Job satisfaction among U.S. pharmacists

A review of the literature on job satisfaction that is relevant to pharmacists is presented. Studies conducted in the United States between 1951 and 1982 were evaluated to answer two questions: (1) What is known about the level of job satisfaction among pharmacists? and (2) What factors are related to pharmacists' job satisfaction? Some study populations were selected on the basis of work setting, others on position in the job hierarchy, and others on different criteria. Job satisfaction measures were of two general types, facet-free measures, which assess overall satisfaction, and facet-specific measures, which gauge satisfaction with respect to a specific aspect of the job. Pharmacists in the studies represented a wide variety of work settings and geographic locations. Most of the studies were not comparable because they used instruments unique to a particular study. In some cases, response rates were low and sample sizes were small. Frequently, results were not analyzed statistically for significance. A few studies compared pharmacists with other job populations; the differences were not striking, although pharmacists may be slightly less satisfied with their specific jobs than the general public. Repeatedly, job position and ability utilization appeared related to pharmacists' job satisfaction. Further study of the extent, causes, and consequences of pharmacists' job satisfaction is needed. Research methods should be designed so that results can be analyzed and compared statistically.     

Alcohol use/abuse and help-seeking among U.S. adults: The role of racial-ethnic origin and foreign-born status

We used data from Wave 1 and Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions to examine racial-ethnic and nativity-based variations in alcohol use/abuse and treatment seeking while accounting for acculturation, stress, and social integration factors. The dependent variables included alcohol use, risky drinking, DSM-IV alcohol use disorder, and treatment seeking in the past 12 months. Racial-ethnic categories included African, European, Asian/Pacific Islander, Mexican, Puerto Rican, and other Hispanic/Latino. Acculturation, social stress, and social integration were assessed with previously validated, detailed measures. Bivariate probit models with sample selection were estimated for women and men. Immigrant status and origin associations with alcohol use/abuse and treatment seeking were strong and largely unaffected by other social factors. Europeans and men of Mexican origin had the highest while women of African, Asian/Pacific Islander, and Puerto Rican origins had the lowest rates of alcohol use/abuse. Years in the United States was associated with a higher risk of alcohol use/abuse for all immigrant groups. Foreign-born individuals were no less likely than U.S. natives to seek treatment if they were abusing or were dependent on alcohol. Further modeling of these relationships among specific immigrant groups is warranted. These findings inform alcohol rehabilitation and mental health services for racial-ethnic minorities and immigrants.     

Asthma medication use among U.S. adults 18 and older

BackgroundAsthma is a chronic lung disease that currently affects an estimated 25 million Americans. One way to control the disease is by regular use of preventive asthma medications and controlled use of acute medications. However, little is known about adults with asthma and factors associated with their medication use.ObjectiveTo identify factors associated with asthma medication use among U.S. adults aged 18 and older.MethodsData were obtained from the 2006 to 2010 Medical Expenditure Panel Survey (MEPS). Medication use outcome variables include: a) daily use of a preventive asthma medication (yes/no) and b) overuse (3+) of acute inhalers in last 3 months (yes/no). The Andersen Behavioral Model of Health Care was used to guide the selection of independent variables. The independent variables were categorized as predisposing, enabling and medical need factors. Logistic regression models were used to examine the relationship between asthma medication use in adults with asthma. Point estimates were weighted to the U.S. non-institutionalized population, and standard errors were adjusted to account for the complex survey design.ResultsCompared to Whites, minority adults 18 and older were less likely to use preventive asthma medication daily (Hispanic-OR: 0.72, CI: 0.54–0.96; African American-OR: 0.62, CI: 0.51–0.75 respectively). Similarly, Hispanic adults age 18 and older were at a significantly higher likelihood of overusing rescue medications compared to Whites (OR: 1.47, CI: 1.03–2.11). Non-metropolitan adults age 18 and older were more likely to overuse acute asthma medications than those from Metropolitan Statistical Area (OR: 1.57, CI: 1.15–2.16). Compared to older adults age 65 and over, late mid-life 50–64 year old adults were less likely to use a daily preventive asthma medication (OR: 0.67, CI: 0.54–0.83).ConclusionsRace, rurality and age were important factors associated with poor asthma medication use in U.S. adults. Although this is a first step toward identifying factors that may influence the use of asthma medications, future studies are needed to develop and implement interventions to overcome issues to improve asthma care.     

