Fostering cultural sensitivity amongst students of pharmacy through an interprofessional book club activity.

BACKGROUND AND PURPOSE: To describe a large-scale, cultural sensitivity-focused interprofessional book club activity that is required in the first-professional year of an accelerated pharmacy curriculum. EDUCATIONAL ACTIVITY AND SETTING: An interprofessional book club activity, focusing on the need for cultural sensitivity in health care, is conducted annually for students in the acupuncture, pharmacy, physical therapy, physician assistant, and sonography programs. Each year over 400 students are required to attend and are assigned to interprofessional groups to discuss guided questions pertaining to the book written by Anne Fadiman, The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Pharmacy students complete multiple assignments before and after the activity. Students are administered a post-survey to collect student feedback and self-assessment data. The book club has been run in both synchronous and asynchronous formats. FINDINGS: Student survey responses have consistently revealed that the majority of students agreed or strongly agreed that they were better prepared for culturally-diverse patient interactions, the activity allowed for interprofessional learning, and the activity should continue for future students. SUMMARY: A book club activity is an effective strategy for delivering content related to cultural sensitivity in an interprofessional format. This activity model can be used to support interactions with multiple professions in different schools within the same university or with multiple professions located at different universities/institutions.

Pharmacists can improve medication management in the vulnerable population of foster care youth.

OBJECTIVE: The objective of this commentary is to recommend that pharmacists take a larger role in medication management for the vulnerable patient population of youth in foster care. To support this objective, it is important to understand (1) what foster care is, (2) the vulnerabilities of youth in foster care, (3) medication use among youth in foster care, and (4) how the foster care system complicates medication management. SUMMARY: Foster care youth are not yet considered a vulnerable patient population from the pharmacy perspective, despite a high rate of prescriptions and medications without proper indication. By virtue of being removed from their homes, foster youth experience trauma and are placed into a system that can be inconsistent, lead to further disruption, and create gaps in their medical care and management. Despite federal mandates, foster youth medication use remains drastically higher than that of the general population. Pharmacists' skills in medication therapy management, medication reconciliation, patient and caregiver education, and interprofessional collaboration can and should be used to reduce overmedication in the foster care population. CONCLUSION: Pharmacists can provide valuable therapeutic services and bring increased attention to the medication needs of foster care patients by assuming a more active role as a member of their care team.

Incorporating the American Pharmacists Association's Delivering Medication Therapy Management services certificate program into an accelerated pharmacy curriculum.

BACKGROUND AND PURPOSE: To describe the incorporation of the American Pharmacists Association (APhA) Delivering Medication Therapy Management (MTM) Services program into a PharmD curriculum and to describe student perceptions of the program. EDUCATIONAL ACTIVITY AND SETTING: The program was delivered over 12 months to students on two campuses via two didactic courses in the second professional year and during the first two advanced pharmacy practice experiences in the third professional year of an accelerated school of pharmacy program. FINDINGS: Student perceptions were assessed by review of responses to the APhA MTM program evaluation survey. DISCUSSION AND SUMMARY: Incorporation of the APhA MTM program into an accelerated PharmD program required careful planning and coordination amongst faculty and course coordinators. Students perceived that the program was valuable, met their educational needs, and incorporated effective learning experiences and cases. These perceptions were reinforced by the high percentage of students who completed the program.

Community education by advanced pharmacy practice experience students: Increasing electronic cigarette awareness amongst teens.

BACKGROUND AND PURPOSE: An electronic cigarette (e-cigarette) is a device used to mimic the experience of smoking tobacco cigarettes. Considering their growing popularity amongst adolescents, it is imperative that education surrounding e-cigarettes be provided. The purpose of this project is to describe the development and delivery of a pilot interactive presentation and survey tool by doctor of pharmacy (PharmD) candidates to gauge the use and understanding of e-cigarettes amongst teens. EDUCATIONAL ACTIVITY AND SETTING: An interactive presentation providing information on e-cigarettes was created by a PharmD candidate, and presented to 357 high school students in Massachusetts and New Hampshire. An anonymous survey tool was administered after the presentation to evaluate students' perception, use, and knowledge of e-cigarettes. FINDINGS: When asked which is safer, an e-cigarette or a tobacco cigarette, most students (84%) responded "neither," and most stated that they learned something new from the presentation. Of the 96% of students that indicated they had heard of e-cigarettes, 27% of them had tried one. PharmD candidates reported increased confidence in public speaking and preparation of patient-suitable material. DISCUSSION: This pilot project provided both education to adolescents and insight into their experience and understanding of the potential harms of e-cigarettes. Having a PharmD candidate deliver the presentation may have increased the students' level of comfort. SUMMARY: An interactive, PharmD candidate-delivered presentation about e-cigarettes is an innovative method to both provide education about e-cigarettes, and ascertain information about knowledge and use in adolescents. Facilitating presentations like this could be successful in other settings or topics.

