Bio

Bio


Dr. Ip is Director of Clinical Therapeutics Curriculum for the Stanford University MSPA Program and Clinical Associate Professor in the Department of Medicine, Division of Primary Care and Population Health. He completed his Doctor of Pharmacy degree from UCSF School of Pharmacy and his post-graduate residency at Kaiser Permanente Santa Clara Medical Center. He is a clinical pharmacist specializing in diabetes and cardiovascular care. He established and currently co-leads the Diabetes Management Program at Kaiser Permanente Mountain View Medical Offices. He is also Chair and Professor of Clinical Sciences at Touro University California College of Pharmacy. Dr. Ip's research interests include anabolic steroids and performancing enhancing drugs as well as educational research.

Academic Appointments


Honors & Awards


  • Medscape's Rising Stars of Healthcare Research, Medscape (2017)
  • Professor of the Year, Touro University California College of Pharmacy (2008, 2010-2013, 2016-2017)
  • Teacher of the Year, American Association of Colleges of Pharmacy (2008, 2010)
  • Clinical Preceptor of the Year, Touro University California College of Pharmacy (2010)
  • Fellow, California Society of Health-System Pharmacists (2014)
  • Bowl of Hygeia Recipient, UCSF School of Pharmacy (2006)

Professional Education


  • Pharm.D., University of California, San Francisco School of Pharmacy, Doctor of Pharmacy (2006)
  • B.S., University of California, Davis, Exercise Science (2002)
  • PGY-1 Residency, Kaiser Permanente Santa Clara Medical Center, Pharmacy Practice (2007)
  • BCPS, Board of Pharmacy Specialties, Board Certified Pharmacotherapy Specialist (2007)
  • CSCS, National Strength and Conditioning Association, Certified Strength and Conditioning Specialist (2006)
  • CDE, National Certification Board for Diabetes Educators, Certified Diabetes Educator (2009)
  • APh, California Board of Pharmacy, Advanced Practice Pharmacist (2017)

Teaching

2018-19 Courses


Publications

All Publications


  • Anabolic steroid users' misuse of non-traditional prescription drugs. Research in social & administrative pharmacy : RSAP Ip, E. J., Doroudgar, S., Lau, B., Barnett, M. J. 2019; 15 (8): 949–52

    Abstract

    BACKGROUND: Few anabolic-androgenic steroid (AAS) users disclose their performance enhancing drug (PED) use with their healthcare providers. AAS users practice polypharmacy with prescription medications to counter adverse effects of AAS, to further their muscular gains, or to lose weight.OBJECTIVES: To compare and contrast AAS using and non-AAS using gym clients regarding PED use, in particular prescription drugs.METHODS: The CASTRO (Castro Anabolic Steroid Research Observation) study was a 108-item cross-sectional survey that took place at four gyms in San Francisco, California between August 2015 and January 2016. 40 AAS users and 179 non-AAS users completed the survey.RESULTS: The prevalence of AAS use in the study cohort was 18.3%. AAS users reported using a greater number of total PEDs (8.7 ± 4.2 vs. 3.7 ± 2.1, p < 0.001) than non-AAS users. AAS users were more likely to misuse the following prescription drugs: antiestrogens (tamoxifen, anastrazole), fertility agents (clomiphene, human chorionic gonadotropin), erectile dysfunction drugs (tadalafil, sildenafil), anabolic drugs (clenbuterol, recombinant human growth hormone), and weight loss drugs (liothyronine).CONCLUSIONS: AAS users practice polypharmacy and misuse multiple prescription drugs. These findings allow researchers and clinicians to be more knowledgeable and to anticipate potential misuse of prescription medications that traditionally are not thought to be abused.

    View details for DOI 10.1016/j.sapharm.2018.07.003

    View details for PubMedID 31303195

  • The CASTRO study: Unsafe sexual behaviors and illicit drug use among gay and bisexual men who use anabolic steroids. The American journal on addictions Ip, E. J., Doroudgar, S., Shah-Manek, B., Barnett, M. J., Tenerowicz, M. J., Ortanez, M., Pope, H. G. 2019

    Abstract

    BACKGROUND AND OBJECTIVES: The majority of anabolic androgenic steroid (AAS) studies have focused on the general male population. Approximately 15% of gay or bisexual men are seropositive for HIV and many AASs are administered via injection. Thus, AAS use among gay and bisexual men likely poses a greater risk of spreading infectious disease. Gay and bisexual men who use AAS were compared with non-users regarding self-reported seropositivity for HIV and hepatitis B and C, sexual behaviors and injection practices, illicit drug and alcohol use, and psychiatric disorders.METHODS: The CASTRO (Castro Anabolic Steroid Research Observation) study was a 108-item cross-sectional survey of 153 gay and bisexual men who exercise. Data collection occurred outside four gyms in the San Francisco Castro District.RESULTS: The lifetime prevalence of AAS use among gay and bisexual men in the study was 21.6%. AAS users and non-users did not differ in self-reported seropositivity for HIV or hepatitis B and C, but AAS users reported higher rates of male-male condomless anal sex in the past year (84.8 vs 60.8%, p<.01) than non-users. More AAS users used ecstasy and methamphetamines (39.4 vs 16.7%, p<.01 and 18.2 vs 5.0%, p=.01, respectively) than non-users.DISCUSSION AND CONCLUSIONS: Gay and bisexual men who used AAS were more likely to engage in unsafe sexual behaviors and use illicit drugs relative to non-users. Multiple factors place AAS users at higher risks for spreading infectious diseases.SCIENTIFIC SIGNIFICANT: Our study suggests increased infectious disease risk among gay and bisexual men who use AAS. (Am J Addict 2019;XX:1-10).

    View details for PubMedID 30724428

  • Differences in Career Satisfaction, Work-life Balance, and Stress by Gender in a National Survey of Pharmacy Faculty. Journal of pharmacy practice Ip, E. J., Lindfelt, T. A., Tran, A. L., Do, A. P., Barnett, M. J. 2018: 897190018815042

    Abstract

    INTRODUCTION:: The percentage of women pharmacy students and pharmacy faculty has greatly increased over the last 40 years. However, it is not known whether gender differences exist in terms of career satisfaction, work-life balance, and stress in the pharmacy academia workplace.METHODS:: Results from a national web-based survey administered to American Association of Colleges of Pharmacy (AACP) members were utilized. Bivariate analyses were conducted to compare differences among faculty according to gender (men vs women). A series of multivariate models controlling for demographic and other faculty and school-level factors were created to explore the impact of gender on satisfaction with current position, satisfaction with work-life balance, and perceived stress.RESULTS:: Among the 802 survey respondents, 457 (57.0%) women were more likely to be younger, hold a lower academic rank, and be in a pharmacy practice department, relative to 345 (43.0%) men. In adjusted results, men pharmacy faculty were more likely to report being extremely satisfied with their current job, more likely to report being extremely satisfied with their work-life balance, and score lower on a standardized stress measure relative to women.CONCLUSION:: While primarily descriptive, the results suggest women pharmacy faculty in the United States are less satisfied with their current academic position, less satisfied with their current work-life balance, and have higher stress levels compared to men even after controlling for age, academic rank, and department (along with other factors). Further research is needed to explore and address causes of the observed gender-related differences among pharmacy faculty.