Associations between smoking cessation and anxiety and depression among U.S. adults

Many studies have shown a relationship between smoking and depression. However, few studies have examined the association between current depression and smoking and even fewer used large cross-sectional data to support these findings. Using the 2006 Behavioral Risk Factor Surveillance System data (n = 248,800), we compared rates of lifetime depression, lifetime anxiety, current depression, and current depressive symptoms among smokers who unsuccessfully attempted to quit (unsuccessful quitters), former smokers (successful quitters), and smokers who made no attempts to quit (non-quitters).Unsuccessful quitters experienced more lifetime depression and anxiety than non-quitters (OR = 1.2; 95% CI, 1.0–1.4), whereas successful quitters experienced less (OR = 0.7, 95% CI, 0.6–0.8). Current depression prevalence was 14.3% among non-quitters, 18.8% among unsuccessful quitters, and 8.0% among successful quitters. On average, unsuccessful quitters also experienced more days of depressive symptoms during the previous month than either non-quitters or successful quitters.Our results suggest that smokers who attempt to quit unsuccessfully may experience lifetime depression as well as current depression at a higher rate than other smokers and former smokers.     

Prevalence and factors associated with use of hookah tobacco among young adults in the U.S.

IntroductionAmong young adults, use of hookah tobacco (HT) is an emerging health-risk behavior. The goals were to demonstrate that (1) the prevalence of ever-use and current use of HT increased among U.S. young adults (18–30 years old) in the period from 2010 to 2015 and (2) the patterns of HT use differed across diverse demographic subpopulations of young adults.MethodsWe merged and analyzed data from the 2010–2011 and 2014–2015 Tobacco Use Supplement to the Current Population Survey. The sample (n = 55,352) was representative of the young adult population in the U.S. Two binary measures were the ever and current use of HT. The significance level was 5%.ResultsThe rate of current use of HT increased from 1% in 2010–11 to 2% in 2014–15 (CI = 0.6%:1.1%). The rate of ever-use increased from 7% to 12% (CI = 4.2%:5.6%). The over-time increase was not uniform: the increase was most rapid among 26–30 year-old adults, non-Hispanic Black and African American adults, and in Northeastern and Midwestern U.S. regions. HT ever-use, overall, was associated (all p's < 0.001) with many sociodemographic factors and current tobacco-use behaviors. The rate of HT ever-use was 16% for daily and 23% for occasional cigarette smokers, 23% for users of smokeless tobacco products, 37% for cigar smokers, and 55% for smokers of regular pipe (filled with tobacco).Discussion/conclusionHT use is becoming increasingly more popular among young adults in the U.S. Methods should target not only cessation of cigarette smoking but use of all tobacco products.     

Alcohol and gambling pathology among U.S. adults: prevalence, demographic patterns and comorbidity.

OBJECTIVE: This study was designed to determine the prevalence and demographic distribution of problem gambling, pathological gambling, alcohol abuse and alcohol dependence in the United States, and to examine the co-occurrence of gambling pathology and alcohol pathology in the United States. METHOD: A representative sample (N = 2,638) of U.S. adults age 18 and older was surveyed in the year 2000 using computer-assisted telephone interviewing. Respondents' gambling pathology and alcohol dependence were assessed by the South Oaks Gambling Screen (SOGS) and the Diagnostic Interview Schedule (DIS). RESULTS: Current pathological gambling had an overall prevalence of 1.3% as measured by the DIS and 1.9% as measured by the SOGS, with a higher prevalence among minorities and lower socioeconomic status (SES) respondents. Current and lifetime alcohol pathology was more common among males and young adults than among females and older adults. Current pathological gambling and alcohol dependence were correlated, and the highest correlation was found among higher SES respondents. CONCLUSIONS: The rate of current pathological gambling in the United States is higher than reported in past surveys. Minorities and lower SES Americans have higher than average rates of current pathological gambling. However, when higher SES persons are classified as current pathological gamblers, they are more likely than lower SES persons to be dependent on alcohol.     

