The Status of Women in US Academic Pharmacy

Objective. To describe the status of women in pharmacy education with particular focus on a 10-year update of a previous study.Methods. Information was obtained from national databases, published reports, scholarly articles, and association websites. Comparisons were made between men and women regarding degree completion, rank, tenure status, leadership positions, research awards, salaries, and career advancement.Results. There have been modest gains in the number of women serving as department chairs and deans. Salary disparities were found between men and women at several ranks within pharmacy practice. Men were more apt to be tenured or in tenure-track positions and received 89.4% of the national achievement awards tracked since 1981.Conclusion. The problem cannot be simply attributed to the pipeline of those entering academia. Barriers to advancement differ between men and women. We recommend that individuals, institutions, and associations implement strategies to decrease barriers and reduce bias against women.     

Emerging role of epidemiologic literacy

BACKGROUND: The ability to understand and apply epidemiology methods is a growing part of pharmacy practice, pharmacy accreditation standards, and evidence-based practice. OBJECTIVE: To examine the trends in epidemiology-related terminology used in the literature over the past 20 years. METHODS: The frequency of the use of epidemiology-related terminology in 3 representative pharmacy journals, 2 representative medical journals, and 1 public health journal from January through December 1984, 1994, and 2004 was recorded. The 3 pharmacy journals were the American Journal of Health-System Pharmacy (formerly American Journal of Hospital Pharmacy), The Annals of Pharmacotherapy (formerly Drug Intelligence and Clinical Pharmacy), and Pharmacotherapy. The 2 medical journals were the New England Journal of Medicine and The Journal of the American Medical Association (JAMA), and the public health journal was the American Journal of Public Health. The number of times an epidemiology-related term was used was summed for each year and each journal. RESULTS: For all the journals examined in this study combined, the proportion of epidemiologic terms used in the literature has increased over the past 20 years. In 1984, of the total articles published in the 6 journals, 7.02% contained epidemiologic terms increasing to 12.27% and 15.46% in 1994 and 2004, respectively. The most dramatic differences in the 20-year comparisons were noted for Pharmacotherapy (0 to 17.75%) and JAMA (7.32 to 26.72%). CONCLUSIONS: The increase in the use of epidemiology-related terms has implications for both curricular planning in schools and colleges of pharmacy, as well as for continuing education programs and effective interprofessional communication.     

PIC1 Markov Chain Estimation of Life Expectancy of HIV-Infected Patients: Comparison of Two Treatment Alternatives

In RA clinical trials, functional status is increasingly being used as an outcome measure. While it is rather simple to determine the statistical significance of changes, placing the magnitude of these changes into a clinically meaningful context has not been well documented. MIC is "the smallest difference in score, which patients perceive as beneficial and which would mandate, in the absence of troublesome side-effects and excessive cost, a change in the patient's management" [Jaeschke et al. 1989].
OBJECTIVE: To determine the MIC in functional status, as measured by the Modified Health Assessment Questionnaire (MHAQ).
METHODS: Data from 123 patients were obtained from a randomized clinical trial of a new RA therapy. Outcomes were MHAQ and patient global assessment, measured at baseline and after 4 weeks of treatment. Eight scale items of MHAQ were summed to obtain a total score ranging from 0 to 24. MIC was determined based on unit changes in patient globals. The accompanying change in MHAQ was calculated. Similar analysis was conducted with physician global assessment for comparative purposes.
RESULTS: Changes of 1, 2, and 3 points in patient globals were accompanied by changes of 2.11, 4.14, and 8.4 points in MHAQ. Changes in MHAQ corresponding to patient globals were proportionate, but similar results were not obtained for the physician global.
CONCLUSION: Inconsistencies in patient and physician assessments stress the continued need for including both perspectives in assessments of new RA therapies. For the overall MHAQ score, the MIC was approximately 2. These results should increase the ability to interpret results using MHAQ.     

Development and validation of a diabetes mellitus severity index: a risk-adjustment tool for predicting health care resource use and costs

STUDY OBJECTIVE: To develop and validate a diabetes mellitus-specific risk-adjustment tool--the diabetes severity index (DSI)--to assist in predicting health care costs and resources within populations of patients with diabetes. DESIGN: Retrospective analysis of clinical and resource use for patients with a diagnosis of diabetes mellitus. Model estimation was conducted with half the sample, and validation analysis was conducted with the other half. SETTING: Southern Arizona Veterans Affairs Health Care System. PATIENTS: Seven hundred thirty-four patients with diabetes (710 men, 24 women; mean age 66 yrs). MEASUREMENTS AND MAIN RESULTS: Clinical measures of diabetes severity (known as the DSI) were used to predict three health care resource outcomes: risk of hospitalization, and total and ambulatory health care costs. Validity of the DSI was assessed by comparing the DSI with the revised chronic disease score (CDS). The DSI weights ranged from -471.5-3081.2 for total health care costs, from -304.3-1582.1 for outpatient costs, and -0.19-0.93 for risk of hospitalization. The DSI explained 6-8% of the variance in total and ambulatory costs and performed significantly (p<0.05) better than demographics alone, but was similar to the CDS. When the DSI was used with the CDS, up to 8% of variability in costs and use were explained. CONCLUSION: The DSI was developed to stratify veterans with diabetes according to diabetes severity and comorbidity. Since additional variance in medical care costs were explained by combining the DSI and CDS, the two indexes may explain different dimensions of a patient's severity of diabetes. However, the utility of such an index based on clinical measures to predict short-term use may be limited due to low yet significant variability explained in the outcomes.