    View details for PubMedID 30518289

  • Transitions of Care Pilot Programs-We Have Your Missing Positive Results JOURNAL OF PHARMACY PRACTICE Thanh, D. N., Bradford, C., Ip, E. J., Kwong, M., Chang, L., Sui, L., Young, G., Barnett, M. J. 2018; 31 (3): 258–59

    View details for PubMedID 29621914

  • Use of condensed videos in a flipped classroom for pharmaceutical calculations: Student perceptions and academic performance CURRENTS IN PHARMACY TEACHING AND LEARNING Gloudeman, M. W., Shah-Manek, B., Wong, T. H., Vo, C., Ip, E. J. 2018; 10 (2): 206–10

    Abstract

    The flipped teaching method was implemented through a series of multiple condensed videos for pharmaceutical calculations with student perceptions and academic performance assessed post-intervention.Student perceptions from the intervention group were assessed via an online survey. Pharmaceutical exam scores of the intervention group were compared to the control group. The intervention group spent a greater amount of class time on active learning.The majority of students (68.2%) thought that the flipped teaching method was more effective to learn pharmaceutical calculations than the traditional method. The mean exam scores of the intervention group were not significantly different than the control group (80.5 ± 15.8% vs 77.8 ± 16.8%; p = 0.253).Previous studies on the flipped teaching method have shown mixed results in regards to student perceptions and exam scores, where either student satisfaction increased or exam scores improved, but rarely both.The flipped teaching method was rated favorably by a majority of students. The flipped teaching method resulted in similar outcomes in pharmaceutical calculations exam scores, and it appears to be an acceptable and effective option to deliver pharmaceutical calculations in a Doctor of Pharmacy program.

    View details for PubMedID 29706277

  • What is the impact of the 2017 cochrane systematic review and meta-analysis that evaluated the use of PCSK9 inhibitors for lowering cardiovascular disease and mortality? EXPERT OPINION ON PHARMACOTHERAPY Jalloh, M. A., Ip, E. J., Doroudgar, S. 2018; 19 (7): 739–41

    Abstract

    In 2017, Schmidt et al. conducted a Cochrane systematic review and meta-analysis to evaluate the effect of using proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors to reduce low-density-lipoprotein- cholesterol (LDL-C) and cardiovascular disease (CVD). The Cochrane review was a systematic review and meta-analysis of 20 randomized, double-blinded trials that compared the use of PCSK9 inhibitors with statins/ezetimibe, ezetimibe, or placebo for a treatment duration of at least 24 weeks. The use of PCSK9 inhibitors lowered the risk for CVD (OR 0.86 (0.80 to 0.92)) but not mortality (OR 1.02 (0.91 to 1.14)) when compared to placebo. Areas covered: The following article evaluates the recently published Cochrane review and clarifies the efficacy of PCSK9 inhibitors for improving cardiovascular morbidity and mortality. Expert opinion: The Cochrane review discussed suggests that PCSK9 inhibitors are effective in lowering LDL-C and the risk of CVD but not the risk of mortality. The higher price of PCSK9 inhibitors is a further deterrent for using them as a substitute for statins - cholesterol lowering medications with history showing they lower mortality. Statins should remain the gold-standard cholesterol-lowering drug class until PCSK9 inhibitors become more affordable and demonstrate consistent efficacy for reducing CVD and mortality.

    View details for PubMedID 29667439

  • Gender-Based Differences Among Pharmacy Students Involved in Academically Dishonest Behavior AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION Ip, E. J., Pal, J., Doroudgar, S., Bidwal, M. K., Shah-Manek, B. 2018; 82 (4): 6274

    Abstract

    Objective. To determine whether differences based on gender exist among pharmacy students involved in cases of admitted cheating or other academic dishonesty and to assess perceptions of academic dishonesty. Methods. Two cohorts of second-year male and female pharmacy students from four Northern California pharmacy programs were invited to complete a 45-item cross-sectional survey. Descriptive statistics and Pearson's chi-squared test were used for statistical analysis. Results. There were 330 surveys completed with a 59% response rate. No significant gender-based differences were found regarding admitted cheating in pharmacy school and in regards to participating in various forms of academically dishonest behavior. Female students were more likely than male students to report witnessing a classmate copying another student's assignment. Male students were less likely than female students to perceive a student who distributed a stolen exam as a cheater. Conclusion. No gender-based differences were noted in cases of admitted cheating or with regards to taking part in various forms of academically dishonest behavior. However, female students report witnessing cheating more than male students, and male students may have a more lenient perception toward academically dishonest behavior than female students. The information gathered from this study may provide further insight to pharmacy programs and educators regarding academic dishonesty at their institution.

    View details for PubMedID 29867239

  • Evaluation of asthma medication adherence rates and strategies to improve adherence in the underserved population at a Federally Qualified Health Center. Research in social & administrative pharmacy Bidwal, M., Lor, K., Yu, J., Ip, E. 2017; 13 (4): 759-766

    Abstract

    Adherence with asthma medications is less than optimal, measuring approximately 30-50%. Several factors have been shown to contribute to medication non-adherence including low-socioeconomic status, low literacy, medication cost, access to care, and language barriers. Community Health Clinic Ole has attempted to reduce medication adherence barriers associated with cost, access to care, and language by 1) allowing medications to be obtained from the clinic at a reduced cost via the 340B drug pricing program and patient assistance programs, and 2) providing one-on-one consultations from bilingual Spanish-speaking clinicians. Limited evidence is available regarding chronic disease-state medication adherence among Spanish-speaking individuals presenting to a Federally Qualified Health Center (FQHC).The purpose of this study is to assess asthma medication adherence and determine predictors of non-adherence in the underserved population at an FQHC.Adult patients with a diagnosis of persistent asthma receiving medication refills from clinic between October 1, 2011 and October 31, 2012 were identified (N = 121). Individuals with intermittent or seasonal asthma only, exercise-induced asthma only, or mixed asthma/COPD; individuals who have not picked up at least one fill of inhaled corticosteroid in the past one-year; and individuals without active prescriptions for asthma controller medications were excluded. Medication adherence was assessed by using the medication possession ratio (MPR) for asthma controller medications (e.g. inhaled corticosteroids, long-acting beta-2 agonists, leukotriene modifiers, and theophylline). Patients were categorized into two adherence groups: medium-high (MPR ≥ 0.5) and low (MPR < 0.5).Approximately one-third of individuals were identified with medium-high adherence to asthma medications, of which only 8.3% of individuals were found to be fully adherent (MPR ≥ 0.8). The majority of individuals (66.1%) were identified with low adherence, despite efforts to reduce medication adherence barriers associated with drug cost, access to care, and language. Patients with low adherence were younger (39.3 vs. 45.4 yo; P < 0.012), had fewer medication refills (2.1 vs. 5.3; P < 0.001), had fewer primary care provider (PCP) visits (3.4 vs. 5.0; P < 0.05), lower baseline Asthma Control Test (ACT) scores (13.1 vs. 17.3; P < 0.001), and lower asthma medication ratios (AMR) (0.7 vs. 0.9; P < 0.001) than patients with medium-high adherence. No significant differences in MPR rates were found between Hispanics and non-Hispanics. The average MPR in both groups was 0.55.Our findings demonstrate that asthma medication adherence remains poor among all underserved patients despite improved access to care via reduced medication pricing and the provision of Spanish-speaking medication consultations at refill pick-ups. Poor adherence rates remained common among both the Non-Hispanic and Hispanic, younger, and lower-socioeconomic patients in our study. Future studies may wish to explore whether providing a service that encompasses healthcare team support, optimal medication counseling, and utilization of patient-centered communication strategies improves asthma medication adherence in the Hispanic population.