A pilot workshop to help refugees navigate the U.S. pharmacy system.

OBJECTIVES: To assess refugees' understanding of the U.S. pharmacy system; to determine whether an educational workshop improved understanding. SETTING: U.S. Committee for Refugees and Immigrants-affiliated institute, Manchester, NH. PRACTICE INNOVATION: Student pharmacist-led workshops for refugees, including slide presentation, interactive activities, and demonstration. MAIN OUTCOME MEASURES: Comparison of pre- and post-workshop responses to knowledge-based questions about the U.S. pharmacy system; ability to interpret a medication label pictogram; comfort level and willingness to speak to a pharmacist. RESULTS: Significant post-workshop increases were seen in awareness that identification is needed when filling a prescription, that prescription medication labels have refill information, and that a translator can be requested in U.S. pharmacies. Participants who had not used a U.S. pharmacy before the workshop showed significant improvement after the workshop in mean percentage of correct responses to knowledge-based questions; those who had previously used a U.S. pharmacy did not. Participants who were in the U.S. for less than 3 months showed significant improvement in mean correct responses to knowledge-based questions after the workshop; those who were in the U.S. for 3 months or more did not. Participants' comfort level and willingness to speak to a pharmacist were not significantly increased after the workshop. CONCLUSION: Participants who were in the U.S. for the least time and those who had never used a U.S. pharmacy showed significant increases in understanding specific aspects of the U.S. pharmacy system after an educational workshop. Participants' comfort level and willingness to speak with a pharmacist did not change post-workshop.

Nonprescription medication use and literacy among New Hampshire eighth graders.

OBJECTIVES: To assess whether New Hampshire (NH) eighth graders were self-medicating with over-the-counter (OTC) medications, had literacy skills necessary to safely and accurately interpret OTC medication labels, and showed improvement in OTC medication safe use and literacy skills after student pharmacist-led education. DESIGN: Cross-sectional repeated-measures study. SETTING: NH, five separate sessions, in 2010 and 2011. PARTICIPANTS: 101 NH eighth grade students. INTERVENTION: Participants answered questions derived from OTC drug facts labels that assessed OTC medication safe use and literacy before and after a student pharmacist-led presentation describing each section of the labels. MAIN OUTCOME MEASURES: Participant use of OTC medications, whether participants interpreted OTC drug facts labels correctly, and whether participants were able to identify safe use of OTC medications before and after instruction about OTC drug facts labels. RESULTS: 57% of participants reported taking OTC medications in the previous month, 22% reported taking OTC medications autonomously, and 43% reported checking with a trusted adult before self-administration. After student pharmacist-led education, significant improvements were seen in identifying product indications, calculating adult doses, interpreting adverse effects, knowing when to call a medical provider, understanding proper medication storage, identifying expiration dates, and identifying duplicate medications in products. CONCLUSION: NH eighth graders were self-medicating with OTC medications. Significant improvements in OTC medication label literacy were seen after student pharmacist-led education. These results provide evidence of the need for, and positive effects of, OTC medication education among U.S. adolescents.

Dexlansoprazole in the treatment of esophagitis and gastroesophageal reflux disease.

OBJECTIVE: To describe the pharmacology, pharmacokinetics, and efficacy of dexlansoprazole in the treatment of heartburn associated with nonerosive gastroesophageal reflux disease (GERD) and healing and maintenance of healing of all grades of erosive esophagitis (EE). DATA SOURCES: Literature searches were conducted using MEDLINE Ovid (1950-December 2009, week 4) and EMBASE (1980-2009, week 53) using the term dexlansoprazole. References from articles obtained from the search were evaluated for other relevant citations. STUDY SELECTION AND DATA EXTRACTION: All articles published in English evaluating the pharmacology, pharmacokinetics, efficacy, and adverse effect profile of dexlansoprazole were selected for inclusion. DATA SYNTHESIS: Dexlansoprazole is the newest addition to the proton pump inhibitor (PPI) class and is approved for the treatment of heartburn associated with nonerosive GERD, healing of all grades of EE, as well as maintenance of healing of EE. Dexlansoprazole has a unique dual delayed-release formulation, which releases drug at 2 points in time; the first peak occurs 1-2 hours after administration and the second occurs within 4-5 hours after administration. In Phase 3 trials conducted in adults, researchers found that dexlansoprazole increases rates of healing of EE, as well as the maintenance of healing, compared to lansoprazole. Relief of heartburn symptoms was comparable among the dexlansoprazole and lansoprazole treatment groups. Common adverse effects of dexlansoprazole are similar to those of the other PPIs, including diarrhea, abdominal pain, nausea, upper respiratory infection, vomiting, and flatulence. CONCLUSIONS: Dexlansoprazole provides another treatment option for the management of EE and symptoms of heartburn. Considering that the cost of dexlansoprazole is not favorable, further studies evaluating potential advantages over other agents are necessary to define the role of dexlansoprazole in the treatment of these conditions.