UHSP Collections (University of Health Sciences and Pharmacy)
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Comprehensive medication management services provided via telehealth or hybrid models: A scoping review
No full textComprehensive medication management (CMM) is increasingly provided by health care teams through telehealth or hybrid modalities. The purpose of this scoping literature review was to assess the published literature and examine the economic, clinical, and humanistic outcomes of CMM services provided by pharmacists via telehealth or hybrid modalities. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Randomized controlled trials (RCTs) and observational studies were included if they: reported on economic, clinical, or humanistic outcomes; were conducted via telehealth or hybrid modalities; included a pharmacist on their interprofessional team; and evaluated CMM services. The search was conducted between January 1, 2000, and September 28, 2021. The search strategy was adapted for use in Medline (PubMed); Embase; Cochrane; Cumulative Index to Nursing and Allied Health Literature; PsychINFO; International Pharmaceutical Abstracts; Scopus; and grey literature. Four reviewers extracted data using a screening tool developed for this study and reviewed for risk of bias. Authors screened 3500 articles, from which 11 studies met the inclusion criteria (9 observational studies, 2 RCTs). In seven studies, clinical outcomes improved with telehealth CMM interventions compared to either usual care, face-to-face CMM, or educational controls, as shown by the statistically significant changes in chronic disease clinical outcomes. Two studies evaluated and found increased patient and provider satisfaction. One study described a source of revenue for a telehealth CMM service. Overall, study results indicate that telehealth CMM services, in select cases, may be associated with improved clinical outcomes, but the methods of the included studies were not homogenous enough to conclude that telehealth or hybrid modalities were superior to in-person CMM. To understand the full impact on the Quadruple Aim, additional research is needed to investigate the financial outcomes of CMM conducted using telehealth or hybrid technologies
Spectrum scores: Toward a better definition of de-escalation
No full textSpectrum scores measure antimicrobial utilization while also quantifying the spectrum of activity. Accordingly, changes in spectrum score can be used to identify antimicrobial de-escalation. We show that spectrum-score-based de-escalation has a 95.7% positive percentage agreement and 81.6% negative percentage agreement versus de-escalation defined as stopping either antistaphylococcal or antipseudomonal agents
UHSP Policy Discussion Board
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How Does Physician (Non)accommodation Affect Patient Behavioral Intention? Using a Web-Based Experiment to Examine Indirect Effects of Language Type on Behavioral Intention Through Goal Inferences and Source Appraisals
No full textDrawing on communication accommodation theory (CAT), we investigated how physician (non)accommodation indirectly affects participants’ intention to engage in advocated health behaviors through participant goal inferences and source appraisals. We conducted a 3 (language type: medical jargon, analogies, literal language) × 2 (health topic: coronary artery disease, influenza vaccine) web-based experiment. Participants recruited from an online research panel (N = 545) were randomly assigned to a condition and watched a video featuring a physician explaining medical information and providing health recommendations. In a serial mediation analysis, results suggested two parallel indirect effects (relational vs. informational). Relative to underaccommodation (i.e. medical jargon), physician accommodation (i.e. literal language, analogies) had positive, indirect effects on participant health behavioral intention through goal inferences and assessment of physicians (i.e. warmth, expertise). Compared to the use of literal language, physician use of analogies had a positive, indirect effect on participant behavioral intention solely through the relational path, not the informational path. These findings extend CAT by explicating a mechanism underlying physician (non)accommodation and patient outcomes, offering practical implications for physicians to foster relationships with patients and facilitate patient comprehension
Modern, Empowered, but Stigmatized: Analyzing the Construction of Menstrual Cups as Feminist Technologies
No full textMenstrual products have long shaped how women manage their menstruating bodies and how menstruation is socially constructed. Historically, these products have simultaneously promoted messages of shame—menstruation is dirty and requires concealment—and modernity or have linked their use to overcoming the constraints of menstruation to become modern and liberated. In this article, which analyzes the websites of companies that produce menstrual cups (an insertable, reusable menstrual technology), I identify a new use of this “modern” discourse that emphasizes the interrelationship between “modern women” and female empowerment. Notions of modernity are connected to depictions of menstrual cups as modern technologies that invoke modern ideologies and promote living a modern lifestyle—all conceptions of modernity that seek to empower women in their menstrual health and wider lives. Although these intertwined discourses of modernity and empowerment reflect those of feminist menstrual activists, menstrual stigmas often remain embedded within these messages. Analyzing the persistent intermixing of these contrasting discourses allows for expanding the theories of feminist technologies to consider how technologies may benefit, empower, and destabilize patriarchal systems in subtle and diverse ways
Denying and Accepting a Family Member’s Illness: Uncertainty Management as a Process
No full textDoubt is a common, yet challenging form of uncertainty to have about another’s illness. Although navigating illness uncertainty is a process of continual (re)appraisal and management, existing research narrowly examines windows of uncertainty experience. To illustrate how uncertainty management in the context of doubt is recursive, nonlinear, and ongoing, we apply a process approach to communication to uncertainty management theory. Drawing on interviews with 33 U.S. adults, our findings explicate a prominently teleological (i.e., goal-driven) process wherein participants’ uncertainty management served to accept or deny illness, depending on the extent individuals valued their own and the other’s identity and the relationship. Participants generally moved through this process along one of three trajectories: growth, stagnation, or resentment. We also observed dialectical, evolutionary, and life cycle processes in the data. Findings demonstrate the heuristic value of studying uncertainty management as a multiple motor process
A qualitative evaluation of a Nudgeathon event for the co-design of sexual health campaign images targeting overseas-born men who have sex with men
No full textBackground: Additional approaches to HIV prevention and management, such as Nudgeathons, are required to increase access to HIV pre-exposure prophylaxis (PrEP) among overseas-born men who have sex with men (MSM). Methods: In September 2021, we conducted a 4-h online Nudgeathon, wherein four teams co-designed behaviourally informed adverts to improve PrEP access and uptake for overseas-born MSM. After the Nudgeathon, eight of 17 invited Nudgeathon attendees were interviewed about their experience. We conducted a qualitative content analysis of interview data to highlight participants\u27 experiences of the co-design process. Results: We identified three major themes: (1) what worked well; (2) group dynamics; and (3) improvement and future directions. The Nudgeathon about PrEP was a positive learning experience, with valuable contributions and overall satisfaction with the end-products. The online format was perceived as less costly than if the Nudgeathon was hosted in person, and suitable for participants from different geographical regions. In-person Nudgeathons with international attendees would require costs for flights, accommodation, function room hire and catering. Within groups, sharing personal experiences essential to co-designing concepts. However, less information on how to create nudges and more information before the Nudgeathon was preferred. Conclusion: Our evaluation finds that Nudgeathons are fast and efficient in developing potential solutions to complex issues related to HIV prevention