    View details for DOI 10.1016/j.sapharm.2016.07.007

    View details for PubMedID 27595427

  • The impact of work-life balance on intention to stay in academia: Results from a national survey of pharmacy faculty. Research in social & administrative pharmacy Lindfelt, T., Ip, E. J., Gomez, A., Barnett, M. J. 2017

    Abstract

    Border-Crossing theory suggests work-life balance and career satisfaction are inter-related and disappointment in work-life balance may predict changes in one's career path. Application of this theory to health profession faculty is plausible but has not been fully explored. The purpose of this study is to examine factors related to reported career change intention among United States pharmacy school faculty and to determine if Border-Crossing theory fits these observations.Results from a national web-based survey administered via Qualtrics® to American Association of Colleges of Pharmacy (AACP) members were utilized. Bivariate analyses were conducted to compare differences among faculty stating an intention to stay or leave academia. A logistic multivariate model was used to determine if work-life balance remains significant when controlling for other variables and if survey results support the Border-Crossing theory.Nearly all (seven hundred of 811 responders, or 86.3%) stated a desire to stay in academia. Faculty with higher work-life balance were more likely to report an intent to remain in academia. Male, older, full-professor and non-pharmacy practice faculty (social or administrative science, pharmacology, medicinal chemistry and others) were more likely to state an intention to remain in academia relative to their counterparts. Lower stress, as measured by the validated Perceived Stress Scale (PSS) scores, was seen among faculty stating a desire to remain in academia. Work-life balance remained significantly inversely related to career change intention after controlling for all other factors.A significant factor related to pharmacy faculty's stated intention to remain in academia was work-life balance. Other factors such as gender, age, rank, stress level and department may also play a role. These results support the application of the Border-Crossing theory in health profession faculty and may provide pharmacy school administrators and stakeholders with insight to foster faculty retention and decrease faculty turnover.

    View details for DOI 10.1016/j.sapharm.2017.04.008

    View details for PubMedID 28416279

  • Polypharmacy, Infectious Diseases, Sexual Behavior, and Psychophysical Health Among Anabolic Steroid-Using Homosexual and Heterosexual Gym Patrons in San Francisco's Castro District SUBSTANCE USE & MISUSE Ip, E. J., Yadao, M. A., Shah, B. M., Doroudgar, S., Perry, P. J., Tenerowicz, M. J., Newsom, L., Mann, A. A., Mkrtchyan, H., Pope, H. G. 2017; 52 (7): 959-968

    Abstract

    Limited studies based in England and Australia reported misuse of anabolic-androgenic steroids (AAS) among homosexual men to enhance body image. Anecdotally, AAS are also being misused by homosexual men in the United States. Since many AAS and certain performance enhancing drugs (PEDs) are administered via injection, this poses a potential vector for the spread of infectious disease in an already at-risk population.This study compared and contrasted homosexual and heterosexual male gym clients regarding use of AAS and PEDs, use of alcohol and illicit drugs, seroprevalence of infectious disease, engagement in risky injection practices and sexual behaviors, and presence of psychiatric conditions.Recruitment and data collection occurred outside four exercise gyms in the San Francisco Castro District area between October 25, 2014 and March 10, 2015. Two hundred and twenty homosexual men and 73 heterosexual men completed the 114-item cross-sectional survey.Ten percent of homosexual men reported lifetime AAS use. Homosexual men had almost four times more sexual partners and were over 14 times more likely to knowingly have unprotected intercourse with a known HIV positive person than heterosexual men. In addition, a quarter of homosexual men who injected drugs admitted to sharing used syringes or needles with another person. Conclusions/Importance: The current study is the first to confirm AAS use among homosexual men in the United States. Homosexual men partook in high-risk sexual behaviors and injection practices which may place them at greater risks for contracting and spreading HIV and other infectious diseases.

    View details for DOI 10.1080/10826084.2016.1267224

    View details for Web of Science ID 000399913400014

    View details for PubMedID 28296533

  • Relationship Between Grit with Academic Performance and Attainment of Postgraduate Training in Pharmacy Students. American journal of pharmaceutical education Palisoc, A. J., Matsumoto, R. R., Ho, J., Perry, P. J., Tang, T. T., Ip, E. J. 2017; 81 (4): 67

    Abstract

    Objective. To determine if Grit-S scores correlate with academic success in a doctor of pharmacy (PharmD) program, as well as the pursuit and attainment of pharmacy postgraduate (residency or fellowship) training. Methods. A 28-item survey was administered to third- and fourth-year (P3 and P4) pharmacy students. Variables queried included Grit-S score, demographics, pharmacy experience prior to the PharmD program, and factors that may affect academic performance during didactic coursework. Didactic coursework GPA was used as a surrogate for academic success. Information about pursuit and attainment of a postgraduate training position was also documented and used in the analyses. Results. There was no significant correlation between Grit-S scores and variables related to academic success. However, students were more likely to pursue postgraduate training with higher academic success and higher Grit-S. Lastly, students with higher Grit-S were also more likely to obtain a postgraduate training position. Conclusion. Grit-S scores correlated with the pursuit and successful attainment of postgraduate training, but not with academic success during the didactic years of a PharmD program.

    View details for PubMedID 28630508

    View details for PubMedCentralID PMC5468705

  • An Analysis of California Pharmacy and Medical Students' Dietary and Lifestyle Practices. American journal of pharmaceutical education Bergeron, N., Al-Saiegh, S., Ip, E. J. 2017; 81 (8): 5956

    Abstract

    Objective. To assess dietary and lifestyle practices of pharmacy and medical students in California and investigate whether they adhered to behaviors consistent with current dietary and exercise guidelines. Methods. The Block Brief 2000 Food Frequency Questionnaire and a supplemental survey assessing demographics, exercise, and dietary behaviors were administered to students across 10 California pharmacy and medical schools. Results. While the majority of students consumed sodium <2300 mg/day (73%) and dietary cholesterol <300 mg/day (84%), only 50% had a saturated fat intake ≤10% total kcal, 13% met fiber intake goals, 10% consumed ≥8 servings/day of fruit and vegetables, and 41% exercised ≥150 minutes/week. The largest barrier to consuming a healthful diet was lack of time. Conclusion. A high proportion of pharmacy and medical students in California did not meet many of the dietary and physical activity recommendations. Health care programs may benefit from implementing nutrition and lifestyle education in their curriculum.

    View details for PubMedID 29200450

    View details for PubMedCentralID PMC5701325

  • Frequency and Perceptions of Herbal Medicine use Among Hmong Americans: a Cross Sectional Survey JOURNAL OF IMMIGRANT AND MINORITY HEALTH Lor, K. B., Moua, S., Ip, E. J. 2016; 18 (2): 397-401

    Abstract

    To determine the frequency and perceptions of herbal medicine use among Hmong Americans. Cross-sectional telephone survey. Sacramento, California Hmong community. Out of 118 subjects reached, 77 (65.3 %) reported lifetime use of herbal medicines. A majority of respondents agreed that herbal medicines were able to treat the body as a whole. Respondents felt that a leaflet of information indicating uses/side effects would be important to include for herbal medicines. Herbal medicine use was commonly reported among Hmong Americans. Thus, health care providers should be encouraged to discuss these alternative medicines with their Hmong American patients.

