Social & Administrative Sciences

Social & Administrative Sciences in Pharmacy

CURRENT PROJECTS

Faculty in the Division of Social and Administrative Sciences in Pharmacy are engaged in numerous and diverse research activities. Major faculty-led projects currently in progress are described briefly below.

Collectively, these projects represent the breadth and depth of scholarship within the Division and indicate the diverse topics, theories, and methods that are addressed. While specific projects illustrate the research streams of individual faculty members, together they reflect the highly collaborative nature of SAS research activities. Most projects are carried out by research teams composed of several Division faculty members and graduate students; many also involve colleagues on the Madison campus, in other U.S. universities, and in other countries.

Each project description identifies the specific faculty member(s) who may be contacted for further information about that project.

2004 National Pharmacy Workforce Study
Addressing Underserved Populations
Aristolochia: Chemistry, History, Applications
Commentaries on Dioscorides
Cornelius Celsus and Roman Medicine
A Documentary History of American Pharmacy
Drug Utilization by Medicare Beneficiaries
Evaluation of Drug Information Provided in U.S. Pharmacies
Improving Hypertension Care in Inner City Pharmacies
International Study of Patient Medication Leaflets Provided in US, UK, and Australian Pharmacies
Key to the Medicine Chests: The Pharmaceutical Trade in Philadelphia in the Era of Lewis and Clark
Mercury: From Medicine to Menace
Older Adults & Drug Decisions: Collaboration & Outcomes
Outcomes of Antidepressant Monitoring in Pharmacies
Patient Roles in Arthritis Management
Pharmacy-based Immunization Laws: Form and Effects
Physician Provision of Prescription Drug Information
Physicians and Shared Decision-making
Prescription Reimbursement Simulation Study
Student Outreach to Prevent and Reduce Smoking (STOPRS) Project
UW-Community Pharmacy Residency Program (UWCPRP)
Wisconsin Medicaid Pharmaceutical Care Program Study
Young Pharmacists’ Worklife Study

2004 National Pharmacy Workforce Study. (Dave Mott, investigator; Dave Kreling, co-investigator) This project is being conducted by the Midwest Pharmacy Workforce Consortium and is a national mail survey of 5,000 pharmacists to identify demographic and practice characteristics of pharmacists, information on careers, workplace parameters, and aspects of pharmacist worklife.

Addressing Underserved Populations. (Betty Chewning, investigator) Building on longstanding interest in public health issues in underserved populations, projects working with two data sets are underway. The first is analyzing a longitudinal data on adolescent health risks, collected with Pat Kokotailo with funding from NIH’s National Institute of Child Health and Human Development. The second is analyzing a longitudinal data set collected on young families in poverty being served by Early Head Start. In both sets of analyses, a resilience framework is being used to identify positive models predicting successful outcomes among community members.

Aristolochia: Chemistry, History, Applications. (John Scarborough, investigator) This project, conducted jointly with Arthur Grollman at SUNY Stony Brook, is a selected review spanning 2000 years (Greek, Roman, Byzantine, Medieval Western, Renaissance Europe, China) of herbal remedies used as medicines, which contain Aristolochic acid (genus Aristolochia L.), with a focus on document toxic actions. Initial stages of the project are underway and consist of reading the Greek, Latin, Arabic, and Chinese, collecting as many references as possible. We will select five or six “prescriptions” (including dose and time) and reproduce them in a laboratory at SUNY Stony Brook.

Commentaries on Dioscorides. (John Scarborough, collaborating with Lily Beck, Vassar College) My introduction to Professor Beck’s translation from the Greek of Dioscorides’ Materia Medica is to be published in December by Olms – Weidmann in Berlin and Hildesheim. A 2 nd edition is currently underway. Added commentaries will make accessible to the wider scholarly public (including pharmacists and physicians) the large varieties of pharmacological technologies characteristic of Dioscorides’ masterpiece.

Cornelius Celsus and Roman Medicine. (John Scarborough, coordinator) Project nearing completion (an earlier version of a paper the topic has been accepted for publication by the Bulletin of the History of Medicine), somewhat delayed due to fresh evidence coming to light.

