carer Assessment of medicaTion management guidanCe for people with dementia at Hospital discharge (CATCH) tool. The CATCH tool included 30 items and was developed using a multi-method approach involving content validation and pretesting with carers of people with dementia. The tool utilized a 5-point Likert scale, and multiple-choice responses. We included carers responsible for managing the medications of the person with dementia, and the person with dementia has had at least one discharge from the hospital. Electronic and hardcopy distribution of the survey occurred Australia wide through advertisement. Data collection started on April 24th , 2022, and is currently ongoing. Quantitative data was descriptively analyzed. To date, 30 participants completed the survey with a median age 66 (IQR 16.5) and 28 were female. Most participants (n = 21) were provided guidance on the day of discharge by the doctor (n = 12) or nurse (n = 7) in written form. Most (n = 18) found that discharge summary and medication list was easy to understand. The most common medication information provided related to administration instructions (n = 13), medication purpose (n = 11) and possible benefits of medications (n = 8). However, some participants reported that they were not given information about possible side effects (n = 8), medications that might increase confusion (n = 7) and how long the medication should be used for (n = 12). Some (n = 12) reported that they were not asked if the person with dementia had any problems taking their medications.. Most (n = 20) stated that medication management guidance could be improved. Our preliminary findings suggest that there are opportunities to improve guidance in medication therapy management provided to carers at discharge. Targets for interventions around comprehensive guidance on all aspects of medication use tailored specifically for the people with dementia are needed.

Behaviors Related to Medication Safety and Use During Pregnancy.

Background: Most women take medication during pregnancy despite limited scientific evidence on safety. We investigated medication use, including changes in and reasons for changes in use during pregnancy, with attention to medication use in pregnant women with chronic conditions. Materials and Methods: We conducted an online survey of pregnant women aged ≥18 years (n = 1,226). We calculated descriptive statistics for aspects of medication use and performed multivariable logistic regression to examine associations between change in use and chronic conditions. Results: Seventy-nine percent of women took at least one medication during pregnancy. Among those, 63.2% made at least one medication change: 42.0% started, 34.9% stopped, 30.0% missed dose(s), and 18.1% lowered dose(s) from that originally prescribed or recommended. More than a third (36.5%) of women who stopped, lowered, or missed medication did so independent of health care provider advice; 54.0% cited concern about birth or developmental defects as reasons for change. Odds of medication change were higher for women with chronic conditions: digestive conditions-starting (adjusted odds ratio [AOR] = 1.8, 95% confidence interval [CI] = 1.1-2.7), stopping (AOR = 2.1, 95% CI = 1.4-3.3), and lowering (AOR = 2.4, 95% CI = 1.7-3.3) medication; mental health conditions-starting (AOR = 1.6, 95% CI = 1.2-2.2), stopping (AOR = 3.0, 95% CI = 2.3-4.0), or missing (AOR = 2.1, 95% CI = 1.6-2.8) medication; pain conditions-stopping (AOR = 2.9, 95% CI = 2.0-4.2); and respiratory conditions-starting (AOR = 2.0, 95% CI = 1.3-3.1), stopping (AOR = 1.7, 95% CI = 1.1-2.6), and missing (AOR = 2.2, 95% CI = 1.4-3.4) medication. Conclusions: Most pregnant women take medication and many, including those with chronic conditions, change their medication use during pregnancy. Medication change may occur independent of health care provider advice and due to women's safety concerns.

Dependence on hypnotics: a comparative study between chronic users of benzodiazepines and Z-drugs.