    View details for DOI 10.1007/s10903-015-0190-4

    View details for Web of Science ID 000373118100015

    View details for PubMedID 25784143

  • Infectious disease, injection practices, and risky sexual behavior among anabolic steroid users AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV Ip, E. J., Yadao, M. A., Shah, B. M., Lau, B. 2016; 28 (3): 294-299

    Abstract

    Anabolic-androgenic steroids (AAS) and other performance-enhancing drugs (PEDs) are commonly misused to increase muscle size and strength, as well as improve physical appearance. Many AAS and certain PEDs are administered via injection and therefore pose a risk for transmission of infectious diseases such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and skin and soft tissue infections (SSTIs). Further, AAS users may be more likely to take part in high-risk sexual behaviors than non-AAS users. This review explores the prevalence of infectious diseases as well as risky injection practices and sexual behaviors of AAS users in the current literature. A comprehensive MEDLINE search (1984-17 April 2015) for English language reports was performed on AAS users. Ten studies analyzed the prevalence of HIV infection, 6 studies analyzed HBV infection, and 6 studies analyzed HCV infection; 20 studies analyzed injection practices and 7 studies analyzed high-risk sexual behaviors of AAS users. HIV, HBV, HCV, and SSTIs have been associated with AAS users. In particular, HIV infection seems much higher among homosexual male AAS users. AAS users also take part in high-risk injection practices but to a much lower extent than intravenous drug users. AAS users are also more likely to engage in high-risk sexual behaviors than the general population. Clinicians and health-policy leaders may utilize these findings to implement strategies to decrease the spread of infectious diseases.

    View details for DOI 10.1080/09540121.2015.1090539

    View details for Web of Science ID 000370682600004

    View details for PubMedID 26422090

  • Motivations and Predictors of Cheating in Pharmacy School AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION Ip, E. J., Nguyen, K., Shah, B. M., Doroudgar, S., Bidwal, M. K. 2016; 80 (8)

    Abstract

    Objective. To assess the prevalence, methods, and motivations for didactic cheating among pharmacy students and to determine predictive factors for cheating in pharmacy colleges and schools. Methods. A 45-item cross-sectional survey was conducted at all four doctor of pharmacy programs in Northern California. For data analysis, t test, Fisher exact test, and logistic regression were used. Results. Overall, 11.8% of students admitted to cheating in pharmacy school. Primary motivations for cheating included fear of failure, procrastination, and stress. In multivariate analysis, the only predictor for cheating in pharmacy school was a history of cheating in undergraduate studies. Conclusion. Cheating occurs in pharmacy schools and is motivated by fear of failure, procrastination, and stress. A history of past cheating predicts pharmacy school cheating. The information presented may help programs better understand their student population and lead to a reassessment of ethical culture, testing procedures, and prevention programs.

    View details for Web of Science ID 000388674800006

    View details for PubMedID 27899829

  • Stress, Drugs, and Alcohol Use Among Health Care Professional Students: A Focus on Prescription Stimulants. Journal of pharmacy practice Bidwal, M. K., Ip, E. J., Shah, B. M., Serino, M. J. 2015; 28 (6): 535-542

    Abstract

    To contrast the characteristics of pharmacy, medicine, and physician assistant (PA) students regarding the prevalence of drug, alcohol, and tobacco use and to identify risk factors associated with prescription stimulant use.Five hundred eighty nine students were recruited to complete a 50-item Web-based survey.Demographics, nonmedical prescription medication use, illicit drug and alcohol use, Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR) psychiatric diagnoses, and perceived stress scale (PSS) scores.Medicine and PA students reported greater nonmedical prescription stimulant use than pharmacy students (10.4% vs 14.0% vs 6.1%; P < .05). Medicine and PA students were more likely to report a history of an anxiety disorder (12.1% vs 18.6% vs 5.9%; P < .05), major depressive disorder (9.4% vs 8.1% vs 3.3%; P < .05), and attention-deficit hyperactivity disorder (ADHD; 4.0% vs 9.3% vs 0.7%; P < .001) than pharmacy students. PSS scores for all 3 groups (21.9-22.3) were roughly twice as high as the general adult population.Illicit drug and prescription stimulant use, psychiatric disorders, and elevated stress levels are prevalent among health care professional students. Health care professional programs may wish to use this information to better understand their student population which may lead to a reassessment of student resources and awareness/prevention programs.

    View details for DOI 10.1177/0897190014544824

    View details for PubMedID 25124376

  • Impact of Educational Levels and Health Literacy on Community Acetaminophen Knowledge. Journal of pharmacy practice Ip, E. J., Tang, T. T., Cheng, V., Yu, J., Cheongsiatmoy, D. S. 2015; 28 (6): 499-503

    Abstract

    Patient understanding of acetaminophen is important for its safe and appropriate self-use. A cross-sectional survey was conducted in the San Francisco Bay Area to determine the impact of educational level, patient health literacy score, and other demographic characteristics on acetaminophen knowledge. A 17-item, in-person, paper-and-pen questionnaire containing questions about demographics and acetaminophen knowledge was administered to 311 adults outside 5 local grocery stores in varying socioeconomic communities. Knowledge assessed was whether Tylenol-McNeil contains acetaminophen, maximum daily dose, and primary organ affected by toxicity. Participant health literacy was evaluated using the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) test. Of the 300 who successfully completed the study, only 3.8% of all subjects were able to answer all 3 acetaminophen knowledge questions correctly regardless of educational level or health literacy score. This reaffirms that a lack of appropriate acetaminophen knowledge remains present in the general population, and further efforts to educate patients will be needed to prevent adverse events.

    View details for DOI 10.1177/0897190014544819

    View details for PubMedID 25112303

  • Characteristics and Behaviors of Older Male Anabolic Steroid Users. Journal of pharmacy practice Ip, E. J., Trinh, K., Tenerowicz, M. J., Pal, J., Lindfelt, T. A., Perry, P. J. 2015; 28 (5): 450-456

    Abstract

    To compare and contrast the characteristics of 2 groups of men ≥40 years old: reported anabolic-androgenic steroid (AAS) users and nonusers.Cross-sectional survey.Thirty-eight online fitness, weight lifting, bodybuilding, and steroid Web sites.A total of 67 male AAS users and 76 male nonusers ≥40 years old.Demographics, utilization of AAS and other performance-enhancing agents (PEAs), exercise patterns, history of illicit drugs and alcohol use, and psychiatric traits/diagnoses.The majority of AAS users ≥40 years old were caucasian (92.5%), heterosexual (97.0%), and classified themselves as recreational exercisers (79.1%). AAS users took more PEAs (11.5 ± 5.6 vs 4.6 ± 2.7; P < .001), were more likely to binge drink (47.8% vs 29.0%; P = .025), report heavy alcohol use (21.0% vs 7.9%; P = .031), meet criteria for substance dependence disorder (27.4% vs 4.0%; P < .001), and report an anxiety disorder diagnosis (12.0% vs 2.6%; P = .046) than nonusers.AAS misuse is prevalent among older men and is associated with polypharmacy, more aggressive alcohol use, and a higher incidence of substance dependence and anxiety disorders compared to nonusers. This information may help clinicians and researchers identify and develop appropriate intervention strategies for AAS abuse among older men.

