scholarly journals Predisposing, Enabling, and Need Factors Associated with the Choice of Pharmacy Type in the US: Findings from the 2015/2016 National Consumer Survey on the Medication Experience and Pharmacists’ Roles

Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 72
Author(s):  
Mohamed Rashrash ◽  
Suhila Sawesi ◽  
Jon C. Schommer ◽  
Lawrence M. Brown
Keyword(s):  
Side Effects ◽  
Service Use ◽  
Patient Characteristics ◽  
Behavioral Model ◽  
Future Research ◽  
Related Factors ◽  
Factors Associated ◽  
Highly Educated ◽  
Medication Therapy ◽  
Medication Experience

Background: Knowing the type of pharmacy used by the patient is meaningful to the pharmacist. Previous studies have assessed different factors predicting the kind of pharmacy selection and reached inconsistent findings. Objectives: To identify patient and health-related factors associated with pharmacy type selection. Methods: The Andersen Behavioral Model of Health Service Use was used to organize the selection of patient characteristics and categorize them as predisposing, enabling, and need factors. The dependent variable was the type of pharmacy used. Logistic regression was used to predict the association between patient-related characteristics and the type of pharmacy used. Results: Older age respondents were less likely to use independent pharmacies (OR = 0.992) and more likely to use mail pharmacy services (OR = 1.026). Highly educated people showed higher use of chain and mail pharmacies (OR = 1.272, 1.185, respectively) and less tendency to use the independent, supermarket, and prescription-only pharmacy types. Men were less likely to use chain pharmacies (OR = 0.932) and more likely to use supermarket pharmacies than women. Patients who use Medication Therapy Management (MTM) services had higher odds of using independent and supermarket pharmacies (OR = 2.808, 1.689, respectively). Patients with a higher number of chronic diseases and experienced side effects of medications were more likely to use independent pharmacies (OR for number of disease = 1.097 and for side effects = 1.095). Conclusions: This study’s findings identify characteristics associated with selecting certain pharmacy settings and direct future research to include other predictors encompassing beliefs, attitudes, and other social factors.

Determinants of Ambulatory Physician Utilization among Adults with Chronic Diseases in Quebec

1998 ◽  
Vol 3 (2) ◽  
pp. 82-91
Author(s):  
Enis Bads ◽  
François Champagne ◽  
Michéle Rivard
Keyword(s):  
Service Use ◽  
Medical Condition ◽  
Explanatory Power ◽  
Patient Characteristics ◽  
Behavioral Model ◽  
Future Research ◽  
Chronic Medical Conditions ◽  
Physician Characteristics ◽  
Physician Utilization ◽  
Main Determinants

Objectives: To test the explanatory power of a model of ambulatory service use and to determine the relative roles of the main determinants of physician utilization for two chronic medical conditions in adults in Quebec. Methods: A behavioral model based on Andersen's model was developed and tested by linking two databases: the Quebec health survey as regards patient characteristics, and the Quebec health insurance board data on physician characteristics and service use. Path analysis was used for data analysis. Results: The model explained a little less than 20% of the variation in service use. The number of hospitalizations, physician's specialty and perceived health were the most important predictors of the volume of visits. Conclusion: Further specification of utilization, relating it to a particular medical condition, does not necessarily lead to an increase in the explanatory power of the model. We recommend that future research should put more emphasis on provider-related determinants rather than focusing on the type and purpose of utilization.

scholarly journals Antipsychotic initiation among adults with intellectual and developmental disabilities in Ontario: a population-based cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028125 ◽  
Author(s):  
Tara Gomes ◽  
Wayne Khuu ◽  
Mina Tadrous ◽  
Simone Vigod ◽  
Virginie Cobigo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Developmental Disabilities ◽  
Psychiatric Diagnosis ◽  
Service Use ◽  
Patient Characteristics ◽  
Population Based ◽  
Future Research ◽  
Intellectual And Developmental Disabilities ◽  
Antipsychotic Therapy ◽  
Factors Associated

