Medicine and Health Sciences Commons^™

Pills And Spills: An Assessment Of Medications And Fall Risk In Older Patients, Kelly L. Covert, Courtney D. Hall

ETSU Faculty Works

No abstract provided.

Clinical Evaluators Take Your Mark, Jodi Polaha, Mckenzie Highsmith, William Lusenhop, Deepu George, Adrian Sandoval

ETSU Faculty Works

• Discuss two implementation outcomes (adoption and reach) and explain why they are important for clinicians to measure and report, with application to own work
• Name sources of data that are accessible to clinicians in health care settings, with consideration of own setting.
• Describe a range of dissemination strategies used to create impact, including new ideas for dissemination of own work.

Relationship Of Patient Self-Administered Copd Assessment Test To Physician Standard Assessment Of Chronic Obstructive Pulmonary Disease In A Family Medicine Residency Training Program, Jessica E. Burchette, Ivy A. Click, Leigh Johnson, Sandra Alicia Williams, Brett Tyler Morgan

ETSU Faculty Works

Assessing the global impact of chronic obstructive pulmonary disease (COPD) on a patient’s life can be difficult to perform in the clinical setting due to time constraints and workflow challenges. The primary objective of this study was to compare disease impact ratings between patient selfadministered COPD Assessment Test (CAT) and physician standard office assessment. This prospective study was conducted at a family medicine residency clinic in northeast Tennessee. The study included two study groups: 1) adult patients seen at the clinic during the 3-month study period with an active diagnosis of COPD, and 2) their physicians. Physicians’ assessment of the …

Maxent Estimation Of Aquatic Escherichia Coli Stream Impairment, Dennis Gilfillan, Timothy A. Joyner, Phillip Scheuerman

ETSU Faculty Works

Background.The leading cause of surface water impairment in United States’ rivers and streams is pathogen contamination. Although use of fecal indicators has reduced human health risk, current approaches to identify and reduce exposure can be improved. One important knowledge gap within exposure assessment is characterization of complex fate and transport processes of fecal pollution. Novel modeling processes can inform watershed decision-making to improve exposure assessment.

How We Close The Gaps: Our Interprofessional Team Approach To Meeting Quality Measures, Peter Blockhurst, William Buselmeier, Mckenzie Calhoun, Paige Gilbert-Green, Jesse Gilbreath, Erin Harris, Amy Lawrence

ETSU Faculty Works

• Define the role/function of an interprofessional team in the management of complex outpatients.
• Identify the types of patients that would benefit most from a team-based approach.
• Implement elements of our team-based patient care model into individual practices.

Student Pharmacists’ Personal Finance Perceptions, Projected Indebtedness Upon Graduation, And Career Decision-Making, Nicholas E. Hagemeier, Chad K. Gentry, Debbie C. Byrd, Leonard B. Cross, Daniel Rose, Nasar Ansari, Pooja Subedi, Tandy Branham

ETSU Faculty Works

Objectives: To evaluate the extent to which students’ personal finance perceptions, projected student loan indebtedness, and demographic characteristics predict post-PharmD career intentions.

Methods: Students at three pharmacy colleges completed a 31-item survey instrument that assessed personal finance perceptions, self-efficacy beliefs, anticipated student loan debt upon graduation, postgraduate intentions, anticipated practice setting upon graduation, and demographic characteristics. Logistic regression models were used to examine the extent to which personal finance perceptions, student loan indebtedness, and demographic characteristics predicted postgraduate intentions and anticipated practice setting.

Results: A total of 763 usable responses were obtained (response rate=90.3%). Students reported an anticipated personal student …

An Update On The Opioid Epidemic: Perception Vs. Reality, Nicholas E. Hagemeier

ETSU Faculty Works

No abstract provided.

Using Mock Interviews To Evaluate An Interprofessional Education (Ipe) Curriculum, Ivy A. Click, Jodi Polaha, Leonard Brian Cross, Richard A. Hess, Adam C. Welch, Jessica Epley Burchette

ETSU Faculty Works

The aim of this study was to evaluate the influence of targeted team care training in our institution’s interprofessional practice and education (IPE) program on medical and pharmacy students' expression of knowledge and attitudes about team care as measured in a mock interview. Medical and Pharmacy students were recruited to participate in a 20-minute mock interview for an advanced placement position.