    View details for DOI 10.1177/0897190014527319

    View details for PubMedID 24643452

  • Survey of career satisfaction, lifestyle, and stress levels among pharmacy school faculty AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY Lindfelt, T. A., Ip, E. J., Barnett, M. J. 2015; 72 (18): 1573-1578

    Abstract

    U.S. pharmacy school faculty were surveyed to assess their career satisfaction, lifestyle, and stress levels.A 48-item survey, administered through Qualtrics (Provo, UT), was sent to current members of the American Association of Colleges of Pharmacy and included questions regarding respondents' academic institution and appointment status; lifestyle traits; career satisfaction; work-life balance; neurologic and psychiatric diagnoses; use of illicit drugs, alcohol, and tobacco; and stress levels.of the 4787 faculty invited to participate in the survey, 811 usable surveys were collected (16.9% response rate). Nearly all respondents (95.0%) reported working 40 or more hours per week. The majority had an average daily one-way commute of less than 30 minutes (64.2%), slept 5.5-7.5 hours per night (74.8%), and exercised for no more than 120 minutes per week (61.8%). A majority of respondents (63.7%) reported being very or extremely satisfied with their current position in academia. Only 36.9% reported being very or extremely satisfied with their work-life balance. Mean perceived stress scores were near those found in the general adult population. Although most respondents reported seeing a primary care provider and dentist annually, other findings regarding preventive health measures were not as encouraging.A survey of pharmacy faculty in the United States revealed high levels of job satisfaction among respondents, but lower levels of satisfaction with work-life balance and comparable levels of stress to the general population were found. Administrators and stakeholders should explore options to improve lifestyle factors to decrease potential burnout among faculty.

    View details for DOI 10.2146/ajhp140654

    View details for Web of Science ID 000361345800011

    View details for PubMedID 26346213

  • The Effects of Dextromethorphan on Driving Performance and the Standardized Field Sobriety Test JOURNAL OF FORENSIC SCIENCES Perry, P. J., Fredriksen, K., Chew, S., Ip, E. J., Lopes, I., Doroudgar, S., Thomas, K. 2015; 60 (5): 1258-1262

    Abstract

    Dextromethorphan (DXM) is abused most commonly among adolescents as a recreational drug to generate a dissociative experience. The objective of the study was to assess driving with and without DXM ingestion. The effects of one-time maximum daily doses of DXM 120 mg versus a guaifenesin 400 mg dose were compared among 40 healthy subjects using a crossover design. Subjects' ability to drive was assessed by their performance in a driving simulator (STISIM® Drive driving simulator software) and by conducting a standardized field sobriety test (SFST) administered 1-h postdrug administration. The one-time dose of DXM 120 mg did not demonstrate driving impairment on the STISIM® Drive driving simulator or increase SFST failures compared to guaifenesin 400 mg. Doses greater than the currently recommended maximum daily dose of 120 mg are necessary to perturb driving behavior.

    View details for DOI 10.1111/1556-4029.12833

    View details for Web of Science ID 000360985000021

    View details for PubMedID 26294136

  • Association of ABC (HbA1c, blood pressure, LDL-cholesterol) goal attainment with depression and health-related quality of life among adults with type 2 diabetes JOURNAL OF DIABETES AND ITS COMPLICATIONS Shah, B. M., Mezzio, D. J., Ho, J., Ip, E. J. 2015; 29 (6): 794-800

    Abstract

    To determine the relationship between ABC goal attainment, depression, and health-related quality of life (HRQoL) among a national sample of patients with type 2 diabetes (T2DM).A retrospective, cross-sectional analysis was performed examining 808 non-pregnant patients ≥20 years old with T2DM from the National Health and Nutrition Examination Survey (NHANES) 2007-2012. ABC goals were defined as HbA1c<7%, BP<130/80 mm Hg, and LDL-C<100 mg/dL. Patient characteristics associated with ABC goal attainment were examined.Overall, 23.7% of participants achieved simultaneous ABC goals. Severe depression was significantly associated with lower rates of ABC goal attainment compared to those with no depression (5.0% vs. 25.4%, p=0.048). ABC goal attainment rates were lower among females, Hispanic and non-Hispanic black minority groups, and patients with a duration of diabetes over five years, while increased visits with health care professionals were significantly associated with meeting all three ABC goals for patients with T2DM.The relationship between simultaneous ABC goal attainment, depression and HRQoL is complex. Patients with T2DM unable to meet ABC goals may benefit from increased contact with health care professionals.

    View details for DOI 10.1016/j.jdiacomp.2015.04.009

    View details for Web of Science ID 000358817500010

    View details for PubMedID 25976863

  • Factors impacting self-perceived readiness for residency training: results of a national survey of postgraduate year 1 residents. Journal of pharmacy practice Truong, J. T., Barnett, M. J., Tang, T. T., Ip, E. J., Teeters, J. L., Knapp, K. K. 2015; 28 (1): 112-118

    Abstract

    To examine the factors impacting postgraduate year 1 (PGY1) residents' self-perceived readiness for residency.A total of 1801 residents who matched in American Society of Health-System Pharmacists (ASHP)-accredited PGY1 programs were e-mailed individualized invitations to take an online survey. The survey collected self-ratings of readiness for residency training competencies including time management and organization, foundational knowledge, clinical practice, project management, and communication.Data from 556 completed surveys were analyzed. Residents agreed they were ready to perform activities requiring time management and organization (median = 4, mean = 4.08), foundational knowledge (median = 4, mean = 3.83), clinical practice (median = 4, mean = 3.67), and communication (median = 4, mean = 4.05). Residents who completed at least 1 academic advance pharmacy practice experience (APPE), 5 clinical APPEs, or held a bachelors degree felt more confident than their counterparts in regard to project management (P < .001, <.001, and .01, respectively).PGY1 residents generally felt prepared for time management and organization, foundational knowledge, and communication residency training competencies. This was significant for those who completed 1 or more academic APPEs, 5 or more clinical rotations, or a bachelors degree. Study results may assist pharmacy schools in preparing students for residency training, prospective resident applicants in becoming more competitive candidates for residency programs, and residency program directors in resident selection.

    View details for DOI 10.1177/0897190014527318

    View details for PubMedID 24674909

  • A Randomized Prospective Study on Outcomes of an Empathy Intervention among Second-year Student Pharmacists AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION Lor, K. B., Truong, J. T., Ip, E. J., Barnett, M. J. 2015; 79 (2)

    Abstract

    To determine the impact of a single, 3-day intervention on empathy levels as measured by the validated Jefferson Scale of Empathy-Health Profession Students version (JSE-HPS).Forty second-year student pharmacists were recruited to participate in a non-blinded prospective study. Subjects were randomized to an intervention group (n=20) or control group (n=20) and completed the JSE-HPS at baseline, 7 days postintervention, and 90 days postintervention. The intervention group consisted of a 3-day simulation, each day including a designated activity with loss of dominant hand usage, vision, and speech.The 3-day simulation increased empathy levels in the intervention group compared to the control group 7 days postintervention (p=0.035). However, there were no effects on empathy levels 90 days postintervention (p=0.38).Empathy scores increased but were not sustained in the long-term with a 3-day empathy intervention.