ObjectivesTo describe factors associated with initiating antipsychotics and patterns of persistence to antipsychotic therapy in a large cohort of adults with intellectual and developmental disabilities.DesignPopulation-based cohort study.SettingOntario, Canada.ParticipantsAdults with intellectual and developmental disabilities (IDD) in Ontario.Outcome measuresWe used multivariable logistic regression to investigate patient characteristics associated with antipsychotic initiation. Patient characteristics studied included sociodemographic characteristics, measures of clinical comorbidity and health service use.ResultsAmong 39 244 individuals eligible for this study, 6924 (17.6%) initiated an antipsychotic over the accrual window, of whom 1863 (26.9%) had no psychiatric diagnosis in the prior 2 years. A number of factors were significantly associated with antipsychotic initiation, including male gender, residence in a group home, prior use of benzodiazepines, antidepressants or cognitive enhancers, a recent emergency department visit or mental health hospitalisation and a visit to a psychiatrist or family physician in the prior 90 days. In a secondary analysis, the association between antipsychotic initiation and age, prior diagnosis of diabetes or myocardial infarction and polypharmacy differed slightly on the basis of whether an individual had a previously diagnosed psychiatric disorder.ConclusionsFactors associated with the initiation of an antipsychotic differ according to the presence of a psychiatric diagnosis. Given the long duration of antipsychotic use in this population, future research is needed to understand the appropriateness of antipsychotic initiation among adults with IDD and the safety implications of long-term use of these products.

scholarly journals Schizotypy in Parkinson’s disease predicts dopamine-associated psychosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Carina R. Oehrn ◽  
Jana Schönenkorb ◽  
Lars Timmermann ◽  
Igor Nenadić ◽  
Immo Weber ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Side Effects ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Related Factors ◽  
Cross Sectional ◽  
Dopaminergic Medication ◽  
Psychosis Proneness

AbstractPsychosis is the most common neuropsychiatric side-effect of dopaminergic therapy in Parkinson’s disease (PD). It is still unknown which factors determine individual proneness to psychotic symptoms. Schizotypy is a multifaceted personality trait related to psychosis-proneness and dopaminergic neurotransmission in healthy subjects. We investigated whether (1) PD patients exhibit lower schizotypy than controls and (2) dopamine-related neuropsychiatric side-effects can be predicted by higher schizotypy. In this cross-sectional study, we used the Oxford-Liverpool Inventory of Feelings and Experiences in 56 PD patients (12 women, mean ± sd age: 61 ± 11 years) receiving their usual dopaminergic medication and 32 age-matched healthy controls (n = 32; 18 women, mean ± sd age: 57 ± 6 years). We further compared schizotypy scores of patients with (n = 18, 32.1%) and without previously experienced psychosis. We found that patients exhibited lower schizotypy than controls. Further, patients with a history of psychosis exhibited higher schizotypy than patients without these symptoms. Using an information theoretic measure and a machine learning approach, we show that schizotypy yields the greatest predictive value for dopamine-associated hallucinations compared to other patient characteristics and disease related factors. Our results indicate an overlap between neural networks associated with schizotypy and the pathophysiology of PD and a relationship between schizotypy and psychotic side-effects of dopaminergic medication.

scholarly journals Dementia Caregivers’ Experiences Engaging Supportive Services While Residing in Under-Resourced Areas

2021 ◽  
pp. 1-9
Author(s):  
Quinton D. Cotton ◽  
Amy J.H. Kind ◽  
Alice J. Kim ◽  
Laura M. Block ◽  
Jochen René Thyrian ◽  
...  
Keyword(s):  
Service Use ◽  
Social Work Practice ◽  
Future Research ◽  
Service Needs ◽  
Supportive Services ◽  
Care Needs ◽  
Related Factors ◽  
Socially Disadvantaged ◽  
Service Engagement ◽  
Supportive Service

Background: Family caregivers of people living with dementia benefit from supportive service use to address care needs associated with caregiving. Yet, research consistently demonstrates low rates of service use. Existing research has focused on barriers and facilitators to service use, with few studies examining the influence of caregivers’ environmental context which often patterns social advantage and health services accessibility. Objective: To describe the perspectives caregivers residing in socially disadvantaged areas have in regards to utilizing supportive services. Methods: Ten informal caregivers residing in socially disadvantaged areas participated in in-depth interviews that were analyzed using thematic analysis. Results: Across all interviews, caregivers spontaneously described common precedents of service use (crisis or accumulation of unmet needs) and a distinct sequence of stages (seeking, initiating, and utilizing) surrounding service engagement. Major themes characterizing caregivers’ experiences throughout service engagement highlight the varied influence of personal, familial, health, and social system-related factors. Findings demonstrate that caregivers may have different service needs as dementia progresses and that gerontological social work practice can facilitate service use. Conclusion: While preliminary, these findings provide important insights into new domains that can be further examined in future research and intervention efforts to improve supportive service use in socially disadvantaged and underserved communities.

