In insured, HIV-infected, adult outpatients, implementation of a medication synchronization program was associated with improved ART adherence. Future studies are needed to better assess the impact of medication synchronization on clinical outcomes.
Introduction: Decreased well-being in medical careers has resulted in increased burnout, errors, and patient mortality rates. However, while well-being and burnout of providers and medical residents has been studied previously, it is difficult to apply this information to pharmacy residents as the programs are different in time, focus, and requirements. In addition, differences in resident demographics and goals further elucidate difficulties in applying these findings to well-being of pharmacy residents.With residency program directors (RPDs) often having the first and most frequent contact with pharmacy residents, ensuring these individuals better understand resident well-being could facilitate increased well-being and satisfaction, as well as stronger connections to the program itself.Objective: The primary objective was to identify discrepancies between residents and RPDs in the perception of resident well-being. Methods: This was a pilot cohort study. Resident and RPD responses were solicited utilizing Listservs of RPDs in 15 states, as well as platforms such as the North Carolina Association of Pharmacist's Residency Community.Results: Residents reported a statistically significant lower overall well-being, with only 49.1% of respondents reporting a "good" or "great" level of well-being, as compared with 80.1% of RPDs reporting their residents' well-being as "good" or "great" (P < .001). Secondary end points, such as perception of communication, relationships, and emotional health, revealed similar significant results of RPDs' higher perception of resident well-being in comparison with resident responses. Of the 15 secondary end points evaluated, 13 showed residents reporting a lower well-being score compared with the RPDs' perception.Conclusion: There is a large disparity between residents' perception and RPDs' perception of well-being. This disparity should be viewed as an opportunity to foster conversation, improve well-being, and implement change in pharmacy residencies across the country. Further studies could be beneficial in understanding specific, successful initiatives that promote higher well-being scores among pharmacy residents.
Interprofessional team-based care has become the standard for practicing clinical pharmacists. However, it is difficult to simulate every aspect of this environment in the didactic curriculum. The purpose of this study was to determine if the addition of standardized patients (SP) or interprofessional student teams with SPs, to the use of a simulated electronic health record (EHR) improved student knowledge retention and perceptions. Methods. This was a prospective cohort study assessing three cohorts of first-year student pharmacists in pharmacy skills laboratory activities that occurred in 2018, 2019, and 2021. The primary objective of the study was to compare knowledge retention at 1-month related to the case material between groups. Each year an element of simulated experience was added onto the previous year's case. In 2018, students completed the case using the EHR web application only. In 2019, an objective structured clinical examination (OSCE) with SPs was combined with the previous year's experience. In 2021, student physician assistants were added to the 2019 experience. Case scores and student perceptions were also compared between groups.Results. Of the 260 potential participants, 238 students were included in the primary analysis. Significant improvement was demonstrated in one-month knowledge retention assessments with the addition of interprofessional team-based care and SPs. Mean knowledge retention assessment scores were 63.8%, 71.7%, and 76.1% respectively. There was also significant improvement in student perceptions. Conclusion. The addition of SPs and interprofessional team-based care to a pharmacy skills laboratory that utilizes a simulated EHR significantly improved student knowledge retention and perceptions.
