ABSTRACT
BACKGROUND: North Carolina immunizing pharmacists are authorized to provide oral and transdermal hormonal contraception to eligible patients. In March 2022, implementation of this enhanced patient care service began statewide, following approval of standing orders and published training from the North Carolina Association of Pharmacists. Two pharmacy locations on a college campus began offering pharmacist-provided hormonal contraception shortly after approval. OBJECTIVE: The objective of this study was to assess the willingness of students to seek pharmacist-provided hormonal contraception and the willingness of students to pay for this service. METHODS: This cross-sectional study was conducted on the campus of a public, research-intensive University. To be included, individuals must have been 18 years of age or older, an enrolled student, and used prescribed hormonal birth control within the last year. Individuals who declined consent or surveys that were not at least 90% complete were excluded. The survey was administered via Qualtrics and distributed via email and printed flyers with a QR code. The survey opened February 10, 2023, and closed April 24, 2023. RESULTS: In total, 170 survey responses were analyzed. Almost three-fourths of participants (72.9%) were not aware that pharmacists could provide hormonal contraception in North Carolina. All participants identified at least one benefit to pharmacist-provided contraception, with the most common responses being "I believe it would save time" (85.3%) and "appointment not needed" (89.4%). Almost two-thirds of participants (65.3%) identified at least one barrier that would prevent them from seeking pharmacist-provided contraception. The most common barrier identified was privacy at the pharmacy (20.0%). Most participants (81.8%) reported that they are willing to pay for this service, with the majority willing to pay up to $29. CONCLUSION: Students on this campus appear to have a receptive attitude towards pharmacist-provided hormonal contraception and are willing to pay for a consultation.
ABSTRACT
BACKGROUND: Published evidence is lacking to describe the pharmacist's role in medication management within an attention deficit hyperactivity disorder (ADHD) specialty clinic. OBJECTIVES: The objectives were (1) to measure the growth of an ADHD clinic in a college health center after the integration of clinical pharmacists and (2) to evaluate provider adherence to clinic policies and procedures before and after pharmacist integration. PRACTICE DESCRIPTION: In 2017, a pharmacist-run ADHD clinic was established at a college campus. PRACTICE INNOVATION: Pharmacists conducted collaborative initial visits with psychiatrists and independently provided follow-up appointments for patients with ADHD. EVALUATION METHODS: Data were extracted from the electronic health record for patients aged 18 years or older with an ADHD diagnosis who completed a medication evaluation or medication follow-up visit from July 1, 2016 to June 30, 2019. Data were excluded if it was for another visit type, was a non-ADHD clinic provider visit, or if the visit note was classified. Data before the pharmacist integration (July 1, 2016-June 30, 2017) were compared with data after the pharmacist integration (July 1, 2017-June 30, 2019). Chi-square tests of independence evaluated differences in blood pressure monitoring, heart rate monitoring, and stimulant medication contract signature between psychiatrist- and pharmacist-run appointments. RESULTS: Pharmacist presence in the ADHD clinic increased from 0 full-time equivalent (FTE) to 0.2 FTE over 3 years. The number of appointments increased by 1003% (from 26 to 287). Compared with psychiatrist-run appointments, pharmacist-run appointments were more adherent to monitoring blood pressure (11% vs. 77%, P < 0.001) and heart rate (6% vs. 75%, P < 0.001), as well as clinic policy requiring a patient's signature on a stimulant medication contract (64% vs. 75%, P = 0.019). CONCLUSION: Pharmacists can assist psychiatrists in medication management of ADHD in the college health setting. A pharmacist-psychiatrist collaboration increased quality of care and monitoring of medication adverse effects.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Drug-Related Side Effects and Adverse Reactions , Ambulatory Care , Ambulatory Care Facilities , Attention Deficit Disorder with Hyperactivity/drug therapy , Humans , PharmacistsABSTRACT
OBJECTIVES: The primary objectives of this study were to determine the percentage of travel recommendations accepted by individuals serviced at a university travel health clinic and to identify barriers to travel recommendation acceptance or implementation by travelers. A secondary objective was to use details regarding the identified barriers to refine travel clinic protocols. METHODS: This cross-sectional study utilized an 11-item questionnaire, conducted via telephone from February 2018 to April 2018. The survey was administered by a pharmacist employed at the travel clinic. The following data were collected: travel itinerary, content of pharmacist provided travel recommendation(s), acceptance of pharmacist travel recommendation(s) or reason for declining the recommendation(s), patient utilization of supplemental recommendations (e.g., traveler's diarrhea treatment flowchart, over-the-counter travel items, accessing medical care abroad), perceived usefulness of travel clinic resources, and the status of patient health during travel and upon return. Data was evaluated using descriptive statistics. RESULTS: A total of 205 travelers were screened to participate in the study; 85 surveys were completed, resulting in a 41% response rate. Of 349 travel vaccination recommendations made, 242 (69%) were accepted by patients. The vaccine recommendations with the lowest acceptance were Japanese Encephalitis (18%, n = 2/11), rabies (27%, n = 15/55), and influenza (51%, n = 41/80). The top reasons for declining included cost (40%, n = 34), lack of perceived necessity (37%, n = 31), and timing (16%, n = 14). In addition, 68% reported using travel clinic advice if they became ill during travel. CONCLUSION: This study showed a positive response to recommendations provided by this travel clinic. Cost and 'lack of perceived necessity' were identified as barriers to acceptance of recommendations. Travel clinic protocols will be refined to provide further education to travelers about unfamiliar disease states that may pose an increased risk during travel, aiming to increase acceptance of pharmacist-provided recommendations.
