Tennessee emergency medicine workforce, 2009.

Objective: Describe the characteristics of the Tennessee (TN) Emergency Medicine (EM) workforce.

Methods: A cross-sectional mail survey of all non-government emergency departments (EDs) in TN was performed between January and April 2009. Data collected included: number and residency training of physicians, ED volume, employment and type of mid-level providers.

Women's understanding of different dosing instructions for a liquid pediatric medication.

Introduction: Dosing errors by caregivers are common and often are directly attributed to poorly designed instructions. The purpose of this study was to assess whether instruction wording--that is, implicit versus explicit dosage intervals--was associated with participants' ability to describe and correctly measure a dose of a commonly prescribed liquid pediatric prescription medication.

Methods: English-speaking women (N = 193) of child-bearing age were recruited to participate in this study from an outpatient residency clinic in the southeastern United States.

Terminology matters: patient understanding of "opioids" and "narcotics".

Background:  The terms "opioid" and "narcotic" are often used interchangeably by healthcare providers. The purpose of this study was to compare understanding "narcotics" vs. "opioids.

Generic medications for you, but brand-name medications for me.

Background: Because generic medications are less expensive than brand-name medications, government and private insurers have encouraged and/or mandated the use of generics.

Objective: This study aimed at evaluating perceptions about generic medications among English-speaking women of childbearing age currently enrolled in U.S.

Smoking cessation: barriers to success and readiness to change.

Background And Objectives: Smoking cessation interventions should be individualized based on patient history and readiness for change. The objective of this study was to assess stages of change and key components of smoking and cessation history among a sample of primary care patients.

Methods: A telephone survey of current or recent smokers identified smoking status, stage of change, motivation, concerns, relapse history, pharmacotherapy, and social support.

Characteristics of container labeling in a sample of commonly prescribed children's oral medications.

Background: Time constraints often limit the amount of instruction pharmacists can provide to patients regarding accurate prescription medication use.

Objectives: To assess the content, text point size, and reading difficulty of medication container labels and auxiliary warning labels (stickers) of 2 commonly prescribed children's medications (prednisolone and amoxicillin) dispensed by 20 US pharmacies. Secondly, to examine variability of pharmacy interpretations of electronically generated physician instructions (signatures [sigs]).

Evaluation of consumer medical information and oral liquid measuring devices accompanying pediatric prescriptions.

Objectives: The aim of this study was to assess supplementary materials accompanying 2 commonly prescribed pediatric medications, including the following: 1) readability and layout characteristics of pharmacy-generated consumer medical information(CMI); and 2) types and features of oral liquid measuring devices(OLMDs) provided.

Methods: We filled the same two prescriptions (prednisolone and amoxicillin) at 20 pharmacies (national grocery store chain [n = 1], regional grocery store chains [n = 4], national pharmacy chains [n = 3], national superstore chains [n = 3], and independently owned [n = 9]) across three states (Colorado,Georgia, and Tennessee). We evaluated readability, using both the Flesch-Kincaid (FK) formula and McLaughlin's Simplified Measure of Gobbledygook (SMOG), and text point size of pharmacy-generated CMI.

Do medication samples jeopardize patient safety?

Background: Medication samples are commonly dispensed by prescribers. Written consumer medication information (CMI) provided with sample packaging is an important source of patient information. Although one-third of Americans have health literacy deficiencies, previous studies have found that CMI is often too complex for many patients to understand.

Using a home blood pressure monitor: do accompanying instructional materials meet low literacy guidelines?

To evaluate the readability and related features of English language Quick Reference Guides (QRGs) and User Manuals (UMs) accompanying home blood pressure monitors (HBPMs). We evaluated QRGs and UMs for 22 HBPMs [arm (n=12); wrist (n=10)]. Using established criteria, we evaluated reading grade level, language availability, dimensions, text point size, use of illustrations, layout/formatting characteristics, and emphasis of key points of English-language patient instructions accompanying HBPMs.

Comprehensibility and readability of patient self-administered opioid assessment screening tools.