Relationship Of Patient Self-Administered Copd Assessment Test (Cat) To Physician Standard Assessment Of Copd In A Family Medicine Residency Training Program, Leigh Johnson, Jessica Burchette, Ivy A. Click, Sandra Alicia Williams

ETSU Faculty Works

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the United States. COPD is of particular concern in certain sectors of the country, including Central Appalachia where our clinic is located. Assessing patients with COPD presents many challenges as symptoms range from those considered "typical" such as shortness of breath and sputum production to those less often identified like anxiety and social isolation. We conducted a pilot study comparing physician standard assessment of COPD to patient self-assessment using the COPD Assessment Test (CAT). The CAT is an eight-item questionnaire that measures the impact COPD has …

Mannitol Prescribing Practices With Cisplatin Before And After An Educational Newsletter Intervention, Morgan Corbin, John B. Bossaer

ETSU Faculty Works

Background: Mannitol has been used in the past for the prevention of cisplatin-induced nephrotoxicity. Studies on its efficacy have conflicting results. An educational newsletter was designed for local oncologists on the conflicting data of mannitol use in preventing cisplatin-induced nephrotoxicity. Purpose: The purpose of this study was to determine whether a pharmacist-created newsletter intervention led to changes in the mannitol prescribing practices of local oncologists. Methods: A newsletter describing the paucity of evidence to support mannitol use to prevent cisplatin-induced nephrotoxicity was distributed via e-mail to local oncologists in October 2010. Mannitol prescribing rates were retrospectively evaluated before and after …

Prescription Drug Abuse Communication: A Qualitative Analysis Of Prescriber And Pharmacist Perceptions And Behaviors, Nicholas E. Hagemeier, Fred Tudiver, Scott Brewster, Elizabeth J. Hagy, Angela Hagaman, Robert P. Pack

ETSU Faculty Works

Background: Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited. Objectives This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists. Methods: Five focus groups (N = 35) were conducted within the Appalachian Research Network (AppNET), a rural primary care practice-based research network (PBRN) in South Central …

Developing Students As Advocates Through A Pilot Advocacy Curricular Thread Within A Pharmd Curriculum, Cortney M. Mospan, Mckenzie L. Calhoun

ETSU Faculty Works

There is a need for education about and development of advocacy skills within student pharmacists. Pharmacy literature describes experiences incorporating advocacy education within curricula; however, these are often singular, limited experiences. To increase student pharmacists’ awareness, knowledge, and skills, effective advocacy curricular threads are necessary within curricula. This paper provides rationale for the need for a greater emphasis on development of these skills within student pharmacists, evidence of curricular experiences surrounding advocacy from the literature, initial observations from a piloted curricular thread at one school, and implications for the academy.

Olanzapine For Chemotherapy-Induced Nausea And Vomiting, John B. Bossaer

ETSU Faculty Works

Excerpt: Navari and colleagues (July 14 issue)1 report on the use of olanzapine for the prevention of chemotherapy-induced nausea and vomiting.

Using Scientific Inquiry To Increase Knowledge Of Vaccine Theory And Infectious Diseases, Zachary Walls, John B. Bossaer, David Cluck

ETSU Faculty Works

Background: The aim of this study was to design and evaluate a laboratory activity based on scientific inquiry to educate first-year pharmacy students in the U.S. about vaccination theory and the attributes of common pathogens. Methods: The laboratory activity had two principal sections. The first consisted of an interactive game during which students rolled a die to determine outcomes based on a set of pre-determined criteria. In the second section, students generated and tested hypotheses about vaccine theory using a computer simulation that modeled disease transmission within a large population. In each section students were asked to evaluate epidemiological data …

Predictors Of Neonatal Abstinence Syndrome In Buprenorphine Exposed Newborn: Can Cord Blood Buprenorphine Metabolite Levels Help?, Darshan Shah, Stacy Brown, Nick Hagemeier, Shimin Zheng, Amy Kyle, Jason Pryor, Nilesh Dankhara, Piyuesh Singh

ETSU Faculty Works

Background

Buprenorphine is a semi-synthetic opioid used for the treatment of opioid dependence. Opioid use, including buprenorphine, has been increasing in recent years, in the general population and in pregnant women. Consequently, there has been a rise in frequency of neonatal abstinence syndrome (NAS), associated with buprenorphine use during pregnancy. The purpose of this study was to investigate correlations between buprenorphine and buprenorphine-metabolite concentrations in cord blood and onset of NAS in buprenorphine exposed newborns.