Correlates of current menthol cigarette and flavored other tobacco product use among U.S. young adults

BackgroundFlavored and menthol tobacco products are particularly appealing to young adults. However, little is known about factors associated with their use in this population.PurposeTo examine characteristics associated with using menthol cigarettes, flavored other tobacco products (OTP), and flavored e-cigarettes among young adults.MethodsUsing a nationally representative online sample of young adults (n = 4239) from the Truth Initiative Young Adult Cohort Study, mutually exclusive groups were created from the subset of current tobacco users (N = 1037) for users of menthol cigarettes (N = 311; 30%), non-menthol cigarettes (N = 426; 41%), flavored OTP only users (N = 114; 11%), and non-flavored OTP only users (N = 186; 18%) to examine factors of being in any one group. Data were collected in July 2012.ResultsIn the full multivariable model, significant correlates of current menthol cigarette use were female gender (AOR = 2.08), Black race (AOR = 5.31), other race (AOR = 2.72), Hispanic ethnicity (AOR = 2.46) and self-identifying as a smoker, social smoker, or occasional smoker (AOR = 10.42). Significant correlates of current flavored OTP use were younger age (18–24; AOR = 3.50), self-identifying as a smoker, social smoker, or occasional smoker (AOR = 30) and generalized anxiety (AOR = 0.30).ConclusionsThis study highlights female gender, Blacks/other race/Hispanics, smokers, social smokers and sexual minorities as correlates of menthol cigarette use and younger age as a predictor of flavored OTP use. Restricting access to flavored tobacco products may be one intervention to help slow the tobacco epidemic, particularly among many of the most vulnerable groups—young women and racial and/or ethnic minorities.     

Association of pleasant sensations at cigarette smoking initiation with subsequent tobacco product use among U.S. adolescents

Approximately 20% of high school students and 7% of middle school students in the United States used tobacco products in 2016. One factor that may contribute to tobacco use is pleasant sensations – typically characterized as physiological reinforcement such as a dopamine response, or as social reinforcement such as social acceptance. In the present study, the Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) Study was analyzed to examine the influence of pleasant sensations at cigarette smoking initiation on current use of other tobacco products among adolescents. While those who reported higher unpleasant sensations at cigarette smoking initiation were less likely to report current use of any tobacco product(s) (Odds Ratio [OR] = 0.70), those who reported higher pleasant sensations at cigarette initiation were more likely to report current use of any tobacco product(s) (OR = 2.12) – including: cigarettes (OR = 2.09), cigars (OR = 1.58), hookah (OR = 1.37), and e-cigarettes (OR = 1.37). Based on these findings, interventions for smoking education and further surveillance may benefit adolescents who report higher pleasant sensations at cigarette smoking initiation.     

The U.S. medicine chest: Understanding the U.S. pharmaceutical supply chain and the role of the pharmacist