Factors Affecting Vocational Rehabilitation Service Use among Latino Men with HIV/AIDS: A National Perspective

2013 ◽  
Vol 44 (3) ◽  
pp. 42-50 ◽  
Author(s):  
Paul A. Datti ◽  
Liza M. Conyers ◽  
K. B. Boomer
Keyword(s):  
Vocational Rehabilitation ◽  
Service Use ◽  
Binary Logistic Regression ◽  
Behavioral Model ◽  
National Sample ◽  
Rehabilitation Service ◽  
Future Research ◽  
People Living With Hiv ◽  
Latino Men ◽  
Hiv Aids

Latino men are an ethnically and racially diverse group who are disproportionately affected by HIV/AIDS and unemployment. State vocational rehabilitation (VR) services represent viable service options for many people living with HIV/AIDS; however, little is known about factors that predict use of these services by Latinos. This study examines predictors of VR use among a national sample of Latino men with HIV/AIDS (n = 311) who completed the National Working Positive Coalition - Vocational Development and Employment Needs Survey. Using the Behavioral Model for Vulnerable Populations as framework, key predictor variables were analyzed using binary logistic regression. Receipt of public benefits (p < .001) and knowledge of VR (p < .001) increased odds of VR use. As confidence in ability to maintain a job (p < .05) and general health perception (p < .05) increased, so did odds of VR use. Study limitations, practical implications, and future research recommendations are included.

scholarly journals Toxicity-Related Factors Associated With Use of Services Among Community Oncology Patients

2016 ◽  
Vol 12 (8) ◽  
pp. e818-e827 ◽  
Author(s):  
Jordan M. Harrison ◽  
Philip J. Stella ◽  
Beth LaVasseur ◽  
Paul T. Adams ◽  
Lauren Swafford ◽  
...  
Keyword(s):  
Emergency Department ◽  
Service Use ◽  
Health Care Service ◽  
Emergency Department Visits ◽  
Survey Study ◽  
Related Factors ◽  
Factors Associated ◽  
Community Oncology ◽  
Ambulatory Oncology ◽  
Patient Reported

Purpose: Community oncology practices frequently manage chemotherapy-associated toxicities, which may disrupt treatment, impair quality of life, and induce unplanned service use. We sought to understand the patterns and correlates of unplanned health care service use among patients receiving first-cycle chemotherapy at five community-based ambulatory oncology practices. Patients and Methods: A survey study examined the dichotomous outcome of unplanned service use, defined as oncologist visits, emergency department visits, and hospitalizations, resulting from toxicity-related factors. Newly diagnosed patients with breast, lung, head and neck, or colorectal cancer or non-Hodgkin lymphoma were recruited during the first chemotherapy cycle. Before beginning the second cycle of chemotherapy, patients completed a questionnaire that measured unplanned service use and overall distress, plus severity of nausea, vomiting, diarrhea, constipation, mouth sores, intravenous catheter problems, pain, fever and chills, extremity edema, and dyspnea on a 5-point scale (1, did not experience; 5, disabling). Medical record reviews captured chemotherapy doses, comorbid conditions, and supportive care interventions. Mixed-effects logistic regression was used to identify factors associated with unplanned service use, with random effects specified for each clinic. Results: Among 106 patients (white, 98%; female, 74.5%; mean age ± standard deviation, 60 ± 11 years), frequently reported toxicities were pain, nausea, diarrhea, and constipation. Thirty-six patients (34%) reported unplanned service use: 29% reported oncologist visits, 14% reported emergency department visits, and 8% reported hospitalizations. Factors significantly associated with unplanned service use were high patient-reported distress and receipt of colony-stimulating factor. Conclusion: Service use resulting from toxicity-related factors occurs frequently in community oncology settings. Monitoring toxicity patterns and outcomes can inform proactive symptom management approaches to reduce toxicity burden between scheduled visits.

