The study purpose was to use the theory of planned behavior to understand factors influencing South Asian consumers’ intention to seek pharmacist-provided medication therapy management services (MTMS). Specific objectives were to assess effects of attitude, subjective norm (SN), perceived behavioral control (PBC), and socio-demographics on South Asian consumers’ intention to seek MTMS. Participants who were ≥18 years of age, of South Asian origin, with a previous visit to a pharmacy in the US for a health-related reason, and with ability to read and comprehend English were recruited from independent pharmacies in New York City. Responses were obtained through a self-administered survey. Descriptive statistics were performed, and multiple linear regression analysis was conducted to assess the study objective. SPSS was used for data analyses. Out of 140 responses, 133 were usable. Mean scores (standard deviation) were 4.04 (0.97) for attitude, 3.77 (0.91) for SN, 3.75 (0.93) for PBC, and 3.96 (0.94) for intention. The model explains 80.8% of variance and is a significant predictor of intention, F (14,118) = 35.488, p < 0.05. While attitude (β = 0.723, p < 0.05) and PBC (β = 0.148, p < 0.05) were significant predictors of intention, SN (β = 0.064, p = 0.395) was not. None of the socio-demographics were significant predictors of intention. Strategies to make South Asians seek MTMS should focus on creating positive attitudes and removing barriers in seeking MTMS.

PURPOSE: The primary purpose of this study was to evaluate the impact of a patient-centered, chronic care self-management support program of clean intermittent catheterization (CIC) on emergency department (ED) visits and hospitalizations within the first 30 days of starting CIC. Secondary research objectives were to compare reuse of catheters, adherence to healthcare provider–instructed frequency of CIC, and reasons for nonadherence. DESIGN: A correlational survey design with 2 respondent groups. SUBJECTS AND SETTING: Four hundred forty-five respondents met inclusion criteria for this study; 321 respondents enrolled in an intermittent catheter manufacturer–supported CIC support program, and 124 respondents were not enrolled in a support program (comparison group). METHODS: Participants completed a 37-item online questionnaire designed for purposes of this study. Chi-square test was used to assess differences in the proportions of patients with ED visits and overnight hospital admissions comparing respondents enrolled in the patient support program to those not enrolled. Regression analyses were performed to estimate the effect of the CIC support program on ED visit events and on hospital overnight stays. RESULTS: Within the first month of CIC initiation, 16.1% and 10.2% of the respondents in the comparison group reported at least 1 ED visit and at least 1 overnight hospital stay, respectively. Respondents participating in the CIC support program experienced a 47% decrease in ED visits (adjusted rate ratio: 0.53; 95% confidence interval: 0.30-0.94, P = .036) and a 77% decrease (adjusted rate ratio: 0.24; 95% confidence interval: 0.10-0.62, P = .002) in hospital overnight stays within the first month of CIC initiation, while controlling for age, sex, education, duration of CIC use, region, health insurance status, and medical conditions necessitating CIC. Respondents in the CIC support program group reported an 8% higher adherence rate with the healthcare provider–instructed frequency of CIC usage compared to the comparison group (88% vs 80%, P = .039). CONCLUSIONS: The burden of CIC-related complications within the first month of CIC initiation is significant. A patient-centered, chronic care self-management program for CIC was associated with fewer ED visits and overnight hospital stays during the first month of CIC and improved adherence to prescribed frequency of CIC use.

Objective: Although studies examining utero exposure to prescription stimulants have suggested an association with maternal and fetal adverse events, results have been inconsistent. Therefore, clinicians may not have clear guidance about stimulant use during pregnancy. The objective of this study was to evaluate maternal and fetal risks of prescription stimulant exposure among women of reproductive age throughout the continuum of pregnancy in a large, commercially insured United States population. Methods: We used a large administrative claims database from 2013 to 2021 to compare stimulant exposed pregnancies to a matched cohort of non-exposed pregnancies. Stimulant exposed pregnancies included early stimulant use, defined as one or more stimulant prescription fills at any point during the first trimester and continued exposure, defined as continuation into the second or third trimesters. Relative risk regression models were used to compare the risk of each outcome between exposure and duration of exposure cohorts matched on clinical conditions and medication used by 1:1 greedy neighbor propensity score matching. Results: Among a sample of 10,265 matched patients, early stimulant exposure (first trimester only) was associated with a higher likelihood of live birth (RR = 1.08, 95% CI [1.06, 1.10]) and lower risks of spontaneous abortion (RR = 0.69, 95% CI [0.64, 0.76]) and preterm birth (RR = 0.75, 95% CI [0.62, 0.90]) compared with no stimulant exposure. Stillbirth and ectopic pregnancy did not differ. When exposure continued into the second or third trimesters, risks increased for placental abruption (RR = 1.63, 95% CI [1.03, 2.57]), pre-eclampsia (RR = 1.42, 95% CI [1.19, 1.69]), gestational hypertension (RR = 1.37, 95% CI [1.16, 1.61]), and preterm birth (RR = 1.34, 95% CI [1.12, 1.62]) compared with non-exposed pregnancies. Stillbirth was not significantly different in this comparison (RR = 1.42, 95% CI [0.76, 2.67]). Direct comparison of continued versus early exposure highlighted more pronounced risks with continuation: higher stillbirth (RR = 3.54, 95% CI [1.48, 8.44]), spontaneous abortion (RR = 1.53, 95% CI [1.38, 1.68]), preterm birth (RR = 1.86, 95% CI [1.51, 2.28]), placental abruption (RR = 1.78, 95% CI [1.11, 2.84]), and pre-eclampsia (RR = 1.33, 95% CI [1.12, 1.59]). Small-for-gestational-age infants were also more frequent in the continuation group (RR = 1.47, 95% CI [1.12, 1.92]). Analyses stratified by stimulant class (amphetamine vs methylphenidate containing) were directionally consistent with the overall findings. Conclusions: Although early stimulant exposure was not associated with increases in maternal or fetal risk, our study suggests that continuation of stimulants into trimesters 2 and/or 3 may increase some pregnancy complications including stillbirth, preterm birth, hypertensive disorders of pregnancy, and placental abruption. Clinicians should consider these risks when making the decision to continue stimulants during pregnancy, especially in treating ADHD.