Methods

Nineteen (19) newborns who met inclusion criteria were followed after birth until discharge in a double-blind non-intervention study, after maternal consent. Cord blood and …

Teaching Communication Skills To Medical And Pharmacy Students Through A Blended Learning Course, Rick Hess, Nicholas E. Hagemeier, Reid Blackwelder, Daniel Rose, Nasar Ansari, Tandy Branham

ETSU Faculty Works

Objective. To evaluate the impact of an interprofessional blended learning course on medical and pharmacy students’ patient-centered interpersonal communication skills and to compare precourse and postcourse communication skills across first-year medical and second-year pharmacy student cohorts.

Methods. Students completed ten 1-hour online modules and participated in five 3-hour group sessions over one semester. Objective structured clinical examinations (OSCEs) were administered before and after the course and were evaluated using the validated Common Ground Instrument. Nonparametric statistical tests were used to examine pre/postcourse domain scores within and across professions.

Results. Performance in all communication skill domains increased significantly for all students. …

Fellowships In Community Pharmacy Research: Experiences Of Five Schools And Colleges Of Pharmacy, Margie E. Snyder, Caitlin K. Frail, Stephanie A. Gernant, Jennifer L. Bacci, Kim C. Coley, Lauren M. Colip, Stefanie P. Ferreri, Nicholas E. Hagemeier, Melissa Somma Mcgivney, Jennifer L. Rodis, Megan G. Smith, Randall B. Smith

ETSU Faculty Works

Objective To describe common facilitators, challenges, and lessons learned in 5 schools and colleges of pharmacy in establishing community pharmacy research fellowships.

Setting: Five schools and colleges of pharmacy in the United States.

Practice description: Schools and colleges of pharmacy with existing community partnerships identified a need and ability to develop opportunities for pharmacists to engage in advanced research training.

Practice innovation: Community pharmacy fellowships, each structured as 2 years long and in combination with graduate coursework, have been established at the University of Pittsburgh, Purdue University, East Tennessee State University, University of North Carolina at Chapel Hill, and The …

Student Performance In A Pharmacotherapy Oncology Module Before And After Flipping The Classroom, John B. Bossaer, Peter Panus, David W. Stewart, Nick E. Hagemeier, Joshua George

ETSU Faculty Works

Objective. To determine if a flipped classroom improved student examination performance in a pharmacotherapy oncology module.

Design. Third-year pharmacy students in 2012 experienced the oncology module as interactive lectures with optional case studies as supplemental homework. In 2013, students experienced the same content in a primarily flipped classroom. Students were instructed to watch vodcasts (video podcasts) before in-class case studies but were not held accountable (ie, quizzed) for preclass preparation. Examination questions were identical in both cohorts. Performance on examination questions was compared between the two cohorts using analysis of covariance (ANCOVA), with prior academic performance variables (grade point average …

Comfort, Complexities, And Confrontation: Health Care Provider Communication And Prescription Drug Abuse And Misuse, Nicholas E. Hagemeier, Fred Tudiver

ETSU Faculty Works

This presentation describes (1) the role of communication in prescription drug abuse prevention and treatment and (2) the outcomes of 5 focus groups conducted in the Appalachian Region.

Etsu Didarp Project 1: Health Care Provider Communication And Prescription Drug Abuse And Misuse, Nicholas E. Hagemeier, Fred Tudiver

ETSU Faculty Works

No abstract provided.

Improving Tennessee Health Care Providers Understanding Of Neonatal Abstinence Syndrome, Ivy Click, Nicholas E. Hagemeier

ETSU Faculty Works

No abstract provided.

Integration Of Rural Community Pharmacies Into A Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis, Nicholas E. Hagemeier, Sarah Blevins, Kyle Hagen, Emily Sorah, Richa Shah, Kelly Ferris

ETSU Faculty Works

Purpose: Practice-based research networks (PBRN) seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1) evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2) explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3) explore pharmacy key informant interest in PBRN participation.