A Documentary History of American Pharmacy. (Gregory Higby, investigator) This project will pull together a book-length collection of letters, speeches, laws, articles, and chapters that document the historical development of pharmacy in the USA. Each will be placed in context with an appropriate introduction and necessary commentary.

Drug Utilization by Medicare Beneficiaries. (Dave Mott and Dave Kreling, investigators) This project examines drug utilization among Medicare beneficiaries over age 65 in the United States using national databases collected between 1994 and 2000. Project goals are to examine trends in drug utilization, insurance coverage for prescription drugs, expenditures for prescription drugs, and out-of-pocket costs for prescription drugs.

Evaluation of Drug Information Provided in U.S. Pharmacies. (Svarstad, investigator; Mount, co-investigator) Funded by the US Food and Drug Administration and National Association of Boards of Pharmacy) form 1998-2003, two multi-state observational studies were conducted to evaluate the distribution and quality of patient drug information provided in U.S. community pharmacies. The first study examined written drug information and patient counseling provided in 306 pharmacies in eight states. The second study examined written drug information and patient counseling provided in 384 community pharmacies located in 44 states. Data were collected by trained shoppers (acting as patients). Researchers also collected data from expert panels, consumer panelists, and state regulations governing patient counseling by pharmacists.

Improving Hypertension Care in Inner City Pharmacies. (Svarstad, director) This NIH-funded study will evaluate the impact of an organizational-level approach in 36 community pharmacies (18 intervention, 18 control) serving 900 African Americans with uncontrolled hypertension in Milwaukee and Chicago. The intervention will redefine pharmacist and technician roles, establish pharmacy-based "refill clinics" for monitoring patients, and implement tools for giving feedback to physicians. It is hypothesized that hypertension control rates will be higher in intervention pharmacies at 6 and 12 months. Researchers also will examine changes in pharmacy practice, patient adherence, prescribing, and cost-effectiveness. If successful, researchers will implement and evaluate a dissemination plan for improving hypertension care for African Americans nationwide.

International Study of Patient Medication Leaflets Provided in US, UK, and Australian Pharmacies. (Svarstad, collaborating with Theo Raynor and Peter Knapp of University of Leeds, UK and Ines Krass and Parisa Aslani of the University of Sydney, Australia) This study assesses and compares the quality of patient medication leaflets currently distributed by community pharmacists in the U.S., U.K., and Australia. The quality of information will be evaluated using standardized forms and criteria endorsed by the Keystone Committee.

Key to the Medicine Chests: The Pharmaceutical Trade in Philadelphia in the Era of Lewis and Clark. (Gregory Higby, investigator) A short version of this invited paper was presented in November 2004 at a conference on the medical aspects of the Lewis and Clark expedition. The full published version will examine the contents of the two medicine chests carried by the Corps, illuminating the unique position of Philadelphia in the early American drug trade.

Mercury: From Medicine to Menace. (Gregory Higby, investigator) For 250 years, mercury and its compounds were among the most consumed medicines in the Western cultures. Debates about mercury and its use in medicines have been in the forefront of therapeutic change and controversy beginning in the early 1800s. This project will explore these issues historically.

Older Adults & Drug Decisions: Collaboration & Outcomes. (Betty Chewning, investigator, collaborating with Betsy Sleath at the University of North Carolina) This NIH-funded project continues a research stream examining patient health behaviors, perspectives and partnerships with health care providers. The goal of this study is to evaluate a computerized assessment and printout of patients’ visit agendas designed to cue more complete discussion of patient priorities at a clinic visit. Through a longitudinal, randomized controlled trial involving 20 physicians and 500 patients, the study is evaluating the impacts of this intervention on the patient-provider interaction, patient pain levels, and health quality of life. Data from of this project and the Patient Roles in Arthritis Management project are being used to help operationalize the concept of concordance in patient-provider encounters for individuals who have chronic conditions.

Outcomes of Antidepressant Monitoring in Pharmacies. (Svarstad, collaborating with Nathaniel Rickles of Long Island University) This NIH-funded study evaluated an organization-level intervention on the quality of pharmacist monitoring and education of patients using antidepressants. Results showed significant improvements in patient understanding of their medications, satisfaction with treatment, and feedback to the pharmacist regarding side effects and other barriers to treatment in this area.

