Polypharmacy (>4 medications) is significantly associated with mortality in Mexican American older adults. This community-based study is the first to demonstrate a direct association between polypharmacy and mortality in this population.

Eighty-one pharmacists from 48 primary care practice sites in 11 states were recruited to join a PBRN. These pharmacists provided descriptive data regarding their practice site, characteristics of patients served, and clinical services provided as a first step in collaborative research efforts.

This study demonstrated that a physician-pharmacist collaborative intervention was effective in reducing mean systolic BP and improving BP control in patients with uncontrolled hypertension with DM and/or CKD, regardless of which BP guidelines were used.

Improving health among people living in poverty often transcends narrowly focused illness care. Meaningful success is unlikely without confronting the complex social origins of illness. We describe an emerging community of solution to improve health outcomes for a population of 6000 San Antonio, Texas, residents enrolled in a county health care program. The community of solution comprises a county health system, a family medicine residency program, a metropolitan public health department, and local nonprofit organizations and businesses. Community-based activities responding to the needs of individuals and their neighborhoods are driven by a cohort of promotores (community health workers) whose mission encompasses change at both the individual and community levels.

There is overwhelming evidence that disparities in the provision of health care exist between various groups of people. Pharmacists must be aware of these disparities and join the health workforce in closing the gap between people of different racial, ethnic, and cultural backgrounds. The role of the pharmacist has expanded, and this profession must embrace diversity to provide a higher quality of care to all patients. Cultural competence in health care is an ongoing process and starts with self-reflection. It incorporates the ability to recognize the unique needs of diverse populations and the ability to adapt care accordingly. In addition to knowledge and skills, cultural competence requires a positive attitude that emphasizes respect across all cultures. While pharmacists have often lacked training in caring for diverse patients, learning a few basic concepts will assist them with their individual patient encounters. This article provides essential elements that will help pharmacists better understand cultural competence and apply this knowledge in pharmacy practice.

Human papillomavirus infection is the most prevalent sexually transmitted disease in the world and is responsible for cervical, vulvar, and vaginal cancers, as well as genital warts. A vaccine against HPV types 6, 11, 16, and 18 has been available since 2006 and has been approved for the prevention of cervical cancer, cervical precancers, and genital warts. Recently, the vaccine also received approval for the prevention of vulvar and vaginal cancers in women aged 9 to 26 years. Although Guillain-Barré syndrome and death have been reported in women who received the vaccine, an analysis of available data by the US Food and Drug Administration found no association between the vaccine and these adverse events. Since post-vaccination syncope is common among young women, providers should ensure that patients remain seated when vaccinated and under observation for at least 15 minutes following vaccination.

How are human papillomavirus (HPV), cervical cancer, and the recently developed HPV vaccines associated with each other? Human papillomavirus is a highly prevalent infection that is easily and unknowingly transmitted because of its asymptomatic nature and long incubation period. Infection requires skin-to-skin contact and is typically sexually transmitted. More than one-half of sexually active women acquire HPV, making it the most prevalent sexually transmitted disease. Cervical cancer ranks second in deaths from cancer among women in developing countries and kills nearly 4000 women in the United States annually. Several types of HPV have been strongly linked to causing cervical cancer and genital warts. Those causing cervical cancer are considered high-risk types and those causing genital warts are considered low-risk types. Until recently, prevention strategies included abstinence, condom usage, and early detection with a Papanicolaou test (Pap smear). New developments have led to 2 vaccines aimed at preventing the viral infection. One is a quadrivalent vaccine preventing infection from 4 HPV types (HPV types 6, 11, 16, and 18) (Gardasil). It is approved in the United States and Europe for the prevention of HPV-associated cervical cancers and genital warts in females between the ages of 9 and 26 years old. The second is a bivalent vaccine preventing infection from 2 high-risk oncogenic HPV types (HPV types 16 and 18) (Cervarix). It is currently under study and not yet available in the United States. Both vaccines have proven highly effective at preventing infection from their corresponding HPV types. Of importance, neither vaccine is to be used for treatment. Vaccination does not replace routine cervical cancer screening with Pap smears, as the vaccines do not protect against all HPV types.

Introduction Health literacy and its associated communication practices are critical to patient-centered care and have been endorsed by various associations as important for health professional training. Unfortunately, there is little published literature on how to teach health literacy to medical students and health professionals. Methods We developed a two-part curriculum during a required module for medical students including an introductory session in their first year and a skill-building workshop in their second year. In the workshop, students studied, observed, and practiced three health literacy communication techniques: teach-back, avoiding jargon, and effective questioning. Results The workshop was implemented with approximately 100 second-year medical students as part of a course in their required curriculum. Results of a Wilcoxon rank sum test of pre/post survey responses showed a statistically significant move towards conviction of importance and confidence in ability to use three health literacy techniques. Discussion A skills-based workshop on health literacy skills can improve medical students' conviction and confidence in using health literacy communication practices.