Objective:To evaluate dependence among chronic benzodiazepine and Z-drug users in Brazil.Methods:Chronic users of benzodiazepines (n=94), Z-drugs (n=74), or both (n=11) were recruited from the community, underwent a psychiatric evaluation and completed self-report instruments on hypnotic dependence, insomnia, anxiety, and depression. Users of benzodiazepines and Z-drugs were compared using t-tests, and logistic regression models were employed to explore significant predictors of a dependence diagnosis.Results:There was no difference in the prevalence of dependence among benzodiazepine (77.2%) and Z-drug (69.4%) users. Benzodiazepine users reported increased psychosocial aspects of dependence, anxiety, and depression. Preoccupation with the availability of medication (prevalence ratio [PR] = 2.39 [1.15-5.20]) and insomnia (PR = 1.10 [1.02-1.19]) were associated with a diagnosis of dependence (n=175).Conclusion:The prevalence of dependence was similar among both drug classes. The increased self-reported dependence, anxiety, and depression among benzodiazepine users may be due to behavioral rather than pharmacological aspects of medication use. Behaviors related to hypnotic use were important predictors of dependence.

Interprofessional learning to enhance Spanish communication skills in Latinx pharmacy students

This case study focuses on an interdisciplinary educational experience in which university Pharmacy and Humanities early and late Spanish-English bilinguals were paired to translate questions related to sociobehavioral aspects of medication use. This work describes the personal and professional benefits reported by the translators and the prevailing themes from verbal negotiations. The participants were an undergraduate in Spanish, seven pharmacy professional doctorate students, and five Hispanic studies graduate students. After completing individual translations, students were paired and met virtually to create a final, collaborative version of their translation. Participants were subsequently invited to answer open-ended questions about their experience. Translators’ transcribed interactions and questionnaire responses became the basis for this article. Results show that the main reported perceived benefit was the participants’ improved language skills. The findings also suggest that length, quality, and richness of interactions depended on whether the members of the pairings exhibited mutual respect, curiosity, and empathy.

ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration-2020.

DisclaimerIn an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.PurposeResults of the 2020 ASHP national survey of pharmacy practice in hospital settings are presented.MethodsPharmacy directors at 1,437 general and children’s medical/surgical hospitals in the United States were surveyed using a mixed-mode method of contact by email and mail. Survey completion was online. IQVIA supplied data on hospital characteristics; the survey sample was drawn from the IMS hospital database.ResultsThe response rate was 18.7%. Almost all hospitals (92.5%) have a method for pharmacists to review medication orders on demand. Most hospitals (74.5%) use automated dispensing cabinets (ADCs) as their primary method for drug distribution. A third of hospitals use barcodes to verify doses during dispensing in the pharmacy and to verify ingredients when intravenous medications are compounded. More than 80% scan barcodes when restocking ADCs. Sterile workflow management technology is used in 21.3% of hospitals. Almost three-quarters of hospitals outsource some sterile preparations. Pharmacists can independently prescribe in 21.1% of hospitals. Pharmacist practice in ambulatory clinics in 46.2% of health systems and provide telepharmacy services in 28.4% of health systems.ConclusionPharmacists continue their responsibility in their traditional role in preparation and dispensing of medications. They have successfully employed technology to improve safety and efficiency in performance of these duties and have employed emerging technologies to improve the safety, timeliness, and efficiency of the administration of drugs to patients. As pharmacists continue to expand their role to all aspects of medication use, new opportunities highlighted in ASHP’s Practice Advancement Initiative 2030 have been identified.

ASHP Statement on the Use of Artificial Intelligence in Pharmacy

Pharmacists are responsible for determining which aspects of medication use and management are best handled by pharmacists, by artificial intelligence (AI), or by pharmacists who receive advice from AI-based systems. Pharmacists should use scientific approaches to determine the degree to which AI is used to automate specific medication-use tasks. Full automation using AI should be reserved for algorithmic tasks for which it is demonstrated that AI performs as well or better than pharmacists. AI of proven value should be adopted and used so that pharmacists can make better decisions and focus their expertise on solving new and confounding problems for patients, families, and organizations.

Suboptimal medication-related quality of care preceding hospitalisation of older patients.

