Browsing by Author "Hughes, Peter J."

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    Drug shortage management in Alabama hospital pharmacies
    (University of Minnesota, College of Pharmacy, 2013) Holmes III, Oliver W; Hughes, Peter J.
    Purpose: The purpose of this study is to identify effective strategies used by Alabama hospitals to manage drug shortages. Moreover, this study aims to determine if there are any relationships among hospital size, utilization of a standard policy for drug shortage management and perceived usefulness of standard procedures for drug shortages. Methods: A paper survey was mailed to 129 hospital pharmacies in Alabama (per the Alabama Hospital Association directory). The survey consisted of 5 demographic questions, questions involving perception of current medication shortages, sources of information about shorted drugs, and frequency of discussion at P&T committee meetings. Most importantly, the survey contained questions about the use of a standard policy for handling drug shortages, the effectiveness of the policy if one is used, and an open-ended question asking the recipient to describe the policy being used. Results: A response rate of 55% was achieved as 71 surveys were completed and returned. Approximately 70% of the survey respondents described the current drug shortage issue as a top priority in their pharmacy department. The pharmacy distributor served as the primary source of information regarding drug shortages for 45% of the facilities. There is a direct relationship between size of hospital and likelihood of utilization of a standard policy or procedure for drug shortage management among the sample. The smaller facilities of the sample perceived their management strategies as effective more frequently than the larger hospitals. Conclusion: Common components of effective management strategies included extensive communication of shortage details and the ability to locate alternative products. The use of portable technology (e.g., Smart phones and tablets) along with mobile applications may emerge as popular means for communicating drug product shortage news and updates within a facility or healthcare system.
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    Fluconazole-Associated Birth Defects: A Comprehensive Review
    (University of Minnesota, College of Pharmacy, 2014) Firth, Janssen M.; Daniel, Nicholas; Hughes, Peter J.
    Background: The August 2013 publication of a large historical cohort study in the New England Journal of Medicine has reignited interest in the potential teratogenic effects of fluconazole when used in pregnant females. Fluconazole is an effective and commonly-utilized antifungal medication. Thus, maternal and fetal exposure to fluconazole is expected in the general population, and pharmacists are expected to counsel patients regarding any risks to their prescribed treatment. Methods: A literature review of all published literature indexed to PubMed (January 1966 to October 2013) and International Pharmaceutical Abstracts (January 1975 to October 2013) including fluconazole and teratogenic effects and published in the English language was conducted. Results: Fourteen publications were included for analysis including case reports (n=7), cross-sectional research (n=2), and historical cohort studies (n=5). Conclusion: There appears to be little to no fetal risk resulting from a single dose or short duration antifungal therapy with fluconazole. However, prolonged high-dose fluconazole therapy has increased potential to confer teratogenic effects. In those cases, the risks of such therapy should be weighed against potential benefits.
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    Medication Adherence of Patient Assistance Program Recipients: A Pilot Study
    (University of Minnesota, College of Pharmacy, 2012-10) Conley, Christian S.; Hughes, Peter J.
    Purpose: Evaluate medication adherence of prescription assistance program recipients at an inner-city clinic. Methods: Surveys were administered at enrollment and 6 months following enrollment to patients who were either recipients of at least one patient assistance program (PAP) or had prescription benefits through Alabama Medicaid. Data on patient demographics, Morisky Medication Adherence Survey (MMAS) scores, mean possession ratio (MPR), and drug classes were collected for 6 months. Results: The baseline MMAS score concluded that both the PAP group and Alabama Medicaid group were highly motivated and highly knowledgeable regarding adherence to prescribed medications. After 6 months, administration of the same MMAS instrument resulted in a category change in the PAP group from highly motivated and knowledgeable to low motivation and high knowledge. The Medicaid MMAS adherence category did not change from baseline after 6 months. The 6-month mean MPR for the PAP and Medicaid groups were 0.542 and 0.823, respectively. Conclusion: Providing free or low-cost medication plus customary counseling should not be the sole interventions for the uninsured patient. In this study, PAP recipient MMAS score change and low mean MPR suggest that additional interventions are needed to ensure that PAP recipients adhere to prescribed therapies.