Cultural Identity and Conceptualization of Depression among Native Hawaiian Women

2010 ◽  
Vol 8 (2) ◽  
pp. 63-85 ◽  
Author(s):  
Van Ta ◽  
Puihan Chao ◽  
Joseph Kaholokula
Keyword(s):  
Cultural Identity ◽  
Native Hawaiian ◽  
Native People ◽  
Future Research ◽  
Depression Symptoms ◽  
Related Factors ◽  
Social Stressors ◽  
Factors Associated ◽  
Hawaiian Women ◽  
High Degree

This study seeks to understand how Native Hawaiian (NH) women identified themselves culturally and conceptualized the causes of depression, and whether there was an association between these two constructs. Among the thirty NH women who were interviewed, a quarter had a high degree of depression symptoms, and a majority expressed a strong/shared identification/affinity with their culture. Our findings suggest that social stressors that contribute to the depressive symptoms of NH women could be, in part, linked to acculturation-related factors associated with U.S. occupation of Hawai‘i and their social status as native people. Future research should examine this relationship further.

Determinants of the Use of Four Categories of Complementary and Alternative Medicine

2006 ◽  
Vol 11 (1) ◽  
pp. 3-26 ◽  
Author(s):  
Darren Hendrickson ◽  
Brett Zollinger ◽  
Roseanna McCleary
Keyword(s):  
Service Use ◽  
Behavioral Model ◽  
Health Determinants ◽  
Future Research ◽  
Medical Systems ◽  
Health Services Use ◽  
The Social ◽  
Interview Survey ◽  
Cam Use ◽  
Complementary And Alternative

The purpose of this research is to assess the social and health determinants of the use of four separate and distinct categories of complementary and alternative medical therapies: biologically based, mind-body, manipulative, and whole CAM medical systems. The behavioral model of health services use, which holds that health service use is a function of predisposing, enabling, and need characteristics, is used as the theoretical framework for linking specific determinants with the four categories of CAM use. Data are taken from a statewide interview survey of Kansas adults ( N = 2,166) conducted in 2001. Results from multivariate analyses demonstrate that there is variation in the determinants of the use of different categories of CAM therapies. Overall, the results indicate that future research on the determinants of CAM must delineate between various CAM therapies to gain an accurate portrayal of the factors contributing to CAM use.

scholarly journals A Qualitative Approach to Understanding the Holistic Experience of Psychotherapy Among Clients

2021 ◽  
Vol 12 ◽  
Author(s):  
Lee Seng Esmond Seow ◽  
Rajeswari Sambasivam ◽  
Sherilyn Chang ◽  
Mythily Subramaniam ◽  
Huixian Sharon Lu ◽  
...  
Keyword(s):  
Service Use ◽  
Behavioral Model ◽  
Qualitative Approach ◽  
Pharmacological Intervention ◽  
Service Research ◽  
Mental Health Stigma ◽  
Service Encounters ◽  
Outpatient Psychotherapy ◽  
Related Factors ◽  
Holistic Understanding

Background: The study of the experience of clients across multiple service encounters (or touchpoints) is important from the perspective of service research. Despite the availability of effective psychotherapies, there exists a significant gap in the optimal delivery of such interventions in the community. Therefore, the aim of this study was to explore the experience of psychotherapy among clients integrating the before–during–after service encounters using a qualitative approach.Methods: A total of 15 clients of outpatient psychotherapy were interviewed, and data saturation was reached. The topics included pathways and reasons to seeking psychotherapy, aspects of the therapy process that have been helpful or unhelpful, and perceived change after receiving psychotherapy. Information was analyzed using the inductive thematic analysis method. Emergent themes pertaining to pre-psychotherapy encounters were mapped onto major components that were identified in Andersen's Health Service Utilization Model.Results: Mental health stigma and the lack of understanding about psychotherapy were the predisposing factors that impeded service use while the preference for non-pharmacological intervention promoted its use. Enabling factors such as affordability and service availability were also of concern, along with perceived and evaluated needs. The attributes of therapists, application of techniques, and the resistance of the client were found to impact the therapeutic alliance. While the majority of the clients experienced positive change or had engaged in self-help strategies after receiving psychotherapy, some cited limited impact on the recovery of symptoms or problematic self-coping without the therapists.Conclusion: This study proposes to expand on Andersen's Behavioral Model by including therapy-related factors so as to provide a more holistic understanding of the use of psychotherapy among the clients. More importantly, the study identified several barriers to access and negative experiences or outcomes, which should be addressed to promote uptake of the psychotherapy intervention.

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