To examine the prevalence of suboptimal medication-related processes of care before the hospitalisation of older patients. We conducted a retrospective cohort study using a clinical indicator set related to medication management that has been validated by an expert panel as consisting of suboptimal aspects of medication use that clinicians should be able to foresee and avoid. Australian Government Department of Veterans' Affairs administrative claims data between 1 July 2007 and 30 June 2012 were analysed according to these clinical indicators to assess medication-related processes of care preceding hospitalisation. Veterans with one or more hospitalisations in Australia for a condition defined by the clinical indicator set. Prevalence of suboptimal medication-related processes of care before hospitalisation as a proportion of all hospitalisations defined by diagnoses in the clinical indicator set. During the 5-year study period, there were 164,813 hospitalisations with primary diagnoses for conditions included in the clinical indicator set, encompassing 83,430 patients. The overall proportion of hospitalisations that were preceded by suboptimal medication-related processes of care was 25.2% (41,546 hospitalisations); 34.5% of patients (28,807 patients) had at least one hospitalisation and 10.4% (8640 patients) had two or more hospitalisations preceded by suboptimal medication-related processes of care. At least one in 10 hospitalisations for chronic heart failure, ischaemic stroke, asthma, gastrointestinal ulcer or bleeding, fracture, renal failure or nephropathy, hyperglycaemia or hypoglycaemia were preceded by suboptimal medication-related processes of care. This study highlights conditions for which there are evidence-practice gaps in medication management in the older population. Routine prospective monitoring of these evidence-based, validated, medication-related clinical indicators provides a means for quality improvement in the management of common chronic conditions.

Expert interview: New ENDO guidelines.

Expert interview: New ENDO guidelines.

Otsenka gipotenzivnogo effekta preparata «GLAUMAKS»

When choosing a medication, a physician has to be sure of its efficacy and safety for the patient. Carrying out of multiple post-clinical studies of different aspects of medication use is intended to help clinicians to correctly appreciate the capacities of proposed medications. The objective of this study is to evaluate the pressure-lowering effect of latanoprost 0.005 % - “Glaumax” according to the data of different tonometry methods at different baseline IOP levels and to compare the IOP-lowering effects of timolol 0.5 % and Glaumax. The pressure lowering effect in the Glaumax group significantly exceeds that of the timolol 0.5 % group regardless of IOP measurement method, at comparable baseline IOP level. In the group with higher baseline IOP level, the IOP decrease in % from baseline was higher. Mean IOP-lowering effect for Glaumax in the present study is comparable to the data of multicenter studies and meta-analyses carried out for the original “Xalatan” medication.

KDOQI US Commentary on the 2012 KDIGO Clinical Practice Guideline for Management of Blood Pressure in CKD

In response to the 2012 KDIGO (Kidney Disease: Improving Global Outcomes) guideline for blood pressure management in patients with chronic kidney disease not on dialysis, the National Kidney Foundation organized a group of US experts in hypertension and transplant nephrology to review the recommendations and comment on their relevancy in the context of current US clinical practice and concerns. The overriding message was the dearth of clinical trial evidence to provide strong evidence-based recommendations. For patients with CKD with normal to mildly increased albuminuria, goal blood pressure has been relaxed to ≤140/90 mm Hg for both diabetic and nondiabetic patients. In contrast, KDIGO continues to recommend goal blood pressure ≤130/80 mm Hg for patients with chronic kidney disease with moderately or severely increased albuminuria and for all renal transplant recipients regardless of the presence of proteinuria, without supporting data. The expert panel thought the KDIGO recommendations were generally reasonable but lacking in sufficient evidence support and that additional studies are greatly needed.

Socioeconomic status and differences in medication use among older people according to ATC categories and urban–rural residency