    View details for Web of Science ID 000352010400003

    View details for PubMedID 25861099

  • Implementation of an Accelerated Physical Examination Course in a Doctor of Pharmacy Program AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION Ho, J., Bidwal, M. K., Lopes, I. C., Shah, B. M., Ip, E. J. 2014; 78 (10)

    Abstract

    To describe the implementation of a 1-day accelerated physical examination course for a doctor of pharmacy program and to evaluate pharmacy students' knowledge, attitudes, and confidence in performing physical examination.Using a flipped teaching approach, course coordinators collaborated with a physician faculty member to design and develop the objectives of the course. Knowledge, attitude, and confidence survey questions were administered before and after the practical laboratory.Following the practical laboratory, knowledge improved by 8.3% (p<0.0001). Students' perceived ability and confidence to perform a physical examination significantly improved (p<0.0001). A majority of students responded that reviewing the training video (81.3%) and reading material (67.4%) prior to the practical laboratory was helpful in learning the physical examination.An accelerated physical examination course using a flipped teaching approach was successful in improving students' knowledge of, attitudes about, and confidence in using physical examination skills in pharmacy practice.

    View details for Web of Science ID 000348582000009

    View details for PubMedID 25657369

  • Pharmacy Students' Performance and Perceptions in a Flipped Teaching Pilot on Cardiac Arrhythmias AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION Wong, T. H., Ip, E. J., Lopes, I., Rajagopalan, V. 2014; 78 (10)

    Abstract

    To implement the flipped teaching method in a 3-class pilot on cardiac arrhythmias and to assess the impact of the intervention on academic performance and student perceptions.An intervention group of 101 first-year pharmacy students, who took the class with the flipped teaching method, were supplied with prerecorded lectures prior to their 3 classes (1 class in each of the following subjects: basic sciences, pharmacology, and therapeutics) on cardiac arrhythmias. Class time was focused on active-learning and case-based exercises. Students then took a final examination that included questions on cardiac arrhythmias. The examination scores of the intervention group were compared to scores of the Spring 2011 control group of 105 first-year students who took the class with traditional teaching methods. An online survey was conducted to assess student feedback from the intervention group.The mean examination scores of the intervention group were significantly higher than the mean examination scores of the control group for the cardiac arrhythmia classes in pharmacology (with 89.6 ± 2.0% vs 56.8 ± 2.2%, respectively) and therapeutics (89.2 ± 1.4% vs 73.7 ± 2.1%, respectively). The survey indicated higher student satisfaction for flipped classes with highly rated learning objectives, recordings, and in-class activities.Use of the flipped teaching method in a 3-class pilot on cardiac arrhythmias improved examination scores for 2 of the 3 classes (pharmacology and therapeutics). Student satisfaction was influenced by the quality of the learning objectives, prerecorded lectures, and inclass active-learning activities.

    View details for Web of Science ID 000348582000012

    View details for PubMedID 25657372

  • Enhancing diabetes care by adding a pharmacist to the primary care team AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY Ip, E. J., Shah, B. M., Yu, J., Chan, J., Nguyen, L. T., Bhatt, D. C. 2013; 70 (10): 877-886

    Abstract

    The impact of pharmacist interventions on short-term clinical markers and long-term cardiovascular risk in patients with type 2 diabetes is investigated.Selected health outcomes were retrospectively analyzed in 147 adults with type 2 diabetes whose care was managed by a team of providers including a pharmacist (the enhanced care group) and a matched sample of patients (n = 147) managed by a primary care physician only (the control group). All patients received services through the same health maintenance organization (HMO). The primary study endpoints were (1) the changes from baseline to 12-month follow-up in glycosylated hemoglobin (HbA(1c)), low-density lipoprotein cholesterol (LDL-C), and blood pressure (BP) values, (2) rates of attainment of HbA(1c), LDL-C and BP goals, and (3) changes from baseline in predicted 10-year risks of coronary heart disease (CHD) and stroke.During the 12-month study period, the mean HbA(1c) value was decreased from 9.5% to 6.9% in the enhanced care group and from 9.3% to 8.4% in the control group (p < 0.001); patients in the enhanced care group were significantly more likely to attain goals for HbA(1c) (odds ratio [OR], 3.9), LDL-C (OR, 2.0), and BP reduction (OR, 2.0) and three times more likely to attain all three goals (OR, 3.2). The estimated 10-year risk of CHD was decreased from 16.4% to 9.3% with enhanced care versus a reduction from 17.4% to 14.8% with usual care (p < 0.001).The addition of a pharmacist to an HMO primary care team improved short-term surrogate markers as well as long-term cardiovascular risk in adult patients with type 2 diabetes.

    View details for DOI 10.2146/ajhp120238

    View details for Web of Science ID 000318890300013

    View details for PubMedID 23640349

  • The Effect of Trazodone on Standardized Field Sobriety Tests PHARMACOTHERAPY Ip, E. J., Bui, Q. V., Barnett, M. J., Kazani, A., Wright, R., Serino, M. J., Perry, P. J. 2013; 33 (4): 369-374

    Abstract

    To evaluate the effects of a single dose of trazodone on the standardized field sobriety test (SFST).A randomized, double-blinded, repeated-measures study.Forty-five healthy adult subjects.University campus.The SFST consists of the horizontal gaze nystagmus, walk-and-turn, and one-leg stand tests. Subjects were administered a baseline SFST and at 2 hours after the administration of either trazodone 100 mg (30 subjects) or acetaminophen 650 mg (15 subjects). At 2 hours post drug administration, there were no statistical differences in failure rates between the trazodone and acetaminophen groups (53.3% vs 20.0%, p=0.054). However, the trazodone group exhibited more impairment clues within the individual tests of the SFST than the acetaminophen group.A one-time dose of trazodone 100 mg does not result in an increased SFST failure rate at 2 hours postdosing compared to acetaminophen 650 mg. However, the number of individual impairment clues detected is increased with trazodone. Trazodone 100 mg may cause cognitive driving impairment.

    View details for DOI 10.1002/phar.1210

    View details for Web of Science ID 000317008000005

    View details for PubMedID 23450804

  • A Markov Model of the Cost-Effectiveness of Pharmacist Care for Diabetes in Prevention of Cardiovascular Diseases: Evidence from Kaiser Permanente Northern California JOURNAL OF MANAGED CARE PHARMACY Yu, J., Shah, B. M., Ip, E. J., Chan, J. 2013; 19 (2): 102-114

