Cultivating COVID-19 Vaccine Confidence in Pharmacy Professionals.

Pharmacists promote vaccinations and challenge misconceptions about vaccine hesitancy, yet pharmacists' knowledge of vaccine confidence has not been assessed. The objective of this study was to compare pharmacists' knowledge of coronavirus disease 2019 (COVID-19) vaccine confidence before and after a live continuing education (CE) session. This pretest-posttest study evaluated the differences before and after a live CE session on COVID-19 vaccine confidence provided to pharmacists at a nationwide health technology company. Participants' total pretest and posttest scores were compared using paired t-tests, while pretest and posttest scores for each item were compared using chi-squared tests. A Bonferroni correction was applied, resulting in an alpha level of 0.005. A total of 279 pharmacists participated in this study. After the CE session, mean knowledge scores increased (5.2 ± 1.5 to 7.4 ± 1.35, p < 0.0001). After the CE session, there was no significant increase in pharmacists' knowledge about the approach that is not recommended when discussing vaccination beliefs with a patient (71.3% to 77.4%, p = 0.099), determinants of vaccine uptake (83.9% to 87.8%, p = 0.182), and social determinants of health that can influence vaccination rates (93.6% to 96.4%, p = 0.121). There was a significant change in pre- and posttest knowledge for the remaining seven items.

Mitigating the Risk of Adverse Effects Related to Augmentation Therapy for Resistant Major Depressive Disorder: A Case Report.

Polypharmacy of psychotropic medications predisposes older adults to adverse drug events (ADEs). One contributing factor is inhibition of metabolic pathways between substrates (competitive inhibition) or between substrates and inhibitors of the same cytochrome P450 (CYP450) isoforms. The purpose of this case report is to demonstrate observed sedation and difficulty concentrating from augmentation therapy for resistant major depressive disorder (MDD) and to highlight the value of clinical tools to identify opportunities for treatment optimization to reduce ADEs. The pharmacist identified significant medication burden and competitive inhibition of drug metabolism in the CYP450 system during a telehealth medication therapy management consultation with a 69-year-old male. The pharmacist recommended clinical monitoring and communicated concerns about medication-induced sedation, difficulty concentrating, and other medication-related problems (MRP) to providers. Several recommendations were implemented which helped improved patient's outcomes. Individualizing MDD pharmacotherapy based on pharmacokinetic and pharmacodynamic drug interactions and geriatric dosage considerations may lead to better outcomes and tolerability among older adults.

Perceptions of COVID-19 vaccines in a predominantly Hispanic patient population from the Texas-Mexico border.

BACKGROUND: Compared with nationwide averages, Hispanic individuals have experienced lower routine vaccination rates and have been disproportionately hospitalized for coronavirus disease 2019 (COVID-19). Few, if any, studies have examined the health beliefs surrounding the COVID-19 vaccines and adult vaccines among this population. OBJECTIVES: This study aimed to (1) describe perceptions of COVID-19 vaccines in a predominantly Hispanic patient population in a federally qualified health center (FQHC) situated on the United States-Mexico border and (2) compare patient confidence in recommendations made by local clinic and government to obtain adult and COVID-19 vaccines. METHODS: A bilingual (English or Spanish) written survey was administered to participants recruited from a convenience sample of patients in waiting areas of 4 clinic sites in an FQHC system on the Texas-Mexico border between March and May 2021. Survey items were derived from the Health Belief Model and captured beliefs surrounding perceived effectiveness, perceived harms, protection from the influenza vaccine, trust in the local clinic, and trust in the government. RESULTS: A total of 58 participants aged 19-90 years, with a mean age of 57.28 years, completed the survey between March and May 2021, with 77.6% of respondents indicating they would accept a COVID-19 vaccine for themselves. Results revealed a trend among older adults in the study cohort to be more likely to trust the government in recommending vaccines than younger adults (r = 0.33, P ≤ 0.05) and a tendency toward higher vaccine acceptance among male survey participants (P = 0.026). The highest correlation that emerged was between perceived trust in local clinic provider and the perceived effectiveness of vaccines (r = 0.74, P < 0.01). CONCLUSION: Trends related to perceptions of adult vaccines among Hispanic patients extend to the COVID-19 vaccines: especially trust in local clinic providers. Increased age may correlate to higher trust in a government-recommended vaccine. Results highlight the importance of the pharmacist giving the patient a clear recommendation to receive vaccination and strong local clinic messaging.