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Adequate counseling from a pharmacist concerning anticoagulation therapy is crucial to the wellbeing of patients. No studies have fully examined the relationship between health literacy, patient-pharmacist communication, and anticoagulation control.To evaluate the relationship between health literacy and the perceived quality of patient-pharmacist communication among those receiving anticoagulation therapy.This investigation utilized structured telephone interviews to evaluate the relationship between health literacy and perceived quality patient-pharmacist communication among patients receiving anticoagulation therapy. Two hundred-twenty participants prescribed anticoagulation therapy continuously for at least 6-months served as the sample for this study. A previously validated one-item screening tool was utilized to estimate health literacy. The primary outcome was patients' perceptions regarding the general communication process with pharmacists, according to the Interpersonal Process of Care questionnaire.Patients possessing inadequate health literacy reported significantly less favorable ratings for the perceived quality of pharmacist communication on the domains of general clarity (p = 0.02), responsiveness to patient concerns (p=0.01), empowerment (p = 0.01), and consideration of patients' desire and ability to comply with recommendations (p = 0.01). Inadequate health literacy was found to be independently associated with poorer quality interpersonal processes of care across the domains of responsiveness to patient concerns and empowerment, (β = -0.207, P =0.01 and β = -0.137, P = 0.04, respectively). Patients with inadequate health literacy did not differ significantly from those with adequate health literacy in terms of time within therapeutic INR range or percent of INRs in therapeutic range over the previous 12 months.Patients receiving anticoagulation therapy and possessing inadequate health literacy appear more likely to percieve poorer communication with pharmacists. This seems especially true as it relates to the percieved time and attention pharmacist devote to the communication encounter, as well as the sense pharmacists provide patients concerning their ability to influence health outcomes.

Objectives Evaluate the impact of an educational intervention based on Theory of Planned Behavior (TPB), on enhancing pharmacy students' attitudes toward health literacy, perceived behavioral control and intentions concerning communicating with patients possessing inadequate health literacy. Methods This TPB-based, educational approach consisted of two 50-minute sessions and employed a pretest/posttest control group design. During the first session, experimental students were provided a 50-minute presentation and two out-of-class assignments. The second session included discussion of the assignments, in-class demonstrations, and small group learning activities. The intervention was administered to third year pharmacy students ( n = 40). Second year pharmacy students ( n = 42) served as controls. Three scales measured the TPB constructs. Results Analyses revealed significant improvements over time within the experimental group for attitudes toward health literacy ( p = 0.033) and perceived behavioral control concerning communicating with patients possessing inadequate health literacy ( p = 0.033). Intentions to communicate were high for both groups at pretest and no differences were found to exist for this construct in any analyses. Conclusions Given the number and severity of negative health related consequences associated with inadequate health literacy, it is imperative that schools of pharmacy be proactive and in preparing students to address patients' health literacy needs. This TPB-based, educational intervention may assist other pharmacy programs in their efforts of incorporating health literacy into their curriculums. The intervention may also be modified and implemented in advanced pharmacy practice experiences, residency programs and continuing education programs.

Objective To evaluate the effect of a social cognitive theory (SCT)-based intervention on the constructs of situational perception, behavioral capabilities, outcome expectations, outcome expectancies, and self-efficacy concerning over-the-counter (OTC) pain medications among an adolescent population. Design Pre–posttest control group design. Setting Rural high school in the southeastern United States, between February and March 2011. Participants 203 high school students recruited from 10 classrooms. Intervention Classrooms were randomly assigned to an SCT-based education intervention group or the control group. Pre- and posttest data were collected from each group 2 weeks before and 2 weeks after the intervention was delivered. Main outcome measures Change in the five selected constructs of SCT. Results Compared with the control group, significant improvements at posttest were observed in the intervention group for outcome expectations of OTC pain medications ( P ≤ 0.05) and behavioral capabilities ( P ≤ 0.05). Conclusion The results suggest that lessons based on SCT to improve the outcome expectations that an adolescent population places on the consumption of OTC pain medications may assist in developing the knowledge and skills needed to consume these products properly.

Objective: The purpose was to assess factors potentially affecting care pharmacists provide to HIV/AIDS patients including comfort level, confidence, education, experience, professional competence, continuity of care and patient-provider relationship between pharmacists and HIV-infected patients. Methods: A 24-item questionnaire assessed the constructs of this study. Surveys were distributed from October 2009 to April 2010 to pharmacists in Alabama with varying levels of experience treating HIV-infected patients. Chi-square tests determined whether relationships existed between responses, consisting of how often respondents reported treating HIV-infected patients, amount of HIV education respondents had, participants' confidence with HIV/AIDS knowledge and comfort level counseling HIV-infected patients about their medications. Results: Thirty-three percent of the pharmacists cared for HIV-infected patients on a monthly basis, yet 86% do not feel very confident with their HIV/AIDS knowledge. Forty-four percent were not comfortable counseling patients on antiretroviral medications, and 77% would feel more comfortable with more education. Significant, positive relationships were revealed concerning how often respondents treat HIV-infected patients and their comfort level counseling them (r=0.208, p