To study how selected indicators of socioeconomic status and urban-rural residency associate with medication use in form of number of daily medications, polypharmacy, and medication use according to Anatomic Therapeutic Classification (ATC) system. Cross-sectional, population-based study among older community-dwelling Icelanders. Criteria for participation were: age ≥65 years, community-dwelling, and able to communicate verbally and to set up a time for a face-to-face interview. Information on medication use was obtained by interviews and by examining each person's medication record. Medications were categorised according to ATC system. A questionnaire and the physical and mental health summary scales of SF-36 Health Survey were used to assess potential influential factors associated with medication use. On average, participants (n=186) used 3.9 medications, and the prevalence of polypharmacy was 41%. No indicators of socioeconomic status had significant association to any aspects of medication use. Compared to urban residents, rural residents had more diagnosed diseases, were less likely to live alone, were less likely to report having adequate income, and had fewer years of education. Controlling for these differences, urban people were more likely to use medication from the B and C categories. Moreover, older urban men, with worse physical health, and greater number of diagnosed diseases used more medications from the B category. There are unexplained regional differences in medications use, from categories B and C, by older Icelanders. Further studies are needed on why urban residents used equal number of medications, or even more medications, compared to rural residents, despite better socioeconomic status and fewer diagnosed diseases.

The Relationship between Caregivers’ Post-traumatic Stress Disorder and Their Asthma Health Beliefs in an Ethnic Minority Inner-City Sample

Objective. Caregivers’ asthma health beliefs can impact healthcare decisions. This study aimed to determine whether caregivers with a diagnosis of post-traumatic stress disorder (PTSD) had asthma illness representations less aligned with the professional model of asthma management and whether their children had worse asthma control. Methods. Participants were 120 children with asthma (age M = 9.25 ± 1.37) and their caregivers recruited from the Bronx, NY, USA. Participants were Puerto Rican (n = 55), African-American (n = 30), Afro-Caribbean (n = 22), and Mexican (n = 13). Caregivers completed: a psychiatric interview to determine diagnosis of PTSD, anxiety and depressive disorders; the Asthma Illness Representation Scale (AIRS) to assess beliefs about their children’s asthma; and the childhood asthma control test (C-ACT). Results. One in five caregivers had PTSD, and these caregivers had lower total AIRS scores, lower scores on the AIRS Emotional Aspects of Medication Use subscale, and the AIRS Nature of Symptoms subscale, indicating illness beliefs less aligned with the professional model. Caregivers with PTSD were more likely to perceive asthma as an acute, difficult to control illness and focused on the emotional aspects of medication use. There was no relationship between PTSD in caregivers and self-report of their children’s asthma control, but children with poorly controlled asthma had caregivers with lower total AIRS scores. Conclusion. Caregivers’ traumatic experiences impact their beliefs about their children’s asthma. Future interventions targeting these beliefs could improve the manner in which they understand and treat their children’s asthma.

The impact of patient knowledge of patient-centered medication label content on quality of life among older adults

BackgroundPrescription drugs have made great contributions to health and quality of life (QOL). However, inappropriate use of drugs may result in just the opposite effect. Older adults often take multiple medications simultaneously and thus are more vulnerable to inappropriate drug use. Knowledge of important aspects of medication use might reduce the risk of inappropriate utilization and improve QOL. ObjectiveTo determine the extent of patient knowledge concerning patient-centered contents of medication labels (PCCMLs) and whether level of patient knowledge is associated with health outcomes. MethodsA survey was administered to members of 6 senior centers in Memphis, TN, USA. Surveys from older adults (65 or older) who were taking at least 1 medication were included in the current analyses (N=287). QOL was measured using the Euroqual EQ-5D and the Visual Analog Scale (EQ-VAS). Older adults reported their knowledge of PCCML on a set of 4 Likert-type scale items concerning the PCCMLs. Statistical analyses included descriptive statistics, analysis of variance, correlation analysis, and linear regression. ResultsStudy participants scored on average 16.20 (standard deviation [SD]=3.41) for knowledge of PCCML. Patient knowledge of PCCML was associated with age (rs=−0.1469, P=.0127), race/ethnicity (F=4.40, P=.0131), education (rs=0.1984, P=.0007), and household income (rs=0.1539, P=.0159). Study participants had an average EQ-5D score of 0.82 (SD=0.16) and EQ-VAS score of 77.80 (SD=15.07). Multivariate linear regression results showed that 1 unit increase in patient knowledge resulted in 0.62 unit increase (P=.017) in EQ-VAS QOL scores after adjusting for the impact of other variables. However, patient knowledge of PCCML did not significantly predict EQ-5D QOL scores (β^=0.002, P=.4633) when all other variables were controlled. ConclusionPatient knowledge of medication use was associated with QOL among older adults. New standardized labels should be designed to improve patient knowledge of PCCML information. Furthermore, providers of medication therapy management should ensure that older adults have a complete knowledge of the PCCML information.

