Purpose Use of adjuvant hormonal therapy, which significantly decreases breast cancer mortality, has not been well described among poor women, who are at higher risk of cancer-related death. Here we explore use of adjuvant hormonal therapy in an insured, low-income population. Methods A North Carolina Cancer Registry–Medicaid linked data set was used. Women with hormone receptor–positive or unknown, nonmetastatic breast cancer, diagnosed between 1998 and 2002, were included. Main outcomes were (1) prescription fill within 1 year of diagnosis, (2) adherence (medication possession ratio), and (3) persistence (absence of a 90-day gap in prescription fills over 12 months). Results The population consisted of 1,491 women (mean age, 67 years). Sixty-four percent filled prescriptions. Predictors of prescription fill included the following: older age (odds ratio [OR], 1.01; P = .017), greater number of prescription medications (OR, 1.06; P < .001), nonmarried status (OR, 1.82; P = .001), higher stage (OR, 1.83; P < .001), positive hormone receptor status (positive v unknown, OR, 1.98; P < .001), not receiving adjuvant chemotherapy (OR, 1.74; P = .001), receipt of adjuvant radiation (OR, 1.55; P = .004), and treatment in a small hospital (OR, 1.49; P = .024). Adherence and persistence rates were 60% and 80%, respectively. Nonmarried status predicted greater adherence (OR, 1.90; P = .006) and persistence (OR, 1.75; P = .031). Conclusion Prescription fill, adherence, and persistence to adjuvant hormonal therapy among socioeconomically disadvantaged women are low. Improving use of adjuvant hormonal therapy may lead to lower breast cancer–specific mortality in this population.

Psoriasis is one of the prevalent skin conditions in the United States. This chronic condition has a significant negative impact on patients' quality of life. Psoriasis has been linked to the depression and suicidal tendencies in the patients. The costs associated with decrements in quality of life, lost productivity, and work absenteeism may be enormous, increasing overall costs associated with the disease management. This review attempts to outline different quality of life measures available for psoriasis and describes their use in studies examining patient reported outcomes associated with pharmacological interventions for psoriasis. Factors associated with quality of life in psoriasis patients are described. It further describes physician's role in the psoriasis management to improve patients' overall well-being.

Objective. The objective of this study was to examine factors such as academic competence, test competence, time management, strategic studying, and test anxiety, and identify whether these factors could distinguish differences among students, based on academic performance and enrollment in the experiential program. Methods. A cross-sectional study design utilizing questionnaires measuring previously validated constructs was used to evaluate the effect of these factors on students with low and high cumulative grade point averages (GPAs). Pharmacy students (N 5 198) enrolled at the University of Houston participated in the study. Results. Academic performance was significantly associated with factors such as academic competence and test competence. Students with a cumulative GPA of 3.0 or greater significantly differed in their level of test competence than those with a GPA of less than 3.0. Students enrolled in their experiential year differed from students enrolled in their second year of curriculum on factors such as test anxiety, academic competence, test competence, and time management skills. Conclusion. Test competence was an important factor to distinguish students with low vs. high academic performance. Factors such as academic competence, test competence, test anxiety and time management improve as students' progress in their experiential year.