    Abstract

    It has been demonstrated in previous studies that pharmacist management of patients with type 2 diabetes mellitus (T2DM) in the outpatient setting not only improves diabetes-related clinical outcomes such as hemoglobin A1c but also blood pressure (BP), total cholesterol (TC), and quality of life. Improved control of BP and TC has been shown to reduce the risks of cardiovascular disease (CVD), which has placed a heavy economic burden on the health care system. However, no study has evaluated the cost-effectiveness of pharmacist intervention programs with respect to the long-term preventive effects on CVD outcomes among T2DM patients.To (a) quantify the long-term preventive effects of pharmacist intervention on CVD outcomes among T2DM patients using evidence from a matched cohort study in the outpatient primary care setting and (b) assess the relative cost-effectiveness of adding a clinical pharmacist to the primary care team for the management of patients with T2DM based on improvement in CVD risks with the aid of an economic model.Clinical data between the periods of June 2007 to February 2010 were collected from electronic medical records at 2 separate clinics at Kaiser Permanente (KP) Northern California, 1 with primary care physicians only (control group) and the other with the addition of a pharmacist (enhanced care group). Patients in the enhanced care group were matched 1:1 with patients in the control group according to baseline characteristics that included age, gender, A1c, and Charlson comorbidity score. The estimated 10-year CVD risk for both groups was calculated by the United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine (version 2) based on age, sex, race, smoking status, atrial fibrillation, duration of diabetes, levels of A1c, systolic BP (SBP) and TC, and high-density lipoprotein cholesterol (HDL-C) observed at 12 months. There was no statistical difference in the baseline clinical inputs to the Risk Engine (A1c [P=0.115], SBP [P=0.184], TC [P=0.055], and HDL-C [P=0.475]) between the 2 groups. A Markov model was developed to simulate the estimated CVD outcomes over 10 years and to estimate cost-effectiveness. The final outcomes examined included incremental cost and effectiveness measured by life years and per quality-adjusted life year gained. Both deterministic sensitivity analysis (SA) and probabilistic SA were conducted to examine the robustness of the results.The estimated risks for coronary heart disease (CHD) and stroke (both nonfatal and fatal) at the end of the follow-up were consistently lower in the enhanced care group compared with the control group, even though baseline risks in both groups were similar. The absolute risk reduction (ARR) between the enhanced care and control groups increased over time. For example, the ARR for nonfatal CHD risk in year 1 was 0.5% (1.2% vs. 0.7%), whereas the ARR increased to 5.5% in year 10 (14.8% vs. 9.3%). Similarly, the ARR between the enhanced care and the control groups was calculated as 0.3% for fatal CHD in year 1 and increased to 4.6% in year 10. Results from the Markov model suggest that the enhanced care group was shown to be a dominant strategy (less expensive and more effective) compared with the control group in the 10-year evaluation period in the base-case (average or mean results) scenario. Sensitivity analysis that took into account the uncertainty in all important variables, such as wage of pharmacists, utility weight (the degree of preference individuals have for a particular health state or condition), response rate to pharmacists' care, and uncertainty associated with the estimated 10 years of CVD risk, revealed that the relative value of enhanced care was robust to most of the variations in these parameters. Notably, the level of cost-effectiveness measured by net monetary value depends on the time horizon adopted by the payers and the magnitude of CVD risk reduction. The enhanced care group has a higher chance of being considered as a cost-effective strategy when a longer time horizon such as a minimum of 4 to 5 years is adopted.Adding pharmacists to the health care management team for diabetic patients improves the long-term CVD risks. The longer-term CVD risk reductions were shown to be more dramatic than the short-term reduction. A longer time horizon adopted by health plans in managing T2DM patients has a higher probability of making the intervention cost-effective.

    View details for Web of Science ID 000341343700001

    View details for PubMedID 23461426

  • Psychological and Physical Impact of Anabolic-Androgenic Steroid Dependence PHARMACOTHERAPY Ip, E. J., Lu, D. H., Barnett, M. J., Tenerowicz, M. J., Vo, J. C., Perry, P. J. 2012; 32 (10): 910-919

    Abstract

    To contrast the characteristics of two groups of anabolic-androgenic steroid (AAS) users-those with versus those without AAS dependence.Subanalysis of data from the Anabolic 500, a cross-sectional survey.One hundred twelve male AAS-dependent users and 367 AAS-nondependent users who completed an online survey between February 19 and June 30, 2009.Respondents were recruited from the Internet discussion boards of 38 fitness, bodybuilding, weightlifting, and steroid Web sites. The respondents provided online informed consent and completed the Anabolic 500, a 99-item Web-based survey. Self-reported data included demographics, exercise patterns, use of AAS and other performance-enhancing agents, adverse effects of AAS use, behavior consistent with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for AAS dependence, history of illicit drug and alcohol use, history of sexual or physical abuse, and psychiatric conditions diagnosed according to the DSM-IV-TR. Behavior consistent with AAS dependence was identified in 23.4% of the survey participants. These AAS-dependent users were more excessive in their AAS use (e.g., higher doses, higher quantity of agents, longer duration of use), more likely to report a history of illicit heroin use in the last 12 months (5.4% vs 1.9%, p=0.049), and more likely to report a diagnosis of an anxiety disorder (16.1 vs 8.4%, p=0.020) or major depressive disorder (15.2% vs 7.4%, p=0.012) than AAS-nondependent users.Data from the Anabolic 500 survey showed that almost one quarter of AAS users were dependent on these drugs. These AAS-dependent users had a higher rate of heroin use as well as anxiety and major depressive disorders compared with AAS-nondependent users. These findings can help clinicians and researchers better understand and address the potential illicit drug use and psychiatric comorbidities that may be present among AAS-dependent users.

    View details for DOI 10.1002/j.1875-9114.2012.01123

    View details for Web of Science ID 000309452700461

    View details for PubMedID 23033230

  • Weightlifting's Risky New Trend: A Case Series of 41 Insulin Users CURRENT SPORTS MEDICINE REPORTS Ip, E. J., Barnett, M. J., Tenerowicz, M. J., Perry, P. J. 2012; 11 (4): 176-179

    Abstract

    Use of performance-enhancing drugs (PEDs) is common among strength-trained individuals, and a growing concern is the misuse of insulin. A 99-item Internet-based survey was posted on discussion boards of various fitness, bodybuilding, weightlifting, and anabolic steroid Web sites between February and June 2009. A case series of 41 nondiabetic insulin users is described. The typical insulin user was 30.7 ± 9.2 years old, male (97.6%), and Caucasian/white (86.8%) who classified himself as a "recreational exerciser" (47.5%). The average insulin user also used anabolic steroids (95.1%) and practiced polypharmacy by incorporating 16.2 ± 5.6 PEDs in his or her yearly routine. Hypoglycemia was reported by most of the subjects (56.8%), and one individual reported unconsciousness. Insulin was obtained most commonly from local sources (e.g., friends, training partners, gym member/dealer; 40.5%) and community pharmacies (37.8%), with most (80.6%) finding it "easy" to acquire their insulin. Strategies aimed to prevent insulin misuse are needed.

    View details for DOI 10.1249/JSR.0b013e31825da97f

    View details for Web of Science ID 000306331700004

    View details for PubMedID 22777326

  • A Mnemonic for Pharmacy Students to Use in Pharmacotherapy Assessment AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION Bruno, C. B., Ip, E., Shah, B., Linn, W. D. 2012; 76 (1)

    Abstract

    To introduce pharmacy students to a patient-centered mnemonic to aid them in remembering the most important parameters when assessing a patient's drug therapy and to determine whether use of the device improved students' clinical examination scores.Second-year pharmacy students were randomized to an intervention group or a control group. A 30-minute presentation on the rationale of the mnemonic and how to apply it to clinical scenarios was given to the intervention group and then a case-based multiple-choice clinical examination was administered. Students in the control group completed the same examination first and then were given the mnemonic.Ninety-five students completed the examination. Examination scores of students in the intervention group were 6% higher than those of students in the control group (p = 0.04). A 6-question survey instrument was administered to both groups and the majority of students agreed that they would use the mnemonic when assessing patients during their upcoming practice experiences. One-hundred percent of the students stated that the mnemonic definitely or probably helped them (or would have helped them) think critically when assessing the patient cases.Pharmacy students who used a mnemonic device for pharmacotherapy assessment exhibited better decision-making skills and made fewer errors than students who did not use the mnemonic.

