Analysis of school-based asthma screenings and need for care coordination in underserved urban communities.

BACKGROUND: Asthma is one of the most common chronic childhood disease states in the United States and continues to become more prevalent. Data suggest the incidence, morbidity, and mortality of asthma are higher among minority children of lower socioeconomic status living in urban settings. There is a lack of data evaluating the impact of mass school-based asthma screenings and care coordination in underserved communities. OBJECTIVE: This study aimed to determine whether a school-based asthma screening program is effective in identifying children who are at risk of undiagnosed and uncontrolled asthma and whether there is a need for care coordination. METHODS: This study is a retrospective review describing the outcomes of the 2021 school-based asthma screening program. Asthma screening data from 6 participating school districts (prekindergarten to twelfth grade) in the greater Pittsburgh area were included in this review. An asthma screening questionnaire was distributed school-wide and included questions about demographics, previous asthma diagnosis, repeated episodes of asthma, and frequency of symptoms. Based on caregiver-reported answers, children who screened positive for previously diagnosed asthma, uncontrolled asthma, or undiagnosed asthma received care coordination for follow-up care. RESULTS: This study included asthma screening results for 561 participants. Approximately 13% of participants (n = 73) displayed asthma symptoms but did not have a diagnosis of asthma. Of those 73 participants, 9.6% (n = 54) were at risk of uncontrolled asthma. The screening tool also identified 5.6% of participants (n = 32) who had a diagnosis of asthma and were at risk of uncontrolled asthma. CONCLUSIONS: The school-based asthma screening program was effective in identifying children at risk of undiagnosed and uncontrolled asthma. Pharmacists are well positioned to implement asthma screening programs in schools and throughout the community.

Podcasts as a Method to Deliver Education on Stigma Surrounding Opioid Use Disorder.

The objective of this research was to evaluate the effectiveness of a podcast miniseries to reduce stigma surrounding opioid use disorder (OUD) among student pharmacists. Students in their second and third professional years from two schools of pharmacy listened to five, 10-23 min podcasts incorporated into their coursework. The podcasts highlighted: (1) interviews with OUD professionals and those with lived experiences; (2) types of stigma and how it affects health outcomes; (3) OUD disease state processes, and (4) harm reduction strategies. Surveys assessed changes in perception of OUD and its associated stigma and included free-response and Likert scale questions. Subjects (n = 121) who completed a pre- and post-podcast survey were included. Paired t-tests assessed changes in survey responses from baseline and a content analysis was performed on all free-responses. There was a statistically significant change from baseline for each survey question, demonstrating a decrease in stigma towards OUD. Free-responses were categorized into four learning domains: (1) Impact of stigma on access to care; (2) Compassion and empathy; (3) Resources and support; and (4) Call to action. Podcasts can be an effective tool to reduce student pharmacist stigma associated with OUD.

The impact of a pharmacist-led naloxone education and community distribution project on local use of naloxone.

OBJECTIVE: To assess the use and public perception of naloxone through distribution and education by pharmacists at local health screenings in low-income communities in Western Pennsylvania. METHODS: A prospective study was conducted, offering education on opioid use disorder and naloxone to individuals attending community outreach events in Allegheny County, PA. Participants with interest and willingness to use naloxone in the event of an opioid overdose were offered naloxone nasal spray and additional training. These individuals were asked to complete a survey at the time of naloxone provision and were recontacted by telephone at a later date to collect follow-up data. The primary objective of the study was to ascertain naloxone use at follow-up. Secondary objectives of the study were to measure the difficulty of obtaining naloxone, identify any change in knowledge of naloxone before and after pharmacist intervention, and assess public perception of stigma associated with naloxone initiatives. Data were analyzed using descriptive and univariate comparative statistics. RESULTS: A total of 265 people received naloxone, and 132 (49.8%) completed the initial survey. Fifty-seven participants subsequently completed both surveys (43.2% follow-up). Naloxone was utilized by 3.5% of respondents over an average of 3 months. Participants' perception of obtaining naloxone before the study was evenly distributed (35.8% never tried, 32.1% difficult, and 30.2% not difficult). A total of 52.6% of respondents believed that naloxone initiatives decreased the stigma of illicit opioid use. CONCLUSION: Naloxone provided in the community setting was utilized by a small percentage of the general public in the 2- to 4-month follow-up. Pharmacists can provide naloxone education and training within communities affected by high opioid overdose rates.

Influence of Viscosity and Consumer Use on Accuracy of Oral Medication Dosing Devices.

Background: In response to numerous reports of overdoses with over-the-counter (OTC) liquid medications, the Food and Drug Administration has recommended that all OTC liquid drug products contain a measuring device but provided no recommendation on the type of device to be included. Objective: To evaluate the accuracy of liquid medication dosing devices (cup, dropper, syringe) in dispensing medications of varying viscosity in the laboratory and clinical settings. Methods: This experimental study evaluated dosing device accuracy. A pharmaceutics laboratory was used to evaluate accuracy under ideal conditions and subjects ≥18 years of age were recruited from community pharmacies to evaluate accuracy when used by consumers. Results: In the laboratory setting, the syringe was the most accurate for the more viscous formulations (cherry and grape suspension; 1% error, 1.2% error, respectively), and the dropper was the most accurate for the less viscous formulation (solution; 0.8% error). A volunteer sample of 320 participants was enrolled from the clinical setting. In the clinical setting, the syringe was most accurate, followed by the cup and then the dropper for all formulations (mean error, 2%, 14%, 33%, respectively). The cup was the most likely to overdose (mean, 5.7 mL), while the dropper was most likely to underdose (mean, 3.3 mL). Conclusions: The results of this study suggest that medication viscosity, consumer use, and dosing device contribute to dosing accuracy. The syringe appears to be the most accurate dosing device, accounting for differences in medication viscosity and the impact of consumer use.