The concordance of self-report and other measures of medication adherence varies widely based on the type of measures used. Questionnaires and diaries tend to have moderate-to-high concordance with other measures of medication adherence. However, interview-based self-reports are not concordant with electronic measures. Questionnaire and diary methods could be preferable to interviews for self-reported medication adherence.

Objective. To assess the coping mechanisms used by pharmacy students and their relationship to perceived stress. Methods. Data were gathered utilizing the Perceived Stress Scale (PSS10) and Brief COPE with the additional coping mechanisms of exercise and use of prescribed medications. Results. A survey that was sent to 368 students had an 81% response rate. Perceived stress was significantly higher than standard populations, but consistent with other pharmacy student populations. The most frequently reported coping mechanisms were the adaptive strategies of active coping, acceptance and planning. Maladaptive strategies of behavioral disengagement, venting and self-blame were significantly associated with higher perceived stress scores and the new addition of an exercise coping mechanism significantly associated with lower perceived stress scores. Use of prescribed medications was not significantly associated with perceived stress levels. Conclusion. Inclusion of exercise as a coping mechanism may be beneficial in similar populations.

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he simultaneous use of multiple prescription medications has been repeatedly identified as an area of concern, particularly among our nation' s older adults.1 While older adults typically require more medications to manage multiple comorbidities, disease-centric prescribing, reduced organ function, and higher use of over-the-counter products among older adults complicates a prescriber' s or pharmacist' s ability to anticipate how concomitant use of multiple medications is likely to affect the underlying mechanisms by which each functions as prescribed.2,3 While risks associated with use of specific medications or combinations of medications among older patients have been well characterized, 4-6 assimilation of this information into prescribing practice is not evident. Perhaps many prescribers simply cannot consider all the medications their patients are already taking when they prescribe a new medication. 7 The likelihood of patients becoming confused by or noncompliant with their own drug regimen also increases with the size of their medication list.2 Too often, a critical review of a patient' s medication use is not conducted until after an adverse drug event occurs and has been recognized as such. 8Many of the studies examining multiple medication use by older adults to date have focused on non-U.S. populations, whereas studies on U.S. populations have focused more on inappropriate prescribing and medication-specific risks. Among the available literature, there is general agreement that multiple prescription medication use is more prevalent among older adults, women, and cardiovascular patients, but estimates vary widely and comparison of findings is complicated by the absence of a standard time period over which medication use ABSTRACT BACKGROUND: The simultaneous use of multiple prescription medications has been associated with an increased risk of adverse drug events and other drug-related complications, especially in the elderly.OBJECTIVE: To quantify the prevalence of use of multiple medications among a sample of Department of Defense (DoD) health care beneficiaries, aged 65 years and older, who used their TRICARE (military health care services) benefit to obtain prescription medication.METHODS: Outpatient pharmacy fill records were analyzed for a 10% random sample of 1.27 million TRICARE beneficiaries aged 65 years and older who obtained 1 or more prescription medications in the 90-day period from (P <0.001). The prevalence of multiple drug use peaked among beneficiaries aged 80 to 84 years. Cardiovascular drugs, central nervous system agents, and hormones and synthetic substitutes were the 3 most common therapeutic categories used by 77%, 48%, and 42% of beneficiaries, respectively.CONCLUSION: This baseline analysis documented the common use of multiple medications among TRICARE beneficiaries. The DoD faces a challenge similar to that of Medicare Part D drug plans to cost-effectively monitor and optimize pharmacotherapy for its older beneficiaries.

Baseline to 8-week follow-up outcomes were as follows: Harris Hip Scale (HHS) scores improved from 60.3(±10.4) to 80.7(±10.5), Numerical Pain Rating Scale (NPRS) scores improved from 4.3(±1.9) to 2.0(±1.9), hip flexion range of motion (ROM) improved from 99 degrees (±10.6) to 127 degrees (±6.3) and hip internal rotation ROM improved from 19 degrees (±9.1) to 31 degrees (±11.5). Improvements in HHS, NPRS, and hip ROM measures reached statistical significance (P<0.05) at 8-weeks and remained significant at the 29-week follow-up. Mean changes in NPRS and HHS scores exceeded the minimal clinically important difference (MCID) at 8-weeks and for the HHS scores alone at 29 weeks. The 8 and 29 week mean Global Rating of Change scores were 5.1(±1.4) and 2.1(±4.2), respectively. Improved outcomes observed following a pre-selected, standardized treatment protocol were similar to those observed in previous studies involving impairment-based manual therapy and therapeutic exercise for hip OA. Future studies might directly compare the two approaches.