Objective: All currently available definitions of health literacy may be considered quite general. Given the complex nature of the patient-pharmacy encounter and the varying tasks required to properly and successfully consume or administer medication or to adhere to a pharmaceutical care regimen, these available definitions may describe inadequately a patient’s health literacy for the purpose of pharmacotherapy and pharmacist intervention. Therefore, the objective of this research was to conceptualize the Pharmacotherapy Literacy construct.Methods: Licensed pharmacists (n=2,368) were mailed a questionnaire providing them with the Healthy People 2010 definition of health literacy and asked, “Given this definition, how would you define Pharmacotherapy Literacy?” A total of 420 usable surveys were returned of which 176 (42%) included responses to the open-ended question concerning pharmacotherapy literacy. Responses were reviewed independently and collectively by the authors. Common themes were identified, compared and discussed until consensus was reached. An initial definition was formulated and distributed to six doctoral-trained academicians and practicing pharmacists who were asked to offer their opinions of the definition as well as suggestions for its improvement. The definition was modified and subjected to further review from 15 additional doctoral-trained academicians and practicing pharmacists who provided feedback concerning its improvement.Results: Based on the recommendations received from the academicians and pharmacists, the following, final definition was formulated by the authors: Pharmacotherapy Literacy – An individual’s capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g. written, oral, visual images and symbols).Conclusions: As the ever-changing pharmacy environment continues to advance and become more complex in nature, a definition of health literacy specific to the pharmacy setting—thereby providing a name and a focus—may improve medication consumption, medication safety, and the patient-pharmacist relationship. Keywords: Health Literacy. Drug Therapy. Medication Errors. Consensus.

The purpose of this study was to examine pharmacy students' knowledge about, attitudes toward, and intention to provide pharmacy-based immunization services (PBIS). Students enrolled in the third professional year of pharmacy school were surveyed using a 30-item survey to assess their knowledge about PBIS, attitude toward PBIS, intention to provide PBIS, and their demographics. Data were analyzed using descriptive statistics and bivariate correlations. Approximately 80% of students felt they had sufficient knowledge/skills to provide PBIS upon graduation; mean knowledge score was 7.12 ± 1.552 (10-point scale) and 58% intended to do so. Statistically significant correlations were found between students' perceived knowledge/skills and their intent to provide PBIS, and between students' attitudes toward PBIS and their intent to provide these services ( p

The effect of symbols on conveying health information has been studied in a variety of contexts and populations. This investigation assessed whether short-term recall of prescription medication information could be enhanced in a low health literate population through the use of symbols. Participants recruited from various nonpharmacy educational service locations were randomly assigned to receive a prescription medication information leaflet in either a text-only, text with symbols, or symbols-only format and then administered the Rapid Estimate of Adult Literacy in Medicine (REALM). Only those with REALM scores indicative of a sixth grade or lower reading level were included in data analysis. An 8-item, interviewer-administered questionnaire was used to assess participants' recall of information contained in the leaflet. A fictitious medication was used to control for participants' past experiences with medications. Results of statistical testing revealed that the three groups did not differ with respect to their ability to recall the medication information, F(2, 157) = 0.943, p = .392. The symbols used in this investigation were not found to enhance the short-term recall of the medication information presented. These findings should not be considered a wholesale indictment of the use of symbols within health care and in pharmacies. Rather, they should serve as a caution to their widespread use without careful consideration.

Objective: To determine the influence of demographics on patient preferences for community pharmacist attire. Methods: A 10-item questionnaire was developed and administered to patients visiting a chain pharmacy or an independent pharmacy in the Birmingham, Alabama metropolitan area. Mann– Whitney was used to examine if statistical differences existed in chain versus independent pharmacy patient’s selections based on pharmacist attire. Results: A statistically significant difference in patient preference for pharmacist attire between the settings in regards to which pharmacist patients felt was more approachable was observed; 51.2% of chain pharmacy respondents compared to 30% of independent pharmacy respondents identified the pharmacist pair with business formal attire and white coat as more approachable. Differences in education was also apparent with 70% of respondents in the independent pharmacy setting reporting having a Bachelor’s degree or higher compared to 45% of respondents in the chain pharmacy setting. Conclusion: With the exception of approachability, patients indicated preference for pharmacist with the white coat regardless of community setting. Given the importance of patient-pharmacist communication for building successful patientpharmacist relationships, if patients do not perceive the pharmacists as approachable, communication and subsequent development of said relationships may not occur regardless of perceived knowledge and competency.

To evaluate first-year doctor of pharmacy (PharmD) students' communication apprehension, outcome expectations, and self-efficacy for communication over the duration of a 15-week patient-counseling course.First-year PharmD students (n=94) were asked to complete a 47-item, self-administered questionnaire on 3 occasions over the duration of the Nonprescription Drugs/Patient-Counseling course during the fall 2009 and 2010 semesters.Eighty-seven of 94 students completed the survey instrument across data collection periods. There were significant reductions in total communication apprehension scores and in the communication apprehension subscores for meetings and public speaking, and significant increases in self-efficacy over time. No differences were found for outcome expectations of communication scores or the subscores for interpersonal conversations and group discussion.Communication apprehension may be decreased and self-efficacy for communication increased in first-year PharmD students through a 15-week Nonprescription Drugs/Patient-Counseling course using small-group practice sessions, case studies, and role-play exercises in conjunction with classroom lectures.