Health literacy refers to the ability of a patient to obtain, communicate, process, and understand basic information related to health and services. It is estimated that the majority of adult Americans may have difficulty understanding health information. In addition, limited health literacy of patients is linked to over $100 billion in health care costs. Measurement of health literacy may aid in improving communication with patients, and thus to improving outcomes and decreasing costs. The Newest Vital Sign (NVS) is a tool that has been used to assess health literacy in a variety of patients. It has been validated against other measures including the Test of Functional Health Literacy in Adults (TOFHLA). Patients are categorized as high likelihood of limited health literacy, possible limited health literacy, or adequate literacy. The NVS has been used in a variety of settings and tested among a wide range of patient groups. The most common setting for use is in primary care, probably due to the relatively quick assessment of health literacy (within 3 minutes). The NVS has been used in Caucasians, African Americans, Hispanics, and several other ethnicities. Assessment with the NVS has been conducted in adult patients across the age continuum, and with several different health conditions, including diabetes, kidney disease, and pain. This article seeks to review the published uses to date and to provide suggestions for potential uses of the NVS.

Introduction: Pharmacist prescribing of contraception is becoming increasingly available in selected states. The objective of this study was to assess US community pharmacists’ perspectives on expanding access, barriers, and facilitators since states have begun pharmacist scope of practice expansions for prescribing contraception. Methods: A survey study of US community pharmacists’ support for expanded access models, pharmacist prescribing practices and interest, and importance of safety, cost, and professional practice issues for prescribing was conducted. Results: Pharmacists are generally supportive of pharmacist prescribing and behind-the-counter models for hormonal contraception and generally opposed to over-the-counter access. A majority (65%) are interested in prescribing hormonal contraception. The top motivation for prescribing contraception is enjoying individual patient contact (94%). Safety concerns (eg, patients not obtaining health screenings) remained most important for pharmacist implementation, followed by cost (eg, lack of payment or reimbursement for pharmacists’ services), and professional practice (eg, pharmacist time constraints and liability) issues. Conclusion: This study provides an updated understanding of attitudes toward models of expanded access to hormonal contraception, interest in prescribing, and barriers and facilitators to this service among community pharmacists. Many barriers such as time and reimbursement remain unchanged. This information can inform policy and implementation efforts.

Although most participants received inhaler education, inhaler misuse was very common. No associations were found regarding method of education and proper inhaler technique.

Introduction: The American Diabetes Association recommends annual screenings for prediabetes if the patient meets the suggested requirements. The overall prevalence of prediabetes has decreased from an estimated 86 million adults in 2012 to 84.1 million adults in 2015 in the United States. Along with lifestyle modifications, the use of metformin as a treatment option or in combination has shown a decrease in weight and health care costs. This study was designed to review the prevalence of screening and treatment of prediabetes in the United States by using the National Ambulatory Medical Care Survey, as well as identify any factors associated with screenings and treatment. Methods: The National Ambulatory Medical Care Survey was used to examine a study sample of office visits between 2012 and 2015, reviewing the prevalence of screenings and lab services ordered or provided at each patient visit. Inclusion criteria consisted of the recommendations given by the American Diabetes Association including any patient >45 years or adult patient <45 years with a body mass index of >25 kg/m 2 and an additional risk factor. Patients with a previous diagnosis of diabetes were excluded from the sample. Results: A total of 105,721 office visits (2012 to 2015) were included in the analysis. The diabetes screening prevalence increased from 10% in 2012 to 13.4% in 2015. Metformin (n ‫؍‬ 140, 76.1%) was the most common antidiabetic medication prescribed to treat prediabetes. Conclusions: The prevalence of diabetes screening during office visits remained lower than 15% between 2012 and 2015 in the United States. Physicians primarily prescribe lifestyle modifications, including a healthy diet and exercise, with metformin being used in some cases for the prevention of diabetes.

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