Objective: The aims of this study were to evaluate the cognitive complexity and reading demands of patient self-administered Opioid Assessment Screening Tools (OASTs) for use in adults with nonmalignant pain.

Methods: Using comprehensive search strategies, we identified english-language OASTs with established validity and reliability for inclusion in our study. Cognitive complexity of individual OAST statements or questions were assessed using three techniques (number of items, number of words, and linguistic problems), whereas readability was measured using the Flesch-Kinkaid formula.

Blood glucose monitor quick reference guides: are they suitable for patients?

Background: The purpose of this study was to assess readability and related characteristics of English-language Quick Reference Guides (QRGs) accompanying home blood glucose monitors (HBGMs), including reading grade level, dimensions, text point size, illustrations, and layout features.

Methods: Using the 2006 Diabetes Forecast Resource Guide, we identified HBGMs currently available in the United States. Reading grade level was calculated using Flesch Reading Ease (FRE).

Suitability and readability of consumer medical information accompanying prescription medication samples.

Objective: To examine readability and formatting characteristics of consumer medication information (CMI) accompanying prescription medication samples.

Methods: We collected the most commonly used prescription medication samples (n=100) from four out-patient clinics at a large teaching hospital in the Southeastern US. Seventeen percent of samples were not pills/tablets and of such diverse nature (e.

Development and validation of a low-literacy opioid contract.

Unlabelled: Opioid contracts (OPCs) are often used to outline the criteria and circumstances for which opioid medications are prescribed. The purpose of this study was to develop and validate an English-language, low-literacy OPC. Specifically, the low-literacy OPC was designed to outline proper administration of prescribed medication(s) as well as highlight patient responsibilities and expectations.

Literacy demands and formatting characteristics of opioid contracts in chronic nonmalignant pain management.

Unlabelled: Chronic nonmalignant pain affects a significant number of adults, with many requiring opioid medications to manage their symptoms. Although the content of typical opioid contracts (OCs) has been explored, no studies have examined the literacy demands and formatting characteristics of OCs currently used throughout the United States. We evaluated 162 English-language OCs submitted to us by current American Pain Society members residing in the United States.

Effects of naltrexone on repressive coping and disclosure of emotional material: a test of the opioid-peptide hypothesis of repression and hypertension.

Objective: The present study was designed to assess the role of endogenous opioids in the relationship of hypertension to repressive coping.

Methods: Ten hypertensive and 8 normotensive males were given either the opioid antagonist naltrexone or placebo in a randomized, double-blind fashion over the course of four laboratory sessions. Measures of repression and disclosure were completed and blood pressure was assessed during a laboratory stressor protocol.

Suitability of written supplemental materials available on the Internet for nonprescription medications.

Purpose: The suitability, readability, and cultural appropriateness of written supplemental materials available on the Internet for nonprescription medications were examined.

Methods: We videotaped 48 hours of television programming, recording a total of 152 advertisements highlighting 37 unique nonprescription medications. The supplemental materials corresponding to each advertised medication were downloaded and printed in their entirety from each product-specific Web site.

Evaluation of web-based osteoporosis educational materials.

Background: Many women are unaware of risk factors for and consequences of osteoporosis. Hence, patient education is an essential step in preventing and managing osteoporosis. Unfortunately, numerous studies have demonstrated a mismatch between the reading difficulty of typical patient education materials and the reading ability of many American adults.

Nutrition in chronic disease management in the elderly.

Older Americans experience chronic disease at rates well above other segments of our society. Rates of health services use are also 2 to 3 times that of younger age groups. The most rapidly growing segments of America's aging population are also its most nutritionally vulnerable-women, minorities, and those 85 years of age and older.

Patients' attitudes regarding physical characteristics of family practice physicians.

Background: This study examined patient perceptions and attitudes toward various aspects of the male and female physician's professional appearance in the family practice setting.

Methods: Four hundred ninety-six patients from two family practice clinics in Knoxville, Tennessee, completed a valid and reliable questionnaire. Questionnaires were offered to all patients on registering at their respective clinic during a 2-week period.