Patient Roles in Arthritis Management. (Betty Chewning, investigator; Dave Kreling, co-investigator) This AHRQ-funded longitudinal study addresses of how individuals with rheumatoid and osteoarthritis manage their condition. Building on the Self Regulation Framework, this research is analyzing patient medication use, decision making and health outcomes related to prescription, over the counter, and complementary alternative medicines.

Pharmacy-based Immunization Laws: Form and Effects. (Jeanine Mount, investigator) As pharmacists work to expand their public health roles, laws in many states have granted authority to pharmacists to administer vaccines directly to patients. State laws vary widely, though, and this project analyzes how differences in laws affect the nature and extent of pharmacy-based immunization activity. It also explores whether pharmacists’ participation in pharmacy-based distribution/ administration of vaccines is related to their participation in public health emergency preparedness and response activities. The goal of this project is to engage key stakeholders in developing recommendations for how to increase pharmacy’s contribution to addressing vaccine-preventable diseases and to public health emergency response.

Physician Provision of Prescription Drug Information. (Henry Young, investigator) Analyzing audiotapes of interactions between physicians and (unannounced) standardized patients, this project examines the information physicians provide patients regarding prescribed antidepressants to determine whether physician and patient characteristics influence physicians’ provision of prescription drug information. Preliminary findings suggest that physicians provide patients with a basic level of drug information and that physician age and primary clinical practice setting are associated with the amount of information areas covered by physicians. Analysis is ongoing.

Physicians and Shared Decision-making. (Henry Young, investigator) The purpose of this project is to examine whether patients’ ad-induced requests affect physicians’ shared decision-making behaviors. Current efforts focus on rating physicians’ shared decision-making behaviors during initial primary care interactions with (unannounced) standardized patients.

Prescription Reimbursement Simulation Study. (Dave Kreling, investigator) Models are being constructed to simulate prescription reimbursement in Wisconsin’s Medicaid program to evaluate the trend in average prescription gross margin amounts from 1998 to 2003. Reimbursement and acquisition costs are estimated for the top 100 oral solid dosage form drugs, by prescription volume, dispensed to Medicaid recipients each year.

Student Outreach to Prevent and Reduce Smoking (STOPRS) Project. (Betty Chewning, investigator; Dave Kreling and Beth Martin, co-investigators) This project is helping Wisconsin pharmacists establish, market, and provide a tobacco cessation counseling service in their community pharmacies. A statewide partnership between UW-Madison PharmD students and practicing pharmacists, the program has achieved a relatively high successful quit rate for clients participating in the pharmacist-offered program. PharmD. students also offer smoking cessation classes to middle schoolers as part of the project. The Transtheoretical Model and Self Efficacy framework shaped both the intervention and evaluation of training

UW-Community Pharmacy Residency Program (UWCPRP). (Joe Bonnarens, director) This program is a joint venture between the School of Pharmacy, in the administration role, and the various community pharmacy practice sites that serve as the training sites for each resident. The UWCPRP provides recent graduates with an outstanding opportunity to gain valuable clinical, management, and research experience during their residency year. As Director, Joe works with each practice site regarding resident training, develops programming for the residents in various areas of interest, such as teaching and research methodology, and is administratively responsible for the program.

Wisconsin Medicaid Pharmaceutical Care Program Study. (Dave Mott and Dave Kreling, coordinators) This project examines claims from the Wisconsin Medicaid Pharmaceutical Care Program to analyze participation by pharmacies and to characterize the kinds of cognitive services pharmacists have provided to Medicaid recipients. Pharmacists also are being surveyed to identify facilitators and barriers to participating in the program.

Young Pharmacists’ Worklife Study. (Dave Mott and Joe Bonnarens, coordinators) To study pharmacist work life issues in retail pharmacy practice settings and among young pharmacists (0-5 years of experience), this study integrates data from the 2000 National Pharmacist Workforce Survey with data from regional pharmacist workforce surveys.