Research in social & administrative pharmacy : RSAP
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Res Social Adm Pharm · Mar 2006
Addressing the issue of channeling bias in observational studies with propensity scores analysis.
Randomized Clinical Trials (RCTs) remain the gold standard for determining the utility of pharmaceuticals especially from a safety and efficacy standpoint. However, restrictive entry criteria and stringent protocols can be barriers to generalizing RCT findings to real world practices and outcomes. Observational studies overcome these limitations of RCTs since they are representative of real world populations and practices. ⋯ During the course of this manuscript we discuss tests for determining the quality of the derived propensity score, various techniques for utilizing propensity scores, and also the potential limitations of this technique. With the increasing availability of high quality pharmaceutical and medical claims data for use in observational studies, increased attention must be given to analytic techniques that adjust optimally for non-random assignment and resulting channeling bias. For research studies using observational study designs, propensity score analysis offers a reasonable solution to address the limitation of non-random assignment, especially when RCTs are too costly, time-consuming or not ethically feasible.
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Res Social Adm Pharm · Dec 2005
Factors affecting collaborative care between pharmacists and physicians.
To have a positive impact on patient outcomes achieved with drug therapy, it is likely that pharmacists will work more closely with physicians to manage medications collaboratively. Yet, little is known about the factors that will support such collaborative care between pharmacists and physicians. ⋯ Overall, the collaborative working relationship model largely explained collaborative care between pharmacists and physicians. Researchers are encouraged to use these findings when studying pharmacist-physician collaboration. In addition, pharmacists seeking to work with physicians should attend to developing trustworthiness and clarifying their clinical roles with physicians.
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Res Social Adm Pharm · Sep 2005
Patient decision making: strategies for diabetes diet adherence intervention.
Patient self-care is critical in controlling diabetes and its complications. Lack of diet adherence is a particular challenge to effective diabetes intervention. The Transtheoretical Model (TTM) of Change, decision-making theory, and self-efficacy have contributed to successful tailoring of interventions in many target behaviors. ⋯ The TTM measures for the stages of change, decisional balance, and self-efficacy are useful for making decisions on individually tailored interventions for diet adherence, with caution asserted about the potential of diabetes patients to self-report the target behavior in a socially desirable manner. Future research directions, implications, and limitations of the findings are also presented.