The U.S. capacity to manufacture key essential medications has diminished. The U.S. pharmaceutical supply chain (USPSC) has diversified and now relies on international sources of active pharmaceutical ingredients and finished drug products (FDPs). Despite years of effort raising concerns about the USPSC, pharmacists and pharmacy technicians continue to spend a substantial amount of time and energy responding to, and mitigating the impact of, medication shortages, drug recalls, and the adverse outcomes related to low-quality medications. The extent of U.S. reliance on foreign sources of medications is largely unknown. Pharmacists do not have a reliable way to determine the country of origin (i.e., source), capacity, or geographic location of pharmaceutical manufacturers, limiting our ability to anticipate challenges or mitigate risks to our Nation’s drug supply. The U.S. Food and Drug Administration’s task of regulating quality and safety is challenging and will likely require additional safeguards and resources. In addition to pharmacists’ engagement, solutions will likely need to leverage a mix of policy, economic incentives, and expanded objective surveillance testing. The U.S. pharmaceutical supply chain is complex, global, and goes beyond FDPs. The 2020 American Pharmacists Association House of Delegates has rightly asserted that “The quality and safety of pharmaceutical and other medical products and the global pharmaceutical and medical product supply chain are essential to the United States national security and public health.” Pharmacy professionals on the front line engage with patients, identify medication-related issues, and engage in drug-procurement decisions. Pharmacists are essential to our nation’s overall health and must be engaged in the development and implementation of strategies to safeguard the USPSC.     

Neighborhood socioeconomic status and substance use by U.S. adults

Background

This study examined relationships of extremes in neighborhood socioeconomic status with use of tobacco, alcohol, marijuana and other drugs. Hypotheses were (1) residence in disadvantaged neighborhoods would be positively associated with stress-related and higher-risk substance use patterns (e.g., drug use), and (2) residence in affluent neighborhoods would be positively associated with “healthy” substance use (e.g., drinking within recommended guidelines) and negatively associated with substance use patterns incompatible with a culture of health. Age was examined as a potential moderator.

Methods

Data were from nationally-representative samples of U.S. adults (N = 14,531) from the 2000 and 2005 National Alcohol Surveys linked with indicators of neighborhood SES from the 2000 U.S. Decennial Census. Analyses included gender-stratified multivariate logistic regression using weights to adjust for sampling and non-response.

Results

As hypothesized, compared to middle-class neighborhoods, residence in disadvantaged neighborhoods was associated with higher odds of both men's and women's tobacco use and with women's other drug use. Residence in affluent neighborhoods was associated with lower odds of men's tobacco use and women's marijuana use. The association of neighborhood SES with men's tobacco use was modified by age, with the highest odds of daily tobacco use evident for all men in disadvantaged neighborhoods, as well as for younger men in middle-class neighborhoods. There were no significant associations of either alcohol outcome with neighborhood SES.

Conclusions

Increased risk of substance use for younger residents in both disadvantaged and middle-class neighborhoods and for older residents in disadvantaged neighborhoods suggest a need for targeted prevention interventions.     

Use of ephedra among rural-dwelling U.S. adolescents

Prior to 2004, ephedra had been readily available to adolescents. Due to reports that use of ephedra produced a number of serious adverse consequences, including death, sales of the compound became illegal in the United States on April 12, 2004. Data are presented from a random sample of 156,050 students in grades 7 through 12 from 185 rural communities across the United States who completed the Community Drug and Alcohol Survey. This study provides a valuable epidemiological benchmark of reported rates of lifetime prevalence of ephedra by adolescents living in rural America before the sale of the drug became illegal (data were collected between 1996 and 2001). While there were small regional, racial, and gender differences, rates of adolescent use were, in general, very low. The highest rates of ephedra use were found among youth using other drugs, particularly stimulants. The study's limitations and implications are discussed.     

Use of Ephedra among Rural-Dwelling U.S. Adolescents

Prior to 2004, ephedra had been readily available to adolescents. Due to reports that use of ephedra produced a number of serious adverse consequences, including death, sales of the compound became illegal in the United States on April 12, 2004. Data are presented from a random sample of 156,050 students in grades 7 through 12 from 185 rural communities across the United States who completed the Community Drug and Alcohol Survey. This study provides a valuable epidemiological benchmark of reported rates of lifetime prevalence of ephedra by adolescents living in rural America before the sale of the drug became illegal (data were collected between 1996 and 2001). While there were small regional, racial, and gender differences, rates of adolescent use were, in general, very low. The highest rates of ephedra use were found among youth using other drugs, particularly stimulants. The study's limitations and implications are discussed.