Development and Evaluation of the Adherence to Refills and Medications Scale (ARMS) among Low-Literacy Patients with Chronic Disease

Objectives Patient literacy affects many aspects of medication use and may influence the measurement of adherence. The aim of the study is to design and evaluate a medication adherence scale suitable for use across levels of patient literacy. Methods The Adherence to Refills and Medications scale (ARMS) was developed, pilot tested, and administered to 435 patients with coronary heart disease in an inner-city primary care clinic. Psychometric evaluation performed overall and by literacy level, included an assessment of internal consistency, test–retest reliability, and factor analysis. Criterion-related validity was evaluated by comparing scores with Morisky's self-reported measure of adherence, medication refill adherence, and blood pressure measurements. Lexile analysis was performed to assess the reading difficulty of the instrument. Results The final 12-item scale had high internal consistency overall (Cronbach's α = 0.814) and among patients with inadequate (α = 0.792) or marginal/adequate literacy skills (α = 0.828). Factor analysis yielded two subscales, which pertained to taking medications as prescribed and refilling medications on schedule. The ARMS correlated significantly with the Morisky adherence scale (Spearman's rho = −0.651, P < 0.01), and it correlated more strongly with measures of refill adherence than did the Morisky scale. Patients with low ARMS scores (which indicated better adherence) were significantly more likely to have controlled diastolic blood pressure ( P < 0.05), and tended to have better systolic blood pressure control. Lexile analysis demonstrated that the instrument had a favorable reading difficulty level below the eight grade. Conclusion The ARMS is a valid and reliable medication adherence scale when used in a chronic disease population, with good performance characteristics even among low-literacy patients.

Medication use and patient satisfaction: a population-based survey

In recent years, there is a growing interest to assess patients' satisfaction which further triggers the existing debate on the severe methodological issues regarding the interpretation of comparative surveys results. This cross-sectional national survey aimed to examine satisfaction of Greek households with specific aspects of medication use and their correlates. Between November 2004 and February 2005, telephone interviews were used for collecting information about socio-demographic and health-related characteristics in a systematic sample of 1000 Greek households. Respondents were classified into three categories: chronic or short-term prescribed medication use, occasional medication use and no medication use during the 3 months preceding the survey. Satisfaction was assessed through various aspects of medication use like physician's consultation, physician's response to adverse events, consultation and advice by pharmacists, symptoms' resolution, route of drug administration, drug tolerability and drug cost. The prescribed drugs' use in the 3 months preceding the survey interview was 36.9%; 28.6% for subjects under chronic treatment and 8.3% under short-term treatment. During the same time period, 52.8% of the respondents reported the occasional self-use of over the counter drugs for minor symptoms. A high prevalence of hypertension, cardiovascular, musculoskeletal and endocrine disorders has been observed. In general, respondents expressed a high degree of satisfaction with all aspects of medication use examined, the only exception being costs. Age, area of residence, social insurance scheme and self-reported health status were associated with specific aspects of patient satisfaction. Patient satisfaction with the aspects of medication use examined seems to be influenced by demographic and social factors; this points out to the necessity of taking into account socio-cultural variations and the structure of the health-care system in policymaking.