Methods: The sample consisted of community pharmacies within city limits …

Impact Of An Interprofessional Communication Course On Nursing, Medical, And Pharmacy Students’ Communication Skill Self-Efficacy Beliefs, Nicholas E. Hagemeier, Rick Hess, Kyle S. Hagen, Emily L. Sorah

ETSU Faculty Works

Objective. To describe an interprofessional communication course in an academic health sciences center and to evaluate and compare interpersonal and interprofessional communication self-efficacy beliefs of medical, nursing, and pharmacy students before and after course participation, using Bandura’s self-efficacy theory as a guiding framework.

Design. First-year nursing (n=36), first-year medical (n=73), and second-year pharmacy students (n=83) enrolled in an interprofessional communication skills development course voluntarily completed a 33-item survey instrument based on Interprofessional Education Collaborative (IPEC) core competencies prior to and upon completion of the course during the fall semester of 2012.

Assessment. Nursing students entered the course with higher interpersonal …

Pharmacy Student Self-Testing As A Predictor Of Examination Performance, David Stewart, Peter Panus, Nicholas E. Hagemeier, Jim Thigpen, Lauren Brooks

ETSU Faculty Works

Objectives. To determine if student self-testing improves performance during a doctor of pharmacy course.

Methods. Students were given access to online quizzes with a large pool of randomly selected questions specific to upcoming examination content. Quizzes were electronically scored immediately upon completion and students were provided corrective feedback.

Results. Examination scores following implementation of the practice quizzes were significantly higher in all but the last testing period. The upper fiftieth percentile of students scored higher on both the practice quizzes and subsequent examinations in all but the fourth testing period.

Conclusions. Providing pharmacy students with self-testing opportunities could increase their …

The Influence Of Faculty Mentors On Junior Pharmacy Faculty Members’ Career Decisions, Nicholas E. Hagemeier, Matthew M. Murawski, Nicholas G. Popovich

ETSU Faculty Works

Objective. To assess junior faculty members’ perceptions regarding the impact of past faculty-mentoring relationships in their career decisions, including the decision to pursue postgraduate training and ultimately an academic career.

Methods. A mixed-mode survey instrument was developed and an invitation to participate in the survey was sent to 2,634 pharmacy faculty members designated as assistant professors in the American Association of Colleges of Pharmacy (AACP) directory data.

Results. Usable responses were received from 1,059 pharmacy faculty members. Approximately 59% of respondents indicated that they had received encouragement from 1 or more faculty mentors that was very or extremely influential in …

Focused Anticoagulation Service In Family Medicine Residencies, Ivy A. Click, Emily Flores, Leonard Brian Cross, Douglas Rose

ETSU Faculty Works

A report on the creation of a new program to improve family medicine residents' understanding, and quality of care, of anticoagulation patients. Patients requiring anticoagulation therapy pose unique issues requiring a systematic approach to their care, balancing the potential benefit from therapy with possible adverse events. Here, we describe a model that helps to standardize both the care received by patients on anticoagulation therapy as well as the training of family medicine residents caring for those patients. A team-based model of care (family medicine residents, clinical pharmacists, and nurses) is used to achieve the goals of improved care and education. …

Max Dose Opioids: How High Can You Go?, John B. Bossaer, Sarah T. Melton

ETSU Faculty Works

Learning Objectives:

• Describe the rationale for the belief that opioids have no maximum dose
• Describe the data supporting the rationale that high doses of opioids increase toxicity
• Describe the data supporting the rationale that high doses of opioids do not improve outcomes
• Identify potential safety concerns with patients taking high doses of opioids

Junior Pharmacy Faculty Members’ Perceptions Of Their Exposure To Postgraduate Training And Academic Careers During Pharmacy School, Nicholas E. Hagemeier, Matthew M. Murawski

ETSU Faculty Works

Objective. To determine the perceptions of junior pharmacy faculty members with US doctor of pharmacy (PharmD) degrees regarding their exposure to residency, fellowship, and graduate school training options in pharmacy school. Perceptions of exposure to career options and research were also sought.

Methods. A mixed-mode survey instrument was developed and sent to assistant professors at US colleges and schools of pharmacy.

Results. Usable responses were received from 735 pharmacy faculty members. Faculty members perceived decreased exposure to and awareness of fellowship and graduate education training as compared to residency training. Awareness of and exposure to academic careers and research-related fields …