    View details for Web of Science ID 000300953600016

    View details for PubMedID 22412215

  • The Anabolic 500 Survey: Characteristics of Male Users versus Nonusers of Anabolic-Androgenic Steroids for Strength Training PHARMACOTHERAPY Ip, E. J., Barnett, M. J., Tenerowicz, M. J., Perry, P. J. 2011; 31 (8): 757-766

    Abstract

    To contrast the characteristics of two groups of men who participated in strength-training exercise-those who reported anabolicandrogenic steroid (AAS) use versus those who reported no AAS use.Analysis of data from the Anabolic 500, a cross-sectional survey.Five hundred six male self-reported AAS users (mean age 29.3 yrs) and 771 male self-reported nonusers of AAS (mean age 25.2 yrs) who completed an online survey between February 19 and June 30, 2009.Respondents were recruited from Internet discussion boards of 38 fitness, bodybuilding, weightlifting, and steroid Web sites. The respondents provided online informed consent and completed the Anabolic 500, a 99-item Web-based survey. Data were collected on demographics, use of AAS and other performance-enhancing agents, alcohol and illicit drug use, substance dependence disorder, other Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnoses, and history of sexual and/or physical abuse. Most (70.4%) of the AAS users were recreational exercisers who reported using an average of 11.1 performance-enhancing agents in their routine. Compared with nonusers, the AAS users were more likely to meet criteria for substance dependence disorder (23.4% vs 11.2%, p<0.001), report a diagnosis of an anxiety disorder (10.1% vs 6.1%, p=0.010), use cocaine within the past 12 months (11.3% vs 4.7%, p<0.001), and report a history of sexual abuse (6.1% vs 2.7%, p=0.005).Most of the AAS users in this study were recreational exercisers who practiced polypharmacy. The AAS users were more likely than nonusers to meet criteria for substance dependence disorder, report a diagnosis of an anxiety disorder, report recent cocaine use, and have a history of sexual abuse. The information uncovered in this study may help clinicians and researchers develop appropriate intervention strategies for AAS abuse.

    View details for Web of Science ID 000293437700006

    View details for PubMedID 21923602

  • Women and Anabolic Steroids: An Analysis of a Dozen Users CLINICAL JOURNAL OF SPORT MEDICINE Ip, E. J., Barnett, M. J., Tenerowicz, M. J., Kim, J. A., Wei, H., Perry, P. J. 2010; 20 (6): 475-481

    Abstract

    To provide an in-depth analysis of 12 female self-reported anabolic-androgenic steroid (AAS) users.Web-based survey.A Web-based survey was posted on 38 discussion boards of various fitness, bodybuilding, weightlifting, and steroid Web sites between February and June 2009.Participants completed a survey regarding demographics and use of AAS and other performance-enhancing agents (PEAs).A cohort of 1519 strength-trained subjects fully completed and submitted a valid survey. Five hundred eighteen subjects were self-reported AAS users consisting of 12 women and 506 men. One thousand one subjects were non-AAS users consisting of 230 women and 771 men.Demographic data and use of AAS and other PEAs.The female AAS users reported using an average of 8.8 PEAs in their routine. Compared with male AAS users and female non-AAS users, respectively, female AAS users were more likely to have met criteria for substance-dependence disorder (58.3% vs 23.4%; P = 0.01; 58.3% vs 9.1%; P < 0.001), have been diagnosed with a psychiatric illness (50.0% vs 17.4%; P = 0.01; 50.0% vs 22.2%; P = 0.04), and have reported a history of sexual abuse (41.7% vs 6.1%; P < 0.001; 41.7% vs 15.3%; P = 0.03).Female AAS users practice polypharmacy. Female AAS users are more likely to have qualified for substance-dependence disorder, have been diagnosed with a psychiatric illness, and have a history of sexual abuse than both male AAS users and female non-AAS users.

    View details for DOI 10.1097/JSM.0b013e3181fb5370

    View details for Web of Science ID 000284379100015

    View details for PubMedID 21079445

  • The Touro 12-Step: A Systematic Guide to Optimizing Survey Research with Online Discussion Boards JOURNAL OF MEDICAL INTERNET RESEARCH Ip, E. J., Barnett, M. J., Tenerowicz, M. J., Perry, P. J. 2010; 12 (2)

    Abstract

    The Internet, in particular discussion boards, can provide a unique opportunity for recruiting participants in online research surveys. Despite its outreach potential, there are significant barriers which can limit its success. Trust, participation, and visibility issues can all hinder the recruitment process; the Touro 12-Step was developed to address these potential hurdles. By following this step-by-step approach, researchers will be able to minimize these pitfalls and maximize their recruitment potential via online discussion boards.

    View details for DOI 10.2196/jmir.1314

    View details for Web of Science ID 000278860800013

    View details for PubMedID 20507843

  • Low-dose filgrastim in patients with breast cancer treated with docetaxel, doxorubicin, and cyclophosphamide AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY Ip, E. J., Lee-Ma, A., Troxell, L. S., Chan, J. 2008; 65 (16): 1552-1555

    Abstract

    The objective of this study was to compare low-dose filgrastim (150 microg/day subcutaneously) with standard-dose subcutaneous filgrastim (300 microg/day) or lenograstim (263 microg/day) in preventing febrile neutropenia and hospitalizations in breast cancer patients receiving the docetaxel-doxorubicin-cyclophosphamide regimen.A single-center retrospective data analysis was performed involving 22 adult women with breast cancer who concurrently received the docetaxel-doxorubicin-cyclophosphamide chemotherapy regimen and low-dose filgrastim from March 2004 to February 2007. Data from this study were compared to previously published data in which patients received standard-dose filgrastim or lenograstim.More patients developed febrile neutropenia in the low-dose filgrastim group compared with the standard-dose group (32% versus 7.5%, respectively; p = 0.0014; relative risk [RR] = 4.24; 95% confidence interval [CI], 2.04-7.83). More patients were hospitalized due to febrile neutropenia in the low-dose filgrastim group compared with the standard-dose group (32% versus 6.5%, respectively; p < 0.001; RR = 4.89; 95% CI, 2.32-9.13). More chemotherapy cycles resulted in febrile neutropenia in the low-dose filgrastim group compared with the standard-dose group (6.7% versus 1.2%, respectively; p < 0.001; RR = 5.58; 95% CI, 2.49-12.27).In patients with breast cancer treated with the docetaxel-doxorubicin-cyclophosphamide regimen, low-dose filgrastim was associated with a higher frequency of febrile neutropenia, hospitalization due to febrile neutropenia, and cycles with febrile neutropenia compared with a historical control group treated with standard-dose filgrastim or lenograstim.

    View details for DOI 10.2146/ajhp070489

    View details for Web of Science ID 000258424700019

    View details for PubMedID 18693211