Patient satisfaction with medication: a challenge for primary health care

Good prescribing is a key issue in modern health-care systems: physicians and patients are concerned about outcomes, albeit from different perspectives, funding agencies are worried about costs and benefits and the pharmaceutical industry is interested in sales and customer satisfaction. Of all these, most research has gone into patient compliance and satisfaction. The theoretical basis of much of this research in recent literature is found in the theory of planned behaviour, an extension of the Theory of Reasoned Action that attempts to explain behaviour regarding medication in terms of beliefs about outcomes and the evaluation of these outcomes. 1,2 Furthermore, satisfaction with medication is related to broader issues, mainly to satisfaction with the services provided by the physician and the physician‐patient relationship, and to considerations about health-care delivery, accessibility and costs. 2 Starting from specific sections of the World Health Organization’s questionnaire on responsiveness of the health-care system, 3 supplemented with questions related to treatment, Geitona et al. 4 studied patient satisfaction with medication in Greece. They report that respondents were in general satisfied with all aspects of medication use examined except for costs. However, wide variations were observed in the levels of satisfaction between subgroups of respondents. The Greek study does not give us any information about the patients’ expectations from their medication or about the opinion of the physicians regarding their patients’ expectations, both of which seem to be strong determinants of prescribing. 5 Also, prescribing

Taking Your Medicine: A Guide to Medication Regimens and Compliance for Patients and Caregivers

Back to table of contents Previous article Next article Book ReviewFull AccessTaking Your Medicine: A Guide to Medication Regimens and Compliance for Patients and CaregiversMichael Angelini M.A., Pharm.D.Michael Angelini M.A., Pharm.D.Search for more papers by this authorPublished Online:1 Aug 2006https://doi.org/10.1176/ps.2006.57.8.1224AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Jack Fincham has created a guidebook that attempts to enhance medication compliance and patient and caregiver knowledge about prescription and over-the-counter medications. In his book, Dr. Fincham tackles such topics as medical abbreviations, methods of enhancing adherence, acceptable ethical behavior of pharmacists and doctors, legal rights regarding health information, useful health care websites for patients, and other practical aspects of medication use. The book is written for the patient or the patient's caregiver but also provides direction to a health care provider as to what are real patient concerns.The book itself can be detailed at times, but the author has added text boxes, Key Points, which highlight the more important points. One of the more valuable chapters discusses barriers to compliance and methods to remove them. Other useful sections discuss professional, appropriate behavior and what to expect from a pharmacist. These areas provide examples of behaviors that will help alert the patient to when a pharmacist may be acting in either unethical or illegal ways. Online pharmacies and other online services are discussed, and Dr. Fincham provides signs of fraud and abuse for the reader so they can address these issues or avoid these pharmacies altogether.Another beneficial chapter reviews herbal products. He cautions about legitimate risks associated with herbal products and also provides examples of harmful and deadly drug interactions between herbal products and prescription medications. At times, however, the author seems to provide information that may be interpreted in a misleading way. He frequently refers to anxiolytics, but his cautions relate only to benzodiazepines and not the multiple other medication classes that are used to treat anxiety disorders. The chapter regarding drug interactions is generally too superficial and runs the risk of causing inappropriate alarm in a patient. He makes a general statement that medications that treat the same condition should not be taken together and further cautions that "pain medications should not be combined together." One section has been mislabeled angiotensin-converting enzyme inhibitors but refers to and lists calcium channel blockers. Also, descriptions of medical conditions and medication characteristics, both kinetic and dynamic, are provided, at times, in terms that are too sophisticated for the lay person. For example, he writes that cisapride and other drugs should not be taken together because "they can lead to cardiac arrhythmias, including torsades de pointes ." He does comment after these sections that consumers should consult with their doctor or pharmacist about these issues. Although the title of the book leads one to think that it is for consumers, the content of the book could also be used as a teaching tool in pharmacy or allied health academic programs. It refers to issues that all pharmacists should be aware of and should be prepared to deal with. By using the book as a required reading in a pharmacy course, the students would be guided to the public's perspective and the information they may be using for decision making.Dr. Fincham has created a text that compiles most of the critical topics related to taking medications. He provides insights into the medical profession that patients may find useful when trying to work with the health care system. The book tries to empower the consumer and help maximize therapeutic outcomes, yet some concerns described in the book may need interpretation by a pharmacist or physician.Mr. Angelini is assistant professor in the Department of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences, Boston. FiguresReferencesCited byDetailsCited ByNone Volume 57Issue 8 August, 2006Pages 1224-1224PSYCHIATRIC SERVICES August 2006 Volume 57 Number 8 Metrics PDF download History Published online 1 August 2006 Published in print 1 August 2006

Taking Your Medicine: A Guide to Medication Regimens and Compliance for Patients and Caregiversby Jack E. Fincham, Ph.D., R.Ph.; Binghamton, New York, Haworth Press, Inc., 2005, 179 pages, $22.95 softcover

Back to table of contents Previous article Next article Book ReviewFull AccessTaking Your Medicine: A Guide to Medication Regimens and Compliance for Patients and CaregiversMichael Angelini M.A., Pharm.D.Michael Angelini M.A., Pharm.D.Search for more papers by this authorPublished Online:1 Aug 2006https://doi.org/10.1176/ps.2006.57.8.1224AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Jack Fincham has created a guidebook that attempts to enhance medication compliance and patient and caregiver knowledge about prescription and over-the-counter medications. In his book, Dr. Fincham tackles such topics as medical abbreviations, methods of enhancing adherence, acceptable ethical behavior of pharmacists and doctors, legal rights regarding health information, useful health care websites for patients, and other practical aspects of medication use. The book is written for the patient or the patient's caregiver but also provides direction to a health care provider as to what are real patient concerns.The book itself can be detailed at times, but the author has added text boxes, Key Points, which highlight the more important points. One of the more valuable chapters discusses barriers to compliance and methods to remove them. Other useful sections discuss professional, appropriate behavior and what to expect from a pharmacist. These areas provide examples of behaviors that will help alert the patient to when a pharmacist may be acting in either unethical or illegal ways. Online pharmacies and other online services are discussed, and Dr. Fincham provides signs of fraud and abuse for the reader so they can address these issues or avoid these pharmacies altogether.Another beneficial chapter reviews herbal products. He cautions about legitimate risks associated with herbal products and also provides examples of harmful and deadly drug interactions between herbal products and prescription medications. At times, however, the author seems to provide information that may be interpreted in a misleading way. He frequently refers to anxiolytics, but his cautions relate only to benzodiazepines and not the multiple other medication classes that are used to treat anxiety disorders. The chapter regarding drug interactions is generally too superficial and runs the risk of causing inappropriate alarm in a patient. He makes a general statement that medications that treat the same condition should not be taken together and further cautions that "pain medications should not be combined together." One section has been mislabeled angiotensin-converting enzyme inhibitors but refers to and lists calcium channel blockers. Also, descriptions of medical conditions and medication characteristics, both kinetic and dynamic, are provided, at times, in terms that are too sophisticated for the lay person. For example, he writes that cisapride and other drugs should not be taken together because "they can lead to cardiac arrhythmias, including torsades de pointes ." He does comment after these sections that consumers should consult with their doctor or pharmacist about these issues. Although the title of the book leads one to think that it is for consumers, the content of the book could also be used as a teaching tool in pharmacy or allied health academic programs. It refers to issues that all pharmacists should be aware of and should be prepared to deal with. By using the book as a required reading in a pharmacy course, the students would be guided to the public's perspective and the information they may be using for decision making.Dr. Fincham has created a text that compiles most of the critical topics related to taking medications. He provides insights into the medical profession that patients may find useful when trying to work with the health care system. The book tries to empower the consumer and help maximize therapeutic outcomes, yet some concerns described in the book may need interpretation by a pharmacist or physician.Mr. Angelini is assistant professor in the Department of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences, Boston. FiguresReferencesCited byDetailsCited ByNone Volume 57Issue 8 August, 2006Pages 1224-1224PSYCHIATRIC SERVICES August 2006 Volume 57 Number 8 Metrics PDF download History Published online 1 August 2006 Published in print 1 August 2006

Advancing the field of health literacy

Advancing the field of health literacy