Objective To review the efficacy, safety, and available literature regarding the novel combination bioidentical product Bijuva, or 17β-estradiol/progesterone (17β-E/P), for the treatment of moderate to severe menopausal symptoms in cisgender females with an intact uterus. Data Sources Literature searches of both PubMed (1966 to October 2020) and Google Scholar were conducted using search terms including bioidentical, estradiol, progesterone, menopause, E2/P4, TX-001HR, and Bijuva. Study Selection and Data Extraction All articles with studies conducted in cisgender human females and in the English language were considered for review; 18 publications were included. Data Synthesis In 1 phase 3 clinical study, 17β-E/P was proven to be effective at reducing the frequency and severity of vasomotor symptoms (VMS) at 12 weeks compared with placebo, and no cases of endometrial hyperplasia were observed over the 52-week safety study period. Menopausal women with an intact uterus were included in the study population. Relevance to Patient Care and Practice Concerns over content and safety of compounded bioidentical hormones have been raised by several professional societies. As women experience VMS of menopause, a desire for a Food and Drug Administration–regulated bioidentical combination product for the treatment of moderate to severe menopausal symptoms may be desirable. Given as a once-daily oral capsule at the dose of 1 mg estradiol/100 mg progesterone, 17β-E/P is approved for the treatment of VMS associated with menopause. Conclusions 17β-E/P is a novel bioidentical product that is the first of its kind in the treatment of moderate to severe menopausal symptoms.
Humanitarian crises such as disease outbreaks, conflict and displacement and natural disasters affect millions of people primarily in low- and middle-income countries. Here, they often reside in areas with poor environmental health conditions leading to an increased burden of infectious diseases such as diarrheal and respiratory infections. Water, sanitation, and hygiene behaviours are critical to prevent such infections and deaths. A scoping review was conducted to map out what is known about the association between three mental health issues and people’s perceived and actual ability to practice hygiene-related behaviours, particularly handwashing, in humanitarian and pandemic crises. Published and grey literature was identified through database searches, humanitarian-relevant portals, and consultations with key stakeholders in the humanitarian sector. 25 publications were included, 21 were peer-reviewed published articles and four were grey literature publications. Most of the studies were conducted in China (n=12) and most were conducted in a pandemic outbreak setting (n=20). Six studies found a positive correlation between handwashing and anxiety where participants with higher rates of anxiety were more likely to practice handwashing with soap. Four studies found an inverse relationship where those with higher rates of anxiety were less likely to wash their hands with soap. The review found mixed results for the association between handwashing and depression, with four of the seven studies reporting those with higher rates of depression were less likely to wash their hands, while the remaining studies found that higher depressions scores resulted in more handwashing. Mixed results were also found between post-traumatic stress disorder (PTSD) and handwashing. Two studies found that lower scores of PTSD were associated with better hygiene practices, including handwashing with soap. The contradictory patterns suggest that researchers and practitioners need to explore this association further, in a wider range of crises, and need to standardize tools to do so.
Objective. The 2019 Hospital National Patient Safety Goal 03.05.01 indicates education regarding anticoagulant therapy should be provided to patients and families. Previous studies assessing pharmacist and pharmacy student involvement in oral anticoagulation (OAC) education services have focused on patient-related outcomes, with limited emphasis on the additional benefit to the student. The purpose of this study was to assess the benefit of pharmacy student involvement in anticoagulation education services both clinically and through their perceptions of participating in the service. Methods. This study assessed students’ knowledge and perceptions of providing OAC education before and after a 1-month learning experience, where students provided counseling 2-3 days per week. The primary endpoint was comparing each student’s pre- and post-rotation OAC education knowledge assessments. Secondary endpoints included percentage change in knowledge between the prospective cohort and a historical comparator group, perceived benefit of student participation in the service, percentage of patients able to recall counseling, and number of interventions made related to OAC therapy. Results. A total of 35 pharmacy students were included in this prospective study with 277 patients receiving counseling from June 2020 through March 2021. A total of 32 pharmacy students had assessment data available for retrospective comparison. The mean pharmacy student score within the prospective cohort improved significantly (21.5%) between the pre-assessment and post-assessment. Change in pre- and post-rotation knowledge assessment was also significantly higher in the prospective cohort compared to the retrospective group. Additionally, students gained confidence in their counseling abilities and OAC knowledge through participation. Conclusion. Pharmacy student participation within anticoagulation education services significantly improved student knowledge and confidence in their counseling abilities. It also allowed for over 70% of patients to successfully recall pertinent information about their anticoagulants over a week later and improved patient care through dosing interventions.
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