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The aim of this study was to compare the SF-36 and two disease-specific instruments--St. George's Respiratory Questionnaire (SGRQ) and Chronic Respiratory Disease Questionnaire (CRDQ) among chronic obstructive pulmonary disease (COPD) patients using healthcare utilization data. The three instruments were administered twice by telephone interview to 40 COPD patients separated by a 3-month interval. Healthcare utilization data were obtained for the 3 months immediately prior to each administration. Reliabilities for sub-scales on the three instruments ranged from 0.70 to 0.90 for the SF-36, from 0.78 to 0.85 for the SGRQ, and from 0.64 to 0.91 for the CRDQ. In general, the study sample had poor physical health, and somewhat better mental health. None of the demographic variables were significantly associated with either health status or utilization. Among the three instruments, the SF-36 explained the most variance in healthcare utilization. The aggregate scores such as the summary scores of the SF-36 and the total score of the SGRQ did not perform as well as the individual sub-scales of the respective instruments in explaining the variation in utilization. The conclusion that the SF-36 provides the best association to healthcare utilization data from among the three instruments studied should be interpreted with caution given the small sample size and relatively brief duration of the study.

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OBJECTIVES: (1) To characterize pharmacists who work part-time and compare them with pharmacists who work a secondary part-time job (moonlighters) with respect to their motivations for working in a part-time job, and (2) to identify the set of characteristics that best describes pharmacists engaged in each of the part-time work arrangements under study. DESIGN: A five-page questionnaire was mailed to 3,002 licensed pharmacists nationwide. Two follow-up surveys were sent to nonrespondents at the fifth and ninth weeks from the original mailout to ensure an adequate response rate. RESULTS: The net response rate was 57% (n = 1,637). Assessment of the sample did not detect any potential nonresponse bias. Sixty-eight percent of the respondents reported working full time, 13% were moonlighters, 14% were part-timers, and 5% were part-timers in more than one job. Reasons for working part-time were analyzed for the moonlighter and part-timer subsamples. A principal components analysis revealed that both groups have distinct motivations for selecting their chosen work arrangement. CONCLUSION: This study provides some insight into those factors affecting pharmacists' decisions to engage in two different types of part-time work. Since pharmacists' alternative work schedules can have repercussions on the quality of pharmacy being practiced, further research on pharmacists' work arrangement choices should provide useful information for work force-related endeavors.

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Despite the success of health education programs for patients with asthma, several researchers have found that patients are reluctant to enroll in and complete a program designed to help them manage their condition. The purpose of this study was to identify factors that influence asthma patients' willingness to pay (WTP) for and willingness to give time (WTGT) to an asthma self-management program. The patient sample consisted of 116 adult asthma patients (age range, 18 to 34 years) from 2 affiliated sites: a county teaching hospital with ambulatory clinics and a staff-model health maintenance organization. To determine WTP and WTGT, patients were presented with a scenario in which the components of an 8-week asthma management program were described. Patients were then asked how much they would be willing to pay for and how much time they would be willing to spend on the program. Regression analyses were used to determine what effect the following factors had on WTP and WTGT with respect to an asthma self-management program: sociodemographic factors; predisposing, enabling, and reinforcing factors; level of asthma self-management; and health care utilization. Mean patient WTP was $29.50 for an 8-week asthma education program. Several factors appeared to influence this amount. Patients who were willing to pay more for a program that would help them manage their asthma exhibited suboptimal behaviors during asthma attacks, had greater perceived access to health care resources, received less educational information from health care providers, had previously participated in a self-management program, and had indicated an interest in participating in a self-management program. This model was statistically significant (P < 0.0001), with 35% of the variation in WTP scores explained by the independent variables. Patients reported that they were willing to spend a mean of 5.8 hours per week on an 8-week asthma self-management program. Patients who were willing to spend more time on an asthma self-management program had indicated an interest in participating in such a program, had a higher number of comorbidities, or had more emergency department visits. This model was statistically significant (P = 0.0018), with 18% of the variance explained. This study identified several factors that may affect WTP and WTGT in relation to an asthma self-management program. This information may be helpful in identifying candidates for educational programs.

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Several major trends were observed in these findings from the 1990-91 National Pharmacists' Compensation Survey (for details see the final report). Only 72.6% of licensed pharmacists were working full-time in pharmacy; another 14.4% were working part-time in pharmacy, and nearly 13.0% were either not working in pharmacy or not working at all. Although 90.0% of active men pharmacists were working full-time, only 70.7% of active women pharmacists were working full-time. Men were more likely to be working in independent and chain pharmacies as a manager or owner. Women were more likely to be working in hospital or chain pharmacies as a staff pharmacist. Pharmacists' base salary in 1990 was substantially higher for men than for women with averages of $46,661 versus $42,668. Total pharmacy compensation showed a similar pattern but an even greater spread between men and women with averages of $51,032 versus $44,751. However, after adjusting for years in practice and number of hours worked per week, the base HWE for employee pharmacists shows that men and women pharmacists do get "equal pay for equal work" in the first 20 years of practice. The difference that develops between men and women with more years in practice is probably due to the higher proportion of men in management positions and to differences in practice setting preferences.(ABSTRACT TRUNCATED AT 250 WORDS)

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A nationwide mail survey of a random sample of the American Pharmaceutical Association membership was conducted to study the degree of burnout among pharmacists and to identify individual and job characteristics that make a pharmacist susceptible to burnout. Analysis of 1,261 returned questionnaires (57.1% response rate) revealed moderate levels of burnout among pharmacists. The study found that the typical pharmacist who reported the highest level of burnout was a woman less than 40 years old, who works in a chain community pharmacy setting, and who has been in practice and in the same job for less than 10 years. Further work is needed to identify other personal and practice conditions that make pharmacists susceptible to burnout. In the meantime, employees are encouraged to establish interpersonal communications designed to identify and deal with signs of burnout.

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Pharmacists were asked to rate their willingness to accept 12 hypothetical third-party prescription contracts offering different combinations of dispensing fees, average wholesale price levels for the ingredients, and payment lag times. Dispensing fee explained the most variance in the dependent variable of willingness to accept third-party contracts, followed by payment lag time and average wholesale price level.

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This study was conducted to establish normative data as well as evaluate the construct validity and reliability of the three subscales of the Maslach Burnout Inventory when given to a national sample of USA licensed practicing pharmacists. Data were subjected to principal factors analysis with iteration and a varimax rotation to obtain a three-factor solution. Visual analysis and statistical comparison provided empirical support for the presence of the hypothesized (a priori) constructs of Emotional Exhaustion, Depersonalization, and Lack of Personal Accomplishment. Internal consistency of the derived subscales, as measured by Cronbach's alpha coefficient, were comparable with previous data. Pharmacists' subscale scores were significantly lower than those obtained in studies of the helping professions.

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This study attempted to identify and develop an understanding of the use of 13 nondispensing services (NDSs) by consumers in the community pharmacy practice setting. A self-administered, postage prepaid questionnaire was sent to 1000 Indiana consumers randomly selected from telephone directories. A 45.5 percent response rate was achieved after one original mailing and two follow-ups. Most consumers had not used NDSs except for advice on nonprescription drugs and advice on minor health problems. Nevertheless, a substantial number of consumers expressed interest in many of the remaining services, including advice on diagnostic test kits and information on poison prevention. Consumers' past use of NDSs and their perceptions of pharmacists as providers of these services were important factors in the consumers' intention to use NDSs. Other variables significantly correlated with average intention to use NDSs were: type of pharmacy patronized, anxiety about health, age, and education. It is recommended that future investigations explore in detail consumer behavior with regard to nondispensing services.

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A survey was conducted of pharmaceutical services in 120 of the 325 short-term hospitals associated with accredited pediatric residency training programs, 52 pediatric hospitals, and 68 adult hospitals with pediatric units or floors. The mail survey conducted in 1983 had a 70% response. Centralized pharmaceutical services were offered by the majority of the hospitals. Seventy-two percent of the respondents indicated that either a complete or partial unit dose drug-distribution system was used for most of their pediatric patients, while 25% indicated that they used either the traditional individual patient-fill system or some combination of drug-distribution systems. A total of 80% of the hospitals provided either complete or partial i.v. admixture services. The preparation of total parenteral nutrient solutions was the most common admixture service provided. Clinical services were provided, to some extent, by 63% of the respondents. Computers were used for multiple functions, such as generating patient profiles, organizing the formulary, and providing labels for unit dose and i.v. admixture services, by 33% of the respondents. Selection of therapeutic alternates was performed by pharmacists in 51% of the responding hospitals, and the majority of institutions had formulary systems. Modern drug-distribution systems and clinical services have been established in many hospitals treating pediatric patients.

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There is a continued emphasis on developing the pharmacist's medication counseling role to better serve the public. To understand this role, the present study utilized a shopper methodology to describe the extent to which 40 rural community pharmacists engage in five dimensions of counseling for each of two drug products. The study demonstrates a significant relationship between the attitudes toward counseling held by these practitioners and their actual counseling behaviors.

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The parents of pediatric patients were questioned regarding the use and selection of nonprescription drugs for their children. A questionnaire was distributed to the parents of 200 hospitalized pediatric patients. It gathered information on nonprescription drug use during the six-month and one-week periods before hospitalization, the importance of various sources of advice regarding the need to self-medicate, and the sources of product information and the factors influencing product selection. One hundred sixty questionnaires were returned. Almost all of the children (97.5%) were self-medicated by their parents within the six-month period before hospital admission. Only 21% of the parents usually sought advice before deciding to self-medicate their children. Physician recommendations were noted as an important factor in the selection of a nonprescription product, followed an importance by pharmacists and then other health-care professionals. Professional recommendations all ranked higher than other recommendation sources, such as television, radio, or printed advertisements. Pharmacists should take a more active role in aiding parents in their decision to self-medicate their children.

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This field study examines the applicability of the central components of Fishbein and Ajzen's model for the prediction of behavior to the medication counselling activities of community pharmacists. The findings from a sample of 40 pharmacists provide support for the attitudes-subjective norms model. Both the attitude and subjective norm measures are significant predictors of behavior for verbal instruction provided and the length of encounter time. Each of the other behaviors examined--written instruction provided, monitoring activity, and pharmacist approachability--is weakly to moderately